Exploring the factors leading to tiered referrals of pregnant women until tertiary healthcare facilities: An in-depth analysis.

Indonesia's maternal mortality rate remains high (305 per 100,000 live births), influenced by prolonged referral processes. Secondary data from 280 medical records at Dr. Soetomo General Hospital, Surabaya (July- September 2023), revealed that most patients were referred from hospitals (196), predominantly exhibiting abnormal BMI (193). Logistic regression analysis identified residential location (rural vs. urban) as significantly impacting referral outcomes (p=0.004), whereas other factors (age, ANC visits, BMI, gravidity, occupation, education) showed no significant influence. These findings highlight the critical role of geographic and socioeconomic conditions in maternal healthcare accessibility and emphasise the importance of an efficient and timely referral system to reduce maternal mortality in Indonesia.