A detailed retrospective analysis was made of the records of 697 women with heart disease who were delivered between 1972 and 1976 and who accounted for 0.83% of all deliveries during this time. Rheumatic heart disease accounted for 65%, congenital lesions for 14% patients who had had cardiac surgery 12%, and miscellaneous heart conditions for 10% of cardiac lesions. The maternal mortality rate in these women was 7,17/1,000 deliveries, compared with 0.46/1,000 deliveries during this time. Cardiac disease was found to be the most important non-obstetric cause of maternal death. The perinatal mortality rate was not significantly higher than that in the total population. The high incidence of cardiac disease in pregnancy is unlikely to be significantly reduced until effective contraception is more widely practised in our community.