Skip Navigation Links
September/October 2019Expand September/October 2019
July/August 2019Expand July/August 2019
May/June 2019Expand May/June 2019
March/April 2019Expand March/April 2019
January/February 2019Expand January/February 2019
November/December 2018Expand November/December 2018
September/October 2018Expand September/October 2018
July/August 2018Expand July/August 2018
May/June 2018Expand May/June 2018
March/April 2018Expand March/April 2018
January/February 2018Expand January/February 2018
July/August 2017Expand July/August 2017
May/June 2017Expand May/June 2017
March/April 2017Expand March/April 2017
January/February 2017Expand January/February 2017
November/December 2016Expand November/December 2016
July/August 2016Expand July/August 2016
May/June 2016Expand May/June 2016
March/April 2016Expand March/April 2016
January/February 2016Expand January/February 2016
November/December 2015Expand November/December 2015
July/August 2015Expand July/August 2015
May/June 2015Expand May/June 2015
March/April 2015Expand March/April 2015
January/February 2015Expand January/February 2015
ArchiveExpand Archive
November/December 2017Expand November/December 2017
PulseTemplate
September/October 2015Expand September/October 2015
September/October 2016Expand September/October 2016
September/October 2017Expand September/October 2017
Special Edition - EPRExpand Special Edition - EPR
Special Edition: Title V Technical Assistance MeetingExpand Special Edition: Title V Technical Assistance Meeting
Title V Technical Assistance Meeting
Trend Reversal: Uninsured rates tick upwards since passage of the Affordable Care Act
Resources for Promoting Healthy Behavioral and Emotional Development in Adolescents
Welcome to Pulse
Building Healthy and Resilient Communities Across Rhode Island
Heeding Lessons Learned from the Zika Response as We Prepare for Emerging Threats and Issues
From the President: Emerging Issues

 Revealing the Scope of Severe Maternal Morbidity in New York City

By Deborah L. Kaplan, DrPH, MPH, R-PA
Assistant Commissioner, Bureau of Maternal, Infant and Reproductive Health, New York City Department of Health and Mental Hygiene

By Sang Hee Won, MPH
Project Director, Severe Maternal Morbidity Surveillance Project, Bureau of Maternal, Infant and Reproductive Health, New York City Of Department of Health and Mental Hygiene

The New York City Health Department, in partnership with the Fund for Public Health in New York, recently released a report titled "Severe Maternal Morbidity, New York City, 2008-2012," which examines life-threatening complications during delivery. This report details findings of the city’s first-ever severe maternal morbidity (SMM) surveillance system based on the Centers for Disease Control and Prevention’s national maternal morbidity surveillance model. It explains how SMM cases are identified; describes the overall trends and leading indicators of SMM; examines SMM by maternal characteristics, place-based indicators and prenatal and delivery characteristics; and estimates direct medical costs associated with SMM. The report is available here.

Key findings of this report include:

– SMM affects approximately 2,500 women each year in New York City.

– The rate of SMM in New York City increased 28.2 percent – up from 197.2 deaths per 10,000 deliveries in 2008 to 252.9 per 10,000 deliveries in 2012 – and was 1.6 times as high as the national estimate from 2008-2009.

– The leading indicators of SMM included blood transfusion, disseminated intravascular coagulation, hysterectomy, ventilation and adult respiratory distress syndrome.

– Women with an underlying chronic condition, such as hypertension, diabetes or heart disease, were three times as likely to have SMM as were women with no chronic conditions.

– There are stark demographic disparities.

• Black non-Latina women were three times as likely to have SMM as were white non-Latina women. Rates were also high among Puerto Rican and other Latina women compared with white non-Latina women.

• Black non-Latina women with at least a college degree had higher SMM rates than did women of other races/ethnicities who never graduated high school.

• SMM rates were highest among women living in high-poverty neighborhoods.

There are likely many contributors to the disparities in SMM, including a woman’s health prior to becoming pregnant, obesity, access to care and factors associated with poverty, including structural racism, inadequate housing, residential segregation and lower educational attainment. The chronic stress of racism also likely plays an important role. Showing these stark disparities through data is key to making injustice visible and reaffirms the Health Department’s commitment to improving maternal health and promoting health equity. These data will inform the agency’s efforts to address this public health concern. For more information, contact Sang Hee Won at swon1@health.nyc.gov.

This project was supported by a grant from Merck through its Merck for Mothers Program.