Maternal Mortality and Severe Maternal Morbidity Surveillance

The NYC Health Department monitors maternal health outcomes throughout the city. Structural racism and inequities in care access and quality contribute to inequity in maternal health outcomes. The Health Department’s maternal mortality and severe maternal morbidity surveillance reports document the crisis of inequities in maternal health.

Maternal Mortality

Although maternal mortality in NYC has declined since 2001, the Health Department recorded 57 pregnancy-associated deaths in 2019. The maternal mortality crisis is especially severe for Black New Yorkers. The pregnancy-related mortality ratio for Black women in NYC is more than nine times that for White women.

The maternal mortality surveillance is based on a comprehensive search and linkage of data sources including vital records, inpatient hospital discharge data and medical examiner reports to identify all women in NYC who died during pregnancy or within one year of the end of the pregnancy from any cause. Case abstractors and a committee then investigate death certificates, autopsy reports and medical records to determine if the death was causally related to the pregnancy, and to determine key contributing factors to the deaths and recommendations to prevent future deaths.

Pregnancy-associated death is the death of a woman or pregnant person from any cause during pregnancy or within one year of the end of pregnancy. Pregnancy-associated deaths are categorized based on whether they are causally related to the pregnancy or not.

  • A pregnancy-related death is the death of a woman during pregnancy or within one year of the end of pregnancy due to a pregnancy complication, a chain of events initiated by the pregnancy or the aggravation of an unrelated condition by the pregnancy.
  • Pregnancy-associated but not-related death is a death of a woman during pregnancy or within one year of the end of pregnancy due to a cause not related to the pregnancy.

The Health Department publishes five-year pregnancy-associated mortality reports. In between the publication of five-year reports, the Health Department posts an annual report including pregnancy-associated mortality data and recommendations to eliminate preventable maternal mortality and racial and ethnic disparities. Annual data are also posted on NYC Open Data.

Severe Maternal Morbidity

Severe maternal morbidity is defined as life-threatening complications of labor and delivery that result in significant short- or long-term consequences to a woman or pregnant person’s health. In 2016, the Health Department recorded 257 cases of severe maternal morbidity for every 10,000 live births. Black women experienced the highest rate of severe maternal morbidity, at 429 cases per 10,000 births.

The leading indicators of severe maternal morbidity include blood transfusion, disseminated intravascular coagulation, hysterectomy, ventilation and adult respiratory distress syndrome. These indicators reflect many of the leading causes of pregnancy-related mortality, including hemorrhage, pregnancy-induced hypertension and embolism. The severe maternal morbidity surveillance is based on matching birth certificate data to hospital discharge records from the New York Statewide Planning and Research Cooperative System (SPARCS) for all NYC hospital deliveries.

The Health Department publishes five-year severe maternal morbidity reports. In between years, the Health Department posts annual data.

Related Publications

Pregnancy Associated Five-Year Mortality Reports

Maternal Mortality and Severe Maternal Morbidity Reports

Severe Maternal Morbidity Toolkit

NYC Open Data Reports

Additional Resources

More Information