Severe maternal morbidity (SMM)—defined by the Centers for Disease Control and Prevention as unintended outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health—is a major determinant of maternal mortality. Each year 15 of every 1,000 people hospitalized for a delivery experience SMM. In addition to adverse health outcomes, SMM can lead to disruptions in mother-infant bonding, which can compromise children’s social and emotional development, and confers substantial economic costs to families, communities, and insurers including Medicaid.

Despite having one of the lowest poverty rates and highest median incomes in the U.S., New Jersey has the fourth-highest maternal mortality rate and one of the highest maternal morbidity rates in the nation. One of the most diverse states in the country, New Jersey has significant maternal health disparities by county, race, and ethnicity, yet few studies have investigated the extent or the underlying causes of these geographic and racial/ethnic disparities.