Severe Maternal Morbidity in Arkansas

This updated infographic, part of our continuing effort to examine each step of the birthing journey in Arkansas, looks at the impact of severe maternal morbidity (SMM), defined by the Centers for Disease Control and Prevention as “unexpected outcomes of labor and delivery that can result in significant short- or long-term health consequences.” Examples include sepsis, acute renal failure, and acute heart failure.

Maternal mortality has been described as the “tip of the iceberg” and severe maternal morbidity as the base. SMM events, also known as maternal near-miss events, occur much more frequently than maternal deaths despite receiving less public attention.

ACHI analyzed hospital discharge data for births that occurred between 2018 and 2022 to determine the impact of SMM among those mothers up to one year postpartum.

Key findings:

• While 170 maternal deaths occurred in Arkansas between 2018 and 2022, 2,050 women who gave birth during that period experienced at least one SMM event up to a year after birth.
• Between 2018 and 2022, for every 1,000 birth events (i.e., hospitalizations during which at least one delivery occurred) in Arkansas, 13.4 were associated with at least one SMM event.
• SMM events most commonly occurred during birth (42.4%), but 35.6% occurred more than six weeks after discharge, 12.2% occurred two to six weeks after discharge, and the remaining 9.7% occurred within a week after discharge.
• The five most common types of SMM events were sepsis (3.4 per 1,000 birth events), adult respiratory distress syndrome (2.6 per 1,000 birth events), acute renal failure (2.6 per 1,000 birth events); pulmonary edema/acute heart failure (2 per 1,000 birth events); and hysterectomy (1.8 per 1,000 birth events).
• Geographically, SMM events were most common in the Northeast Public Health Region (16.3 per 1,000 birth events), followed by the Southeast Region (15.9 per 1,000 birth events), the Southwest Region and the Central Region (14.2 per 1,000 birth events in both), and the Northwest Region (10.9 per 1,000 birth events).
• By age, SMM events were most common among women 40 and older (29.1 per 1,000 birth events), followed by women ages 35-39 (20.7 per 1,000 birth events), women ages 30-34 (13.6 per 1,000 birth events), women under 20 (12.6 per 1,000), women ages 25-29 (11.8 per 1,000 birth events), and women ages 20-24 (11.3 per 1,000 birth events).
• By race and ethnicity, SMM events were most common among Black women (20.7 per 1,000 birth events), followed by women whose race was identified as Pacific Islander/American Samoa (19 per 1,000 birth events), women of unknown race or ethnicity (14.7 per 1,000 birth events), American Indian/Alaskan Native women (12.6 per 1,000 birth events), White women (12.2 per 1,000 birth events), Asian women (10 per 1,000 birth events), and Hispanic women (9.5 per 1,000 birth events).

See more information about maternal and infant health in Arkansas on our topic page.