Severe Maternal Morbidity in the United States

Severe maternal morbidity (SMM) includes unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health.1 Using the most recent list of indicators, SMM has been steadily increasing in recent years.

The consequences of the increasing SMM prevalence, in addition to the health effects for the woman, are wide-ranging and include increased medical costs and longer hospitalization stays.2 Tracking and understanding patterns of SMM, along with developing and carrying out interventions to improve the quality of maternal care are essential to reducing SMM.

Severe Maternal Morbidity Indicators and Corresponding ICD Codes During Delivery Hospitalizations

To identify delivery hospitalizations with SMM, CDC uses administrative hospital discharge data and International Classification of Diseases (ICD) diagnosis and procedure codes. The original list of 25 SMM indicators based on the 9th Revision of ICD was published in 2012.2 In October 2015, the United States transitioned to the 10th Revision of ICD to code diagnoses and procedures. CDC, along with our clinical and public health partners, took the opportunity to review this new version of ICD coding to update the indicators, taking into account results from validation studies. The updated list of 21 indicators and corresponding ICD codes used to identify delivery hospitalizations with SMM for both ICD-9 and ICD-10 can be used to track SMM when using administrative hospital discharge data from October 2015 and beyond. Access the table which includes the list of 21 indicators and corresponding ICD codes.


  1. American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine, Kilpatrick SK, Ecker JL. Severe maternal morbidity: screening and review. Am J Obstet Gynecol. 2016;215(3):B17–B22.
  2. Callaghan WM, Creanga AA, Kuklina EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United StatesObstet Gynecol. 2012;120(5):1029–1036.