Every mother in Colorado deserves a safe and respectful start to parenthood.
For the first time, Colorado has a comprehensive, statewide picture of severe maternal morbidity (SMM), the most serious complications of childbirth that do not result in death and a critical indicator of how well our systems support safe, healthy births. This new analysis from the Colorado Perinatal Care Quality Collaborative (CPCQC) marks an important milestone for maternal health in our state. Until now, Colorado lacked a unified, statewide view of SMM trends, disparities, and risk patterns. This report changes that.
By bringing together five years of delivery hospitalization data, the analysis sheds light on where complications occur, who is most affected, and what patterns can help guide prevention. It equips Colorado with the kind of actionable information that strengthens maternal safety systems, advances equity, and guides policy and quality improvement across the state.
This report also reflects CPCQC’s role as Colorado’s statewide leader devoted to advancing safe, equitable, high-quality care for mothers and babies. By translating complex data into clear, useful insights, CPCQC continues to support hospitals, providers, community partners, and policymakers in improving outcomes for families across the state.
The findings highlight important patterns in maternal health and point toward steps we can take to make childbirth safer and more equitable for every family in Colorado.
Read the brief here: A Closer Look at Severe Maternal Morbidity in Colorado: Trends, Disparities, and Opportunities for Action
Key takeaways from this new analysis:
SMM is a useful tool for understanding patterns in maternal health because it captures complications that pose immediate, significant risk. Colorado’s data show that these conditions are relatively rare, but when they occur they can have lasting impacts on women and families. The new report provides a statewide picture of these complications and the environments where they occur, helping Colorado identify where prevention efforts can have the greatest impact.
The report finds clear disparities that reflect social and structural conditions, not individual choices. Black and Native American women in Colorado experience SMM at nearly twice the statewide rate. Women with Medicaid coverage also have higher rates of severe complications.
These differences align with national trends and reflect longstanding gaps in access, resources, and support. Addressing these disparities requires coordinated work across clinical care, community systems and policy.
Rural communities face some of the highest SMM rates in the state. Many families in rural areas must travel long distances to reach a hospital that delivers babies, and recent closures of obstetric units have increased those travel times even further.
Research from other states reinforces this concern. A large study from Pennsylvania found that the risk of adverse maternal outcomes increased significantly for people who lived 60 kilometers (about 37 miles) or more from their delivery hospital. Colorado shows a similar pattern: among rural birthing people who experienced SMM, the average distance to the delivery hospital was also roughly 37 miles.
Colorado’s mountain roads, winter weather, and maternity unit closures mean longer, more complex journeys to care for many rural families.
SMM is more common among older birthing people and among those with chronic conditions. Birthing individuals age 40 and older experience severe complications at more than twice the rate of those in their early twenties. Cesarean deliveries also carry higher risk than vaginal births because they involve major surgery and often occur in already medically complex situations. These findings underscore the importance of well-coordinated systems of care that can identify risks early and respond quickly when complications arise.
The report outlines five areas where coordinated action across hospitals, communities, and state partners can make the greatest difference:
Colorado has strong quality improvement infrastructure through CPCQC, statewide collaboration with hospitals, and new commitments under SB 24-175. These systems provide a strong foundation for reducing preventable complications.
The complete analysis, including regional data and recommendations, is available here:
A Closer Look at Severe Maternal Morbidity in Colorado: Trends, Disparities, and Opportunities for Action
