All ETDs from UAB

Advisory Committee Chair

Kevin Fontaine

Advisory Committee Members

Tera Howard

Loretta Lee

Ann Elizabeth Montgomery

Suzanne Perumean-Chaney

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Education


Non-Hispanic Black women (Black women) are disproportionately affected by adverse maternal health outcomes as compared to women of other races. Little is known about the distribution of adverse maternal health outcomes among Black women. Using the 2014 National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ), a nationally representative sample of hospital discharges in the United States (U.S.) from January 1 through December 31, 2014, we examined severe maternal morbidity (SMM) experienced during delivery hospitalization among Black women. We conducted population-based, cross-sectional studies to examine the distribution of SMM prevalence; assess within-race variability based on sociodemographic, geographic, and clinical characteristics; and identify exposures associated with SMM among Black women in the U.S. We identified 454,760 discharge records with an indication of inpatient delivery of which 13,100 had an indication of SMM. There were significant differences between women with and without SMM across sociodemographic characteristics, clinical factors, and hospital characteristics. There was also geographic variability, by census region and census division, among those who experienced SMM. Factors associated with experiencing SMM during inpatient delivery included sociodemographic characteristics iv (age, primary payer, rurality, median household income for zip code), clinical factors (length of stay, number of chronic conditions, discharge disposition), and hospital characteristics (hospital control/ownership, census region, census division.)

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