In Every Region of the U.S., Mothers are Living In Maternal Red Flag Zones: New Data Maps Communities Where Risks are Highest

Surgo Health's updated Maternal Vulnerability Index – the most comprehensive picture of maternal risk since CDC's Pregnancy Risk Assessment Monitoring System was paused – reveals communities where U.S. women face highest risks of pregnancy-related complications and deaths

WASHINGTON, June 3, 2026 /PRNewswire/ -- As the Trump Administration pauses data collection for a critical maternal health surveillance program, abortion restrictions reshape reproductive care across the country, and Medicaid cuts begin closing rural maternity wards, Surgo Health today released the most comprehensive available picture of where U.S. women are most vulnerable to pregnancy-related complications and death.

The updated Maternal Vulnerability Index (MVI), which is validated against actual maternal mortality, morbidity, and birth outcomes in peer-reviewed research, maps maternal risk down to the county, zip code and census tract level across all 50 states. The MVI is a composite of 43 indicators grouped into six core themes: reproductive healthcare, physical health, mental health and substance abuse, general healthcare, socioeconomic determinants, and physical environment. Every U.S. county is scored and ranked on a scale from 0 (least vulnerable) to 100 (most vulnerable). Each county's score is shown as a quintile, ranging from "very low vulnerability" to "very high vulnerability."

"When federal data systems go dark, communities pay the price and decisions get made without the evidence needed to protect those who are most vulnerable," said Dr. Sema Sgaier, Co-Founder and CEO, Surgo Health. "The Maternal Vulnerability Index tells us exactly where the maternal red flag zones are and what factors are driving risk in each of them. Without this kind of precise, place-based intelligence, reproductive care rollbacks, Medicaid cuts, hospital closures, and other policy decisions will land hardest where communities can least absorb them."

U.S. Maternal Red Flag Zones at a Glance

By analyzing data from the updated MVI, Surgo Health has identified where the most vulnerable 10% of women of reproductive age in each U.S. Census region actually live, and has identified corresponding "maternal red flag zones" across the country. These are communities where the structural conditions most strongly associated with poor maternal health outcomes converge:

WRA = Women of reproductive age (ages 15–44). Maternal red flag zones are defined as the counties needed to account for the most vulnerable 10% of WRA in each region, ranked by MVI score. Note: WRA in the Northeast Maternal Red Flag Zones are not as vulnerable, overall, compared with women in the other U.S. regions. Source: Surgo Health.

The findings are striking in their geographic reach:

• In the South, 439 counties (nearly one in three Southern counties) qualify as maternal red flag zones.
• In the Midwest, maternal red flag zones are overwhelmingly located in Rust Belt urban centers.
• In the West, California's Central Valley is where most maternal red flag zones are concentrated.
• In the Northeast, two counties alone (Philadelphia and the Bronx) contain nearly two-thirds of the region's most-at-risk pregnant women.

ADDITIONAL FINDINGS FROM SURGO'S ANALYSIS OF THE MVI DATA

• Counties with 'Very High' Reproductive Healthcare vulnerability scores are concentrated in rural, majority-White communities, challenging the common assumption that reproductive care gaps fall only along racial lines. While dense population centers feature the highest number of women at risk, vast numbers of rural communities are also at risk due to infrastructure challenges.
• In all four regions of the U.S., socioeconomic conditions and the physical environment are the most consistent stress points causing women to be at risk, pointing to the upstream structural drivers of maternal health that policymakers must address.
• The South is the most pervasively vulnerable region in the country, with 439 (mostly rural) counties — spanning Texas, Georgia, Tennessee, Louisiana, Mississippi, and Oklahoma — containing the 2.5 million most-at-risk women of reproductive age.
• In the Midwest, vulnerability is concentrated in Rust Belt urban centers — specifically, Wayne County (Detroit), Marion County (Indianapolis), Milwaukee, and St. Louis — not in the rural areas most people assume are hardest hit. These areas contain 1.4 million women in maternal red flag zones.
• In the West, California dominates: 11 California counties contain 58% of the region's most-vulnerable women, centered in the Central Valley (Fresno, Kern, Tulare, and Merced Counties) and San Bernardino County. Across these areas, 1.9 million women are in maternal red flag zones.
• In the Northeast, maternal vulnerability is primarily urban: just 9 counties contain the 1.1 million most-vulnerable women, and Philadelphia County and the Bronx together account for 63% of them.

WHY IT MATTERS

Unlike standard health data, the MVI allows decision-makers to pinpoint why a specific community is struggling, such as lack of transportation, poor hospital access, or socioeconomic disadvantages – enabling highly targeted, community-based interventions.

The updated MVI arrives at a moment of compounding risk for maternal health in the United States:

• The updated MVI reflects the post-Dobbs reality. Since the Supreme Court's 2022 decision eliminated federal abortion protections, more than a dozen states have enacted total bans or severe restrictions on reproductive healthcare access (Source: Center for Reproductive Rights). Consequently, this Index is the first national data tool to capture the cumulative effect on community-level maternal vulnerability across the country.
• The One Big Beautiful Bill Act of 2025 is projected to increase the uninsured population by more than 6 million people, with cascading effects on rural hospitals and labor and delivery units already operating at the financial edge. Up to 308 rural hospitals are at risk of closure in 2026. In states with the highest MVI scores, 104 rural hospitals and 35 rural L&D units face potential closure, in the communities that can least afford to lose them. (Source: Predictable, Place-Based, and Preventable: What the Updated Maternal Vulnerability Index Tells Us)
• At the same time, the CDC's Pregnancy Risk Assessment Monitoring System (PRAMS), a key federal source of data on maternal health behaviors, has paused centralized data collection, a development significant enough that Congress has flagged it and called for a report on barriers to effective and consistent data collection (Source: Georgetown Center for Children and Families)

Download the full Surgo Health report, "Predictable, Place-Based, and Preventable: What the Updated Maternal Vulnerability Index Tells Us."

ABOUT THE MATERNAL VULNERABILITY INDEX

The Maternal Vulnerability Index (MVI) is a national data tool developed by Surgo Health that scores all U.S. geographies on a scale of 0 to 100 across six thematic domains: Reproductive Healthcare, Physical Health, Mental Health & Substance Use, General Healthcare, Socioeconomic Determinants, and Physical Environment. Available at the state, county, ZIP code, and census tract levels, the MVI has been included in more than 25 peer-reviewed publications, with research validating its association with maternal mortality, severe maternal morbidity, preterm birth, low birthweight, stillbirth, and infant mortality. First introduced in 2021 and updated annually since then, the new MVI data released today represents the first update reflective of the post-Dobbs reproductive healthcare landscape. The full report is available at https://www.surgohealth.com/mvi-report.

ABOUT SURGO HEALTH

Surgo Health is a Public Benefit Corporation building the world's most comprehensive and insightful AI-powered data platform that reveals the 'why' behind people's behaviors. We uncover the unseen drivers of health — people's beliefs, barriers, and behaviors — and transform that intelligence into scalable products that enable healthcare organizations to drive impact, reduce costs, and advance equity. By revealing the human side of healthcare, we're making it more personal, precise, and effective — for everyone.

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SOURCE Surgo Health, PBC