Pregnant Maori women and their children are more likely to suffer harm and death than non-Maori women. Severe acute maternal morbidity (SAMM) occurs in more than 1% of all pregnant women and is associated with considerable personal and public health care costs. Our previous research suggests that Maori women may be at increased risk of preventable SAMM. The proposed study will examine the reasons why some pregnant women become severely ill, whether the severity of disease is preventable, and what impact any disproportionate burden of harm has on Maori women, their whanau, and the health service. This work will highlight the importance of keeping women at risk of a SAMM event from progressing along the continuum of morbidity. The overall goal of this proposal is to study causes and consequences of preventable severe acute maternal morbidities to reduce the impact of severe harm for pregnant Maori women and their whanau.