Objective Nearly half of Wisconsin women live in rural areas, where access to obstetrical care remains a major concern. Rural communities are often disproportionately affected by national emergencies. This study aimed to evaluate the impact of the COVID-19 pandemic on severe maternal morbidity (SMM) rates across Wisconsin, with a focus on geographic variation. Study Design A retrospective cohort study was conducted using Wisconsin Hospital Association coding data for all births in Wisconsin from March 1, 2017 to March 31, 2023. The pre-pandemic period was defined as 3/1/2017 – 2/29/2020, and the pandemic period as 3/1/2020 to 3/31/2023. Generalized additive logistic regression models assessed changes in the SMM rates by ZIP code. Statistical analyses were performed using the mgcv package in R. Results Among 334,366 births (172,737 pre pandemic and 161,629 during the pandemic) there were 2,210 SMM events (0.7%). The SMM rate increased from 0.6% pre-pandemic to 0.8% during the pandemic (RR 1.33, 95% CI 1.23–1.45, p<0.0001). However, no significant geographic variation in the pandemic’s impact on SMM rates was observed (p=0.56). The most common SMM diagnoses during the pandemic included acute renal failure, disseminated intravascular coagulation, and acute respiratory distress syndrome. Conclusion There is strong evidence that the COVID-19 pandemic was associated with an increase in SMM events. Despite concerns about rural healthcare access, no geographic disparities were found, suggesting that further efforts are needed to analyze SMM events in rural areas.