Nearly Half of US States Are Failing Mothers and Babies


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It’s no secret that maternal and infant health in the US needs massive improvement.

As 2022 comes to a close, this year’s March of Dimes Report Card for maternal and infant health is yet another indication of what our nation’s New Year’s resolution should be: improving health outcomes for mothers and babies.

On an A – F grading scale, with A being the best score, and F being the lowest, the report card revealed that 24 states are failing in maternal and infant health with a grade of a “D+” or lower.

Let’s unpack the report card and what these findings mean for Latinas and all women and babies.

What’s Included in the Report Card?

The report card uses the latest key indicators to describe and improve maternal and infant health in each state.

These key indicators include pre-term birth and infant mortality rates, a maternal vulnerability index, the adoption and implementation of policies that support maternal and infant health, and the establishment of a Maternal Mortality Review Committee and Perinatal Quality Collaborative.

What States Are Failing in Maternal and Infant Health?

States with a grade of a “D+” or lower are primarily concentrated in the southeastern US.

These states include:

“D+” South Dakota (4.6% Latino)

“D+” Illinois (18% Latino)

“D+” Ohio (4.3% Latino)

“D+” Michigan (5.6% Latino)

“D+” Maryland (11.1% Latino)

“D” Wyoming (10.6% Latino)

“D” Nebraska (12% Latino)

“D” Indiana (7.7% Latino)

“D” Delaware (10.1% Latino)

“D” North Carolina (10.2% Latino)

“D” Florida (26.8% Latino)

“D-” Missouri (4.7% Latino)

“D-” Tennessee (6.1% Latino)

“D-” Texas (40.2% Latino)

“D-” Nevada (29.9% Latino)

“F” Oklahoma (11.7% Latino)

“F” Arkansas (8.3% Latino)

“F” Louisiana (5.6% Latino)

“F” Mississippi (3.5% Latino)

“F” Alabama (4.8% Latino)

“F” Georgia (10.2% Latino)

“F” South Carolina (6.4% Latino)

“F” West Virginia (1.9% Latino)

“F” Kentucky (4.2% Latino)

What States Are Doing Well in Maternal and Infant Health?

Sadly, the only state to earn an “A” was Vermont.

States that scored a “B-” or higher were primarily concentrated on the east and west coast, including:

“B+” New Hampshire (4.4% Latino)

“B” Washington (13.7% Latino)

“B” Oregon (14% Latino)

“B-” California (40.2% Latino)

“B-” Massachusetts (12.8% Latino)

“B-” New Jersey (21.5% Latino)

“B-” Idaho (13.3% Latino)

Comparing the Highest and Lowest Scoring States

Vermont, the highest scoring state with an “A”, has the lowest pre-term birth rate in the nation of 8% (the national average is 10.5%) and an infant mortality rate of 2.8% (the national average is 5.4%).

In all but one of Vermont’s counties, mothers have the lowest possible vulnerability to poor pregnancy outcomes and pregnancy-related deaths.Vermont maternal vulnerability

Perhaps these better-than-average health outcomes are rooted in Vermont’s health policies.

The state has expanded Medicaid to give women greater access to preventative care during pregnancy. It also is in the process of extending Medicaid coverage beyond the standard 60 days after pregnancy, which would help mothers remain insured for up to a year after the birth of their child.

Additionally, the state supports the use of midwiferies and has established a Maternal Mortality Review Committee and Perinatal Quality Collaborative to identify, understand, and address maternal and infant health issues.

In comparison, Mississippi, which earned the lowest possible score of an “F,” has the highest pre-term birth rate (15%) and infant mortality rate (8.3) in the nation.

Mothers have the highest possible vulnerability to poor pregnancy outcomes and pregnancy-related deaths in almost all Mississippi counties.Mississippi maternal vulnerability

Just as Vermont’s better-than-average health outcomes may be rooted in its health policies, Mississippi’s worse-than-average health outcomes may be a result of not expanding or extending Medicaid.

Not adopting these policies makes it difficult for low-income mothers and babies to receive affordable care, especially since nearly a quarter of the state population lives in poverty.

However, Mississippi does support midwifery services and has a Maternal Mortality Review Committee and Perinatal Quality Collaborative.

What Do These Results Mean for Latinas and All Women and Babies?

Receiving regular, affordable care while pregnant can help prevent or manage complications, such as mental health disorders – the leading underlying cause of maternal mortality in Latinas, and gestational diabetes – of which Latinas are 2 to 4 times more likely to develop during pregnancy than non-Latinas.

Further, studies show that babies born to mothers who get prenatal care, especially group prenatal care, have a reduced risk for pre-term birth and low birth weight.

Considering Latinas already face health inequities, such as lack of access to nutritional food and health insurance, and sky-high maternal mortality rates due to the COVID-19 pandemic, living in a state with a failing grade for maternal and infant health can make health outcomes for mothers and babies even worse.

Promoting Health Equity for All Mothers and Babies

Millions of women and babies lack access to affordable quality healthcare.

Federal policies can help provide this healthcare access, but states have a part to play.

Currently, only 39 states have expanded Medicaid, which helps more mothers get the care they need to have a healthy pregnancy and post-partum experience.

Further, only 26 states have extended Medicaid coverage beyond the standard 60 days after pregnancy, which insures mothers for up to a year after the birth of their child.

Maternal healthcare also runs dry in maternity care deserts, which make up make up 36% of all US counties, according a 2022 March of Dimes report.

Clearly, our nation has some work to do if we want to stop failing our mothers and babies.

You can help.

March of Dimes offers several opportunities for you to get involved in promoting maternal health equity, including organizing community walks to raise awareness.

Get involved in a March of Dimes campaign!

You can also participate in March of Dimes’ Mamagenda for #BlanketChange campaign, which is an emergency call to action for Congress to address the maternal health crisis in America.

You can also promote maternal health equity by selecting your county and getting a Health Equity Report Card by Salud America! at UT Health San Antonio.

In your report card, you will see maps, data, and gauges to compare health equity issues, including access to healthcare and infant mortality, to the rest of your state and nation.

You can email your Health Equity Report Card to local leaders to stimulate community change. Use the data in your materials or share on social media to raise awareness.

Get your Health Equity Report Card!

By The Numbers By The Numbers



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