State of Infant Health Care in the U.S.

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A lot goes into the decision to have a baby.  

More than being a physical, mental, and emotional decision, it’s also become a larger financial decision that parents must weigh before starting or adding to their families. 

And the costs don’t stop after you bring the baby home from the hospital. Many parents are burdened by the rising costs of childcare. 

What’s more, the decision is also heavily influenced by access to prenatal care, postpartum support, affordable healthcare, childcare, and other community resources. 

A new report by WalletHub ranked the states by how expensive having a child is and health care outcomes based on access to care.  

Let’s break down the report’s findings, what they mean for child and maternal health care in the U.S.  

Hospital Delivery Charges in the U.S. 

Hospital births account for 98.4% of births in the U.S., according to the Centers for Disease Control and Prevention (CDC).  

Of those births, 32.4% were born via cesarean delivery.  

Cesarean deliveries are associated with much higher medical costs and have a higher risk for maternal health complications.  

The average cost of cesarean delivery in the U.S. was $17,000 with employee-sponsored health insurance in 2017. 

However, these costs varied widely by state with some of the highest costs for cesarean deliveries in Alaska, California, Florida, Nevada, and New Jersey, according to the report. 

Maryland, Delaware, North Dakota, Montana, and Vermont were among the lowest costs associated with cesarean delivery. 

This is a stark contrast from conventional hospital delivery methods (67.6% of deliveries), which average around $12,235 with employee-sponsored insurance in 2017.  

The states with the highest and lowest costs for conventional deliveries were roughly the same as for cesarean delivery.  

Annual Child Care Costs in the U.S. 

As the costs of giving birth in the U.S. continue to rise, so does the cost of childcare. 

The national average cost of childcare in the U.S. rose by 29% between 2020 and 2024, according to an Axios report.  

As of 2025, the national average of annual childcare was $13,184, according to ChildCareAware.  

This represents 10% of a median income for a two-parent household and 33% for a single-parent household.  

However, these costs vary widely by state, especially in the states that haven’t created legislation, programs, and regulations that help families afford the cost of childcare.  

Mississippi was ranked with the lowest cost for infant childcare in the U.S. while California had the highest, representing a 3-times-higher cost than infant childcare in Mississippi, according to the WalletHub report. 

The rising cost of childcare is forcing many parents to make the choice to quit their jobs to provide at-home childcare.  

A Pew Research Center poll found that 18% of U.S. parents were not in paid employment in 2021, with 79% reporting that they stayed home to care for the family.  

Most unpaid parents were mothers (26%), with fathers at 7%. The number of stay-at-home fathers rose from 11% in 1989 to 18% in 2021.  

To add to the childcare crisis in the U.S., there is a deficit of childcare centers per capita.  

Vermont had 7-times more childcare centers per capita than Indiana, which had the fewest childcare centers per capita, according to the WalletHub report.  

Infant Mortality in the U.S. 

In 2022, over 20,000 babies died before their first birthday, according to the 2024 March of Dimes Report Card. 

These deaths range from birth complications and defects to accidents.  

Birth defects account for 20% of infant deaths, preterm birth and low birth weight at 15%, SIDS at 7.3%, and accidents at 6.4%, according to the report. 

When considering the states with the lowest rates of infant mortality, New Hampshire, New Jersey, Massachusetts, New York, and California top the list, according to the WalletHub report. 

Infant mortality rates were highest in states such as Oklahoma, Louisiana, Delaware, Arkansas, and Mississippi. 

Many of these states lack support services following birth and haven’t expanded Medicaid coverage.  

Prenatal Care Access in the U.S. 

One of the biggest contributing factors in infant health outcomes is having access to prenatal care.  

Prenatal care visits can help identify risks, manage care, and intervene in health complications, leading to better infant and maternal health outcomes.  

Maternal health conditions, such as high blood pressure, diabetes, infections, and other complications, can cause preterm birth and infant death.   

Preterm birth is one of the leading causes of infant mortality.  

However, only 3 out of 4 pregnant women in the U.S. receive adequate prenatal care.  

This is due to the cost of prenatal care and the lack of maternal health care centers (because many can’t afford to stay open), doctors, and midwives, especially in rural low-income areas. 

This effect is known as maternal health care deserts, and the consequences of these areas are higher rates of preterm birth, infant, and maternal mortality.  

When it came to midwives and OB-GYNs per capita, Delaware, Vermont, Minnesota, Rhode Island, and the District of Columbia had the most while Mississippi, Alabama, Louisiana, Arizona, and Oklahoma had the least, according to the WalletHub report. 

Pediatricians & Family Medicine Physicians in the U.S. 

Prenatal care is vital to a child’s future success, but after birth the child must also have regular visits with a pediatrician or family medicine physician to make sure the child is hitting all physical and developmental milestones.  

During these visits, providers can assess if the child needs early intervention, a specialist, or referral to address concerns.  

However, due to rising healthcare costs, access to insurance, and limited access to facilities, that care isn’t always consistent, leading to worse child health outcomes. 

In examining the difference by state for pediatricians and family medicine physicians per capita, Massachusetts, Delaware, California, Vermont, and Alaska had the most and Alabama, Mississippi, Nevada, Arkansas, and Kansas had the least, according to the WalletHub report. 

What’s the State of Healthcare Where You Live? 

What is the state of health for children and adults where you live? 

Find out by downloading a Salud America! Health Report Card for your town!  

Enter your county name and get auto-generated local data with interactive maps and comparative gauges on several health indicators. This can help you visualize and explore local issues in education, housing, transportation, food, health, and more.  

See how your county stacks up compared to the rest of your state and nation.  

Then email the Report Card to local leaders to raise awareness, include the data in a presentation or grant proposal, or share it on social media to drive healthy changes in your community! 

GET YOUR HEALTH REPORT CARD!