By Stacy M. Brown
Black Press USA Senior National Correspondent
The March of Dimes has released its 2025 Report Card, and across the United States, the findings tell a story of mothers and infants facing preventable risks that too often lead to tragedy. The national preterm birth rate remains at 10.4 percent. Babies born to Medicaid-insured mothers experienced an 11.7 percent preterm birth rate, while babies born to mothers with private insurance recorded a 9.6 percent rate. For Black mothers, the rate climbed to 14.7 percent, the highest of any group in the country.
“Behind every statistic is a mom, a baby, and a family that deserves their best chance at a healthy start,” Dr. Elizabeth Kielb, Director of Maternal and Infant Health at the March of Dimes, stated.
Those numbers speak to families whose lives can change in an instant. Preterm birth remains one of the leading causes of infant death and long-term health complications. For many mothers, the first signs of a problem appear months before delivery, yet too often they cannot secure the early prenatal care that could help keep a pregnancy safe. The United States now has hundreds of counties with no obstetric providers or birthing facilities. Some families travel for hours for a basic checkup. Others miss appointments because clinics are full or insurance does not cover the visit.
The Commonwealth Fund’s 2025 national analysis found that the United States continues to have the highest maternal mortality rate among wealthy nations. American women die from pregnancy-related causes at rates far beyond those of peer countries. The Fund reported that Black women face the greatest danger, in part because of delays in care, long-standing gaps in coverage, unaddressed chronic conditions, and limited access to trusted providers. These findings match the patterns documented by the March of Dimes.
The March of Dimes identifies several reasons behind the country’s performance. Many women enter pregnancy with unmanaged hypertension, diabetes, or other chronic conditions. Large portions of the country are considered maternity care deserts, with no birthing hospitals and few clinicians trained in maternal health. Millions of women lose health insurance shortly after childbirth, leaving complications untreated. Black and Native mothers often report that their concerns are dismissed during prenatal and postpartum appointments, which can lead to dangerous complications that go unnoticed until they become life-threatening. These conditions place families at greater risk, no matter where they live.
The states struggling the most sit in every region of the country. Mississippi recorded a preterm birth rate of 14.8 percent. Alabama stood at 13.6 percent. Louisiana recorded 13.2 percent. South Carolina reached 12.7 percent. Georgia reported 12.4 percent. These states received failing grades from the March of Dimes. Each has large rural regions with few maternity care providers, high rates of chronic medical conditions, and long-standing racial gaps that make pregnancy more dangerous for families of color.
Cities face their own challenges. Memphis recorded one of the highest preterm birth rates among major metro areas. Detroit continued to see some of the largest racial gaps in infant outcomes. In Fresno and Bakersfield, mothers face long waits for prenatal care and limited access to specialists. In Washington, D.C., the preterm birth rate rose to 11.8 percent, the largest one-year increase in the country.
Maryland and Virginia show mixed signs of progress. Maryland received a D+ with a 10.5 percent preterm birth rate. Virginia earned a C minus at 10.1 percent. Both states continue to wrestle with racial gaps and shortages in maternity care providers across rural communities and urban neighborhoods.
The March of Dimes notes that these conditions are not distributed evenly. Families with higher incomes and stable private insurance can often secure early prenatal care, while families with low incomes or public insurance face delays that increase the risk of complications. Many women do not receive postpartum care beyond the immediate weeks after childbirth, even when ongoing monitoring is needed.
The organization is trying to address these gaps through mobile health centers, NICU Family Support programs, and partnerships with hospitals aimed at improving maternal and infant care. On the national level, the March of Dimes is calling for investment in maternal mortality review committees, research funding through the PREEMIE Act, and nationwide adoption of extended Medicaid postpartum coverage.
Dr. Michael Warren, Chief Medical and Health Officer at the March of Dimes, said the findings show how much is at stake. “As a clinician who has seen how much is possible when we get it right, the data is deeply frustrating,” Dr. Warren said. “We have known about risk factors for preterm birth, including a history of prior preterm birth, chronic disease, and unequal access to care for years.”
