US stuck in maternal & infant health crisis: 10.4% preterm birth rate leads to fourth straight D+ grade in 2025 March of Dimes Report Card
New March of Dimes data reveal persistent inequities and rising health risks, underscoring the urgent need to strengthen Medicaid, early care access, and maternal health policies.
ARLINGTON, Va., Nov. 19, 2025 /PRNewswire/ -- The United States again earned a D+ grade in the 2025 March of Dimes Report Card, marking the fourth consecutive year at this historically low grade for preterm birth. Released on Monday, November 17, the Report Card revealed the national preterm birth rate remains at 10.4%, which means nearly 380,000 babies were born too soon in 2024 (1 in 10 births). Behind this year's grade lies a sobering reality: our maternal and infant health system remains dangerously stalled.
What's new in 2025
- Racial disparities worsening: Preterm birth rates among babies born to Black moms and birthing people climbed to 14.7%, now nearly 1.5 times higher than the rate for babies overall.
- New Medicaid data: Babies born to moms covered by Medicaid face a preterm birth rate of 11.7%, compared to 9.6% for privately insured births.
- Prenatal care decline: 24.5% of pregnant people did not begin care in the first trimester, the fourth straight year of decline.
- Chronic conditions rising: Preexisting conditions like hypertension increased 6% and diabetes 8% this year among pregnant people, both known risk factors for preterm birth.
- Infant mortality unchanged: The rate held at 5.6 deaths per 1,000 live births, with more than 20,000 babies dying before their first birthday in 2023.
"As a clinician who has seen how much is possible when we get it right, these data are deeply frustrating," said Dr. Michael Warren, March of Dimes Chief Medical and Health Officer. "We have known about risk factors for preterm birth, including a prior history of preterm birth, chronic disease, and unequal access to care, for years. That the national rate remains unchanged while disparities continue to widen means we must deepen our commitment to research, expand maternity care access, and push for better policies that protect our nation's moms and babies."
Additional 2025 Report Card findings
The national preterm birth rate of 10.4% places the US among the highest of developed nations. But beneath the headline number lie even more troubling trends.
- State extremes: While 19 states improved, led by South Dakota (down 10%), 21 states worsened, including Washington, Michigan, Ohio, Kentucky, Virginia, Louisiana, and Connecticut. Washington, D.C., saw the steepest increase (up 8%).
- Maternal health remains fragile: Maternal mortality declined to 18.6 deaths per 100,000 live births (669 deaths), returning to pre-pandemic levels. Yet Black, American Indian/Alaska Native, and Pacific Islander moms and birthing people still die at two to three times the rate of White moms and birthing people, and over 30,000 experience severe complications each year.
"This year's Report Card shows that while we remain stalled in our progress on preterm birth, we are also losing ground in other critical areas of maternal and infant health," said Cindy Rahman, President & CEO of March of Dimes. "Our country is stuck in a maternal and infant health crisis where too many families are being forgotten. We must confront the systemic inequities that leave families of color and those covered by Medicaid at higher risk, improve access to early prenatal care, and tackle the growing burden of chronic disease—because every mom and baby deserves the chance for a healthy start."
A multipronged strategy
March of Dimes is tackling the drivers of preterm birth on multiple fronts, expanding its Prematurity Research Centers, including a new Texas collaborative, and operating Mom & Baby Mobile Health Centers® that deliver prenatal and postpartum care directly to communities where maternity care is limited.
The organization is advocating for policies, including the Preventing Maternal Deaths Act to sustain funding for Maternal Mortality Review Committees, reauthorization of the PREEMIE Act to renew federal investment in research and data, and expanded Medicaid postpartum coverage. Additional policy efforts include increasing access to doulas and midwives, strengthening telehealth in rural areas, and addressing structural racism that drives disparities in maternal and infant outcomes.
While the 2025 Report Card confirms the US remains stuck in a dangerous status quo, March of Dimes continues to advance research, expand access to care, and advocate for policies that protect moms and babies.
About the Report Card
Since 2009, March of Dimes has issued its annual Report Card to assess maternal and infant health in the US, across preterm birth, prenatal care, infant mortality, maternal mortality, and related indicators. The full 2025 Report Card, featuring state-by-state and city-level data, trend analyses and progress towards policy and program efforts, is available at marchofdimes.org/reportcard.
About March of Dimes
March of Dimes leads the fight for the health of all moms and babies. We support research, education, and advocacy, and provide programs and services so that every family can get the best possible start. Since 1938, we've built a successful legacy to support every pregnant person and every family. Visit marchofdimes.org or nacersano.org for more information.
SOURCE March of Dimes Inc.
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