Headline: U.S. Earns ‘D+’ Grade as Preterm Birth Rates Climb, New March of Dimes Report Reveals
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The United States has received a near-failing grade for its rising rates of preterm births, according to the latest annual report from the March of Dimes. The 2024 Report Card on maternal and infant health assigns the nation a “D+” grade, signaling a worsening crisis that now affects one in every nine infants born in the country.
Released on November 12, the report reveals that the U.S. preterm birth rate—defined as delivery before 37 weeks of pregnancy—has risen to 10.4%, an increase from the previous year’s rate of 10.2%. This marks the fourth consecutive year of heightened preterm birth rates, reversing a decade of modest progress prior to the COVID-19 pandemic.
Preterm Births: A Persistent and Growing Public Health Crisis
Preterm birth remains the leading cause of infant death and long-term neurodevelopmental disabilities in the United States. According to the March of Dimes, the national average of 10.4% equates to roughly 384,000 babies born too early each year. While the figure may appear small in percentage terms, the impact is profound: infants born preterm are at significantly higher risk for respiratory problems, feeding difficulties, cerebral palsy, and developmental delays.
The report card assigns grades to each state, with “D+” representing a failure to meet the March of Dimes target of a preterm birth rate at or below 8.1%. No state achieved an “A” this year. Vermont and Oregon came closest with “B” grades, while the Southern states—including Mississippi, Louisiana, and Alabama—received the lowest marks, with rates exceeding 12.0%.
Key Findings: By the Numbers
The report highlights stark racial and ethnic disparities. Black mothers experience preterm birth at a rate of 14.6%, compared to 9.1% for White mothers and 10.0% for Hispanic mothers. This disparity persists even when controlling for income and education levels. The March of Dimes emphasizes that these structural inequities are not explained by biology alone but by factors such as chronic stress, limited access to quality prenatal care, and environmental exposures.
Additionally, the report notes that the increase in preterm births is not uniform across all gestation windows. The largest rise occurred among moderately preterm births (32–36 weeks), which saw a 4% relative increase from the prior year. Very early preterm births (before 32 weeks) remained relatively stable but still accounted for the highest rates of neonatal mortality.
Why the Grade is Dropping: Experts Weigh In
Health experts point to several systemic drivers behind the worsening rates. “We’re seeing a perfect storm of maternal stress, rising chronic health conditions like hypertension and diabetes, and gaps in access to prenatal care,” said Dr. Elizabeth Cherot, President and CEO of March of Dimes, in a statement. “The D+ grade is a wake-up call that we must invest in comprehensive prenatal support and address social determinants of health.”
The report also correlates the rise with a national shortage of obstetric providers and maternal care deserts. An estimated 36% of U.S. counties lack a single OB-GYN or certified nurse-midwife, a factor directly linked to delayed initiation of prenatal care. Furthermore, the recent Dobbs v. Jackson Women’s Health Organization decision has created a fragmented landscape of abortion restrictions, which, the report suggests, may inadvertently increase the risk of childbirth among individuals with limited access to early care.
What Can Be Done?
The March of Dimes calls for a multi-pronged strategy:
– Expanding Medicaid coverage for postpartum care from 60 days to 12 months in all states (currently, 44 states have done so).
– Strengthening group prenatal care models that incorporate mental health and nutrition counseling.
– Supporting paid family leave to reduce stress and improve birth outcomes.
– Funding community health worker programs to navigate high-risk pregnancies.
The report underscores that small policy shifts can yield large returns. For example, a 1% reduction in preterm births could save the healthcare system an estimated $300 million annually in initial neonatal intensive care costs.
Conclusion
The United States’ D+ grade for rising preterm birth rates is more than a symbolic mark; it is a reflection of a fractured maternal health system that fails too many mothers and babies. As the March of Dimes report makes clear, the trend is reversible, but it requires immediate, coordinated action at the federal and state levels. Without systemic investment in equitable prenatal care and postpartum support, the nation risks falling further behind—leaving the most vulnerable infants to bear the burden.