The United States has earned a D+ for the fourth consecutive year on the March of Dimes Report Card, a stark sign that the nation’s maternal and infant health system remains in crisis. Behind the stagnant national preterm birth rate of 10.4% lies a widening racial divide: babies born to Black mothers now face a preterm birth rate of 14.7%, nearly one and a half times the rate for all births. These gaps persist even as nearly 380,000 babies were born too soon last year.
The report also highlights disparities linked to insurance coverage. Babies born to mothers covered by Medicaid experience an 11.7% preterm birth rate—far higher than the 9.6% rate among privately insured births. Declining early prenatal care is worsening the problem: nearly a quarter of pregnant people did not begin care during the first trimester, marking the fourth straight year of decline. Rising rates of preexisting hypertension and diabetes among pregnant people—conditions that disproportionately affect Black, Indigenous, and low-income communities—add further risk.
Maternal mortality has returned to pre-pandemic levels overall, yet Black, American Indian/Alaska Native, and Pacific Islander mothers still die at two to three times the rate of white mothers. “Our country is stuck in a maternal and infant health crisis where too many families are being forgotten,” said March of Dimes CEO Cindy Rahman, calling for action to confront “systemic inequities that leave families of color and those covered by Medicaid at higher risk.”
The report urges expanded prenatal access, stronger Medicaid protections, and policies that address structural racism affecting maternal and infant outcomes—changes that advocates say are critical to giving every family a fair chance at a healthy start.
See: “US Earns D+ for Fourth Year in March of Dimes 2025 Report Card” (November 17, 2025)
