Preterm birth has become a blunt measure of how uneven maternal health outcomes remain across the United States, with communities of color facing the heaviest risks. Nationally, 10.4% of babies were born before 37 weeks of pregnancy in 2024, earning the U.S. a D+ rating and placing it behind many other high-income countries, according to recent data highlighted in a new analysis.
The picture is especially stark in Texas. More than 43,000 babies there were born prematurely in 2024, a rate of 11.1% that exceeds the national average. Ten of the 46 U.S. cities receiving failing grades for preterm birth rates are in Texas, amplifying the state’s role in the national crisis. Nearly half of Texas counties lack maternity care providers or birthing facilities, limiting access to timely prenatal care.
Racial disparities drive much of the gap. Non-Hispanic Black mothers experience preterm birth at a rate of 14.7%, far higher than the 9.5% seen among non-Hispanic White mothers. Elevated rates are also reported among American Indian or Alaska Native, Pacific Islander, and Hispanic mothers, while Asian mothers have the lowest rates. These patterns reflect broader inequities in maternal health nationwide .
Inadequate prenatal care emerges as a central factor. Women of color in Texas receive sufficient prenatal care at much lower rates than White women, and 17% of women in the state lack health insurance—more than double the national average. Chronic conditions such as hypertension, obesity, and diabetes further increase risks for early delivery and pregnancy-related deaths.
Preterm birth is now the second-leading cause of infant death in the U.S., contributing to more than 20,000 deaths each year. The analysis warns that without dismantling structural barriers in health care access and investing in equitable, community-centered solutions, racial disparities in maternal and infant outcomes will continue to widen, exacting a lasting toll on families and communities.
See: “Texas cities have some of the highest preterm birth rates in the US, highlighting maternal health crisis nationwide” (December 1, 2025)
