United States receives D+ on 2025 March of Dimes Report Card

The March of Dimes 2025 Report Card reveals continued concerns in maternal and infant health across the United States, beginning with the overall national grade of D+, unchanged in recent years.

This grade is primarily driven by the country’s preterm birth rate of 10.4%, meaning approximately 1 in 10 US babies are born prematurely. According to Michael Warren, MD, MPH, FAAP, Chief Medical and Health Officer at March of Dimes, this stagnant grade signals the need for urgent, coordinated action to improve outcomes for birthing people and infants.

Beyond preterm birth, the report card highlights several additional indicators that together offer a comprehensive assessment of perinatal health. These include infant mortality, maternal mortality, severe maternal morbidity, and measures of prenatal care initiation and adequacy. Warren emphasized that the report serves as a roadmap for identifying gaps and targeting interventions.

A central theme throughout the findings is the persistence of racial and ethnic disparities. While the national preterm birth rate is just over 10%, outcomes worsen significantly for certain groups—particularly non-Hispanic Black, American Indian, and Alaska Native women and infants. These disparities extend across multiple indicators, including maternal mortality and infant survival, and reflect systemic inequities that have persisted for generations. Addressing these gaps is essential not only for improving overall national performance but also for achieving equitable health outcomes.

In terms of infant mortality, the national rate remained flat at 5.6 deaths per 1,000 live births, yet this seemingly small figure represents a stark reality: more than 20,000 US infants die each year before their first birthday. As with preterm birth, this measure also shows significant racial and geographic disparities.

The report also documents worsening access to prenatal care. More than 25% of pregnant people did not begin prenatal care in the first trimester, a decline from previous years. Additionally, 16% received inadequate prenatal care, based on both timing and the number of recommended visits. These declines raise concerns, given strong evidence linking timely, consistent prenatal care to improved birth outcomes.

Warren noted that improving maternal and infant health requires looking beyond the pregnancy period itself. Broader issues—such as access to health insurance, the availability of local health care providers, and the growing prevalence of maternity care deserts—play a critical role in shaping risks well before pregnancy begins. Sustained, systemic investment in access and equity is necessary to reverse current trends and support healthier pregnancies nationwide.

This video is part 1 of a 2-part series. Check back tomorrow for part 2.

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Reference

Lucas R, Thames T, Chestnut JF, DeMaria AL, Stoneburner A. Maternity care access and infant mortality. JAMA Netw Open. 2025;8(11):e2542831. doi:10.1001/jamanetworkopen.2025.42831