Maternal Health Crisis: Addressing the Stagnation and Inequities in the U.S.

The March of Dimes report finds U.S. maternal health has stalled: persistent preterm birth and widening inequities demand system-level responses.

The report documents a national preterm rateof 10.4% — nearly 380,000 infants born prematurely in 2024 — which immediately increases NICU demand and strains maternal support services. The nation's current trajectory undermines neonatal outcomes and requires coordinated health-system action.

The preterm birth rate remains unchanged from recent years and maintaining elevated NICU occupancy, higher early-life morbidity, and expanded follow-up needs across pediatric and developmental services. For planning, that persistent case load requires prioritizing prevention and reallocating resources to neonatal and perinatal care pathways.

Black mothers face about a 50% higher preterm birth rate than the overall population, and gaps are widening across racial and socioeconomic groups; Medicaid-covered women also experience higher rates than privately insured peers. These disparities reflect differences in timely prenatal access, greater background chronic disease burden, and adverse social determinants that compound risk. Targeted, equity-focused actions—from community outreach to insurance and access reforms—are needed to narrow these gaps.

Chronic conditions among pregnant people are rising: the report notes increases in hypertension and diabetes that amplify preterm risk and complicate prenatal management, with obesity and mental-health comorbidity further increasing care complexity. Short-term implications include higher maternal morbidity and more medically complex pregnancies requiring multidisciplinary management; downstream effects extend to infant health and long-term developmental outcomes. Screening protocols and care-coordination models should be adapted to account for this shifting risk profile.

The report’s system-level recommendations emphasize addressing structural inequities, expanding early prenatal access, stabilizing insurance coverage, and strengthening community-based supports. Rapid operational levers include expanding first-trimester enrollment programs, funding and scaling community health worker initiatives to improve engagement and follow-up, and aligning Medicaid perinatal coverage with postpartum needs to reduce coverage gaps. If implemented with defined metrics and surveillance, these steps can reduce preterm births and narrow disparities.