March of Dimes Report Card 2020

The U.S. is facing an ongoing maternal and infant health crisis and in 2020 we are still among the most dangerous developed nations for a woman to give birth. Too many moms are dying or facing serious health complications due to childbirth. Too many babies are born too soon or not living to see their first birthday. And far too many of those impacted are moms and babies of color.

To bring awareness of this crisis and the actions we can take to drive change, March of Dimes is releasing its annual Report Card. The report card highlights the factors that impact the health of moms and babies across the U.S. For the first time, this year we looked at rates of infant mortality to give a more comprehensive picture of the factors affecting infant and maternal health.

What is causing this health crisis?

While there’s no single cause of the maternal and infant health crisis, much of it is caused by gaps in our healthcare system. The implicit bias and stigma women of color experience when accessing care have made way for the many disparities (differences) in maternal and infant health outcomes in our nation.

The reality is that the alarming trends we are seeing affect moms and babies in this country, are deeply rooted in systemic racism. Chronic stress from things like racism, floods the body with dangerous levels of stress hormones (a condition known as toxic stress) which contributes to maternal and infant health complications. Racism is a public health crisis.

Sadly, the coronavirus pandemic has made health inequalities and disparities among Americans even wider. We know from the limited research available that pregnant women have an increased risk of severe illness or death from COVID-19.

What do the data in the March of Dimes Report Card tell us?

The report card shows that in the U.S., for the fifth year in a row, too many babies are being born too soon. The U.S. preterm birth rate went up to 10.2 percent (of births in 2019) earning the nation a “C-” grade. In 2018, the grade was a “C.” This is a major difference from the 2014 preterm birth rate, which was 9.57.

Additionally, preterm birth rates remain much higher for Black, American Indian, Alaskan Native and Hispanic women. Women of color are up to 50% more likely to give birth prematurely. To better understand this, we looked at social determinants of health for this year’s report card. The data show that women of color are more likely to be uninsured, live in poverty and compared to white women receive poorer quality care. Some important points to know:

  • In the U.S., 15% of women began their prenatal care late (after the fourth month of pregnancy) or went to less than half of the recommended prenatal check-ups. This most often occurs among American Indian/Alaskan Native, Black and Hispanic women.
  • Nearly 12% of women of childbearing age in the U.S. have no health insurance and most of them were American Indian/Alaska Native or Hispanic. 
  • About 15% of women of childbearing age are living in poverty in the U.S., and most are American Indian or Black.

Although rates of infant death have declined for all states, this is not the case for states in the southern part of the U.S. In these areas, the rate of infant death remains high. The leading causes of infant death include birth defects, preterm birth and low birthweight, maternal complications and sudden infant death syndrome (SIDS). Black, American Indian/Alaskan natives are twice as likely as White babies to die before their first birthdays.

What is March of Dimes doing about this?

March of Dimes is taking action by addressing implicit bias and structural racism in health care and community settings. We launched an implicit bias training for healthcare providers to help address racism in the healthcare system and train healthcare workers break the cycles of discrimination. 

We are also focused on driving change through our #BlanketChange agenda that focuses on equity, access and prevention. Some ways in which we are doing this includes:

  • Eliminating racial and ethnic health disparities and driving economic, social and health equity by focusing on prevention, treatment and social determinants of health
  • Improving access to care through expanding critical health programs and closing gaps in coverage. We are advocating for Medicaid coverage to be extended for postpartum moms.
  • Improve mom and baby health through expansion of group prenatal care 
  • Addressing preventable health conditions by expanding research and improving maternal morbidity and mortality data collection

What can I do to help?

Because there’s no single cause of the maternal and infant health crisis, we must take action across multiple fronts of research, education, advocacy and programs. We ask that you join us in the fight for the health of all moms and babies.

As an individual, you can join March of Dimes and help support moms and babies across the country. Here are two simple ways to get involved: 

  • Advocate by calling on Congress to prioritize our nation’s moms and babies at
  • Donate at to help us improve the health of moms and babies across the country through programs, research and advocacy.

For more information visit