In the United States, where you live can make a big difference in your experience of pregnancy and birth. Whatever your position is on healthcare, there’s no denying that not all parts of the country are created equal, and disparities in care have real outcomes for families. There are various standards by which to measure which states are the best or worst to have a baby, but whatever factors weigh on your mind, knowing what to expect can better prepare you to advocate for yourself or your partner, and have as smooth a birthing experience as possible.
Medical expenses matter when it comes to having a baby, especially if you don’t have health insurance. Struggling to afford prenatal care can lead to missing recommended appointments, and possibly dealing with complications that a doctor otherwise could have treated. (If you don’t have health insurance, you can still cover your baby’s birth by enrolling through a Special Enrollment Period within 60 days of delivery.) The worst-ranked states to have a baby based on cost, according to Wallet Hub, are:
- South Dakota
The best-ranked states are:
- North Dakota
Of course, cost is only a small part of a birth story. Health, complications, and support for new families matters, too.
The World Health Organization recommends that C-section births should happen at a rate of 10-15%. While cesarean birth is sometimes the best choice to keep mother and baby safe, it’s a major surgery, with a longer recovery time and possible complications.
No state meets this target, according to the CDC. The states with the lowest rates are:
- Utah: 22.3%
- Alaska: 23%
- Idaho: 23.9%
- New Mexico: 24.8%
- Hawaii: 25.2%
The highest C-section rates in the country are:
- Mississippi: 38.2%
- Louisiana: 37.5%
- Florida: 37.4%
- New Jersey: 36.2%
- Connecticut: 35.4%
If a vaginal delivery is a priority for you, screen providers early to learn who is most supportive of that goal, especially if you’re hoping for a VBAC (vaginal birth after cesarean).
Maternal Mortality Rate
While most parents will tell you what they’re hoping for most is “a healthy baby,” a healthy parent is just as important. The maternal death rate in the U.S. has increased in recent years, and national news stories are highlighting the need for improvements in care, especially for black women, who die of pregnancy-related causes at over three times the rate of white women. (Even high-profile black women, including Serena Williams and Beyonce, have spoken out about serious complications in their pregnancies.)
The states with the best (i.e., lowest) maternal mortality rates are:
The states with the worst maternal mortality rates are:
- New Jersey
Infant Mortality Rate
Losing a baby is one of the most devastating events possible. All parents and providers want to give babies their best chance at going home and starting a full, healthy life. The states with the lowest infant mortality rates per 1,000 live births are:
- Vermont: Reporting 19 deaths in 2016, Vermont’s infant mortality rate was too low to register a stable rate per 1,000 live births.
- New Hampshire: 3.7
- Massachusetts: 3.9
- New Jersey: 4.1
- California: 4.2
The states with the highest rates are:
- Alabama: 9.1
- Mississippi: 8.6
- Arkansas: 8.1
- Louisiana: 8.0
- Delaware: 7.9
Life After Birth
Wallet Hub’s report also considered quality of life after that momentous first day of meeting your baby. After all, birth is only the beginning of “having a baby”! Their “baby-friendliness” measure rated states’ parental leave policies, availability of mom groups and child care centers (including the state’s share of nationally accredited child care centers), and birth rate to determine what it would be like to raise a baby. Their best-ranked states are:
- District of Columbia
The worst-ranked states are:
- South Carolina
- West Virginia
As you can see, it’s tough to make a definitive call about “best” and “worst,” but some patterns emerge when you look at the data. States like Alabama, Arkansas, Louisiana, and Mississippi appear on the negative end of multiple rankings. California and Massachusetts make several favorable top 5 lists. Where you live doesn’t guarantee what kind of birth experience you’ll have with your baby, but it’s worth looking into rankings to learn your state’s strengths and weaknesses surrounding this life-changing event.