Shocking Rankings Expose Which U.S. States Fail Expecting Mothers Worst—Is Yours on the List?

Ever wondered how a shortage of midwives could turn your state into a maternity minefield? Turns out, it’s more than just a question—it’s becoming a harsh reality for expecting moms in parts of the U.S. A fresh study by the Birth Injury Lawyers Group dived into the nitty-gritty of midwife availability and preterm birth rates, handing out a “Maternity Risk Score” to each state. The findings? Some Southern and Midwestern states are juggling dangerously high risks, with Mississippi topping the list like a heavyweight champ nobody wants to face. The scarcity of skilled midwives combined with soaring preterm births paints a troubling picture, especially when mothers might need to hop miles just to find basic prenatal care. Meanwhile, places like Massachusetts seem to have cracked the code with solid midwifery networks and better healthcare investments. If you think all 50 states are on equal footing here, this study might just make you think twice—because when it comes to bringing life into the world, the stakes couldn’t be higher. LEARN MORE.

A new nationwide study has revealed the ten U.S. states where maternity care is most at risk — with severe midwife shortages and high preterm birth rates creating dangerous conditions for expecting mothers.

The research, conducted by the Birth Injury Lawyers Group, analyzed the availability of midwives and preterm birth rates across all 50 states to rank where maternity care access and outcomes are most concerning. Each state received a Maternity Risk Score out of 100, calculated using two key indicators:

• Average Births to Midwife Ratio (2023) — reflecting how many births each certified midwife handles on average.
• Average Preterm Birth Rates (2018–2022) — the percentage of babies born before 37 weeks’ gestation.

A higher score represents greater maternity care concerns, from limited access to skilled professionals to increased rates of early or medically complicated births.

Southern and Midwestern States Face the Most Alarming Risks

The results show a clear pattern: Southern and Midwestern states dominate the list, highlighting ongoing disparities in maternal healthcare. Mississippi, Alabama, and Louisiana rank as the top three states with the most severe challenges, while Arkansas, Oklahoma, and Texas also appear among the top six.

These states often suffer from widespread maternal care deserts — areas where hospitals and certified midwives are scarce or entirely unavailable, forcing women to travel long distances for essential prenatal care.

In contrast, states like Massachusetts, Oregon, and Washington perform much better, with stronger midwifery networks, better prenatal programs, and higher healthcare investment per birth.

The 10 U.S. States With the Highest Maternity Risk

A Growing National Crisis

The study highlights how the lack of midwives is contributing to worsening maternal health outcomes across the U.S. Midwives play a vital role not just in delivering babies but in providing essential prenatal, postnatal, and preventative care. When states have too few certified midwives, expecting mothers are more likely to experience delays in care, higher stress during pregnancy, and poorer birth outcomes.