Texas earns 'D' on March of Dimes report as infant mortality worsens

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TEXAS - Texas has earned a dismal "D" grade in the 2025 March of Dimes Report Card, with state data revealing that maternal and infant health outcomes are deteriorating across multiple critical measures, according to the advocacy organization.

March of Dimes Report Card

Big picture view:

The March of Dimes assigned the failing grade based on the state’s high rate of preterm birth, which stood at 11.1% in 2024. This means 43,344 babies were born prematurely in Texas last year, a rate that held steady from 2023 but ranks Texas as 40th out of 52 states, the District of Columbia, and Puerto Rico.

Beyond preterm birth, the report highlighted significant and worsening trends in mortality and care:

• Infant Mortality: The state's infant mortality rate was 5.8 deaths per 1,000 births in 2023, a rate that worsened compared to the prior year. The report noted 2,263 babies died before their first birthday in 2023.
• Racial Disparity: The infant mortality rate among babies born to Black mothers is 1.7 times the state rate, underscoring severe systemic inequities in care.
• Maternal Health: Metrics related to prenatal care and delivery worsened. The rate of women receiving inadequate prenatal care worsened, landing Texas at 48th out of 52 for this measure. Additionally, rates for both maternal mortality and low-risk Cesarean births also worsened significantly.

Texas Counties in Crisis

Local perspective:

The poor statewide grade is reflected in localized data, with several major Texas counties and cities receiving an "F" grade for their preterm birth rates in 2024. Counties including El Paso (13.3%), Harris (12.0%), Bexar (12.0%), and Fort Bend (12.1%) all had preterm birth rates substantially higher than the national average.

The city of Houston, Texas, received an 'F' grade with a preterm birth rate of 12.1%, which worsened from the previous year.

Lack of Supportive Policies

Dig deeper:

The report also criticized the state for lagging in adopting supportive policies and programs essential for improving maternal and infant health equity.

Texas is currently implementing only two of the six key supportive initiatives tracked by the March of Dimes: Medicaid Extension (to one year postpartum) and a Maternal Mortality Review Committee.

The state has not adopted several policies identified as critical by the organization, including:

• Medicaid Expansion
• Paid Family Leave
• Doula Reimbursement through the state Medicaid agency

While Texas ranked favorably (16th out of 47) for having a low rate of severe maternal morbidity (unexpected outcomes of labor and delivery), the report's overall findings suggest the state’s maternal and infant health crisis is intensifying.