Chances are where you grew up, where you went to school and where you're able to find work will take part in dictating where you raise your family.
Most of us don't have the luxury of researching the most family friendly states, and simply picking up and relocating based on the results.
Nonetheless, the research is out there, and where you live matters when it comes to having a baby.
Of course, there are many factors which impact how your birth unfolds, your baby's health, your postpartum experience and birth costs.
We also know the US has some of the highest maternity care costs without the best outcomes. A birth in the US can cost over $10,000 for a vaginal birth and over $15,000 for a c-section birth.
Compare that to the Netherlands where the average birth costs just $2,824 and we might assume that extra costs would equal better outcomes. However, when it comes to US maternity care, the exact opposite is true. The US ranks as one of the worst developed countries to give birth in.
However, it's hard to discount statistics which show some really big disparities among birth outcomes and costs throughout the US.
WalletHub‘s annual rankings show which states rank best and worst in the US, and it's always very eye opening to see what's happening with birth in the United States.
How Did They Rank States?
WalletHub looked at three major categories to rank states: budget, healthcare and baby-friendly environment. They looked at the cost of maternity care, cost of living, infant death rate, rate of pre-term births, air pollution, number of childcare centers, and more.
Every birth and every maternity care provider are unique. A low ranking doesn't guarantee a bad birth experience or difficulty finding appropriate care for your baby, nor does a high ranking guarantee a positive experience.
What this information can do, however, is help us look at what is working overall for some states and what needs improvement in others. It can help you personally plan for maternity care costs and learn about the importance of choosing a maternity care provider you trust.
So, which states rank best? The best state in the United States to have a baby is…
For the second year in a row Vermont ranks as the best state for having a baby. While it wasn't number one in every category, overall it scored best.
While Vermont did rank seventeenth when it comes to budget, it ranks first when it comes to healthcare. It also ranked fifth for baby-friendly environment. Vermont ranks third for lowest infant death rate, second for maternity care providers per capita and number one for pediatricians per capita – making it a solid choice for the best state to have a baby.
#2: North Dakota
This state ranks well in each of the three major categories. While it doesn't rank as high as Vermont in healthcare, it ranks lower in budget coming in tenth. Also ranking tenth in baby-friendly environment means North Dakota has lower air pollution than some other states and more resources available for new families.
Oregon doesn't rank amazingly well when it comes to budget – coming in 34th place. However, they rank second in healthcare. The healthcare category takes into consideration maternal and fetal mortality and morbidity, available healthcare providers and rates of pre-term births – making it a very important category.
Which States Rank The Worst?
As mentioned, the rankings don't mean it's impossible to have a positive and safe birth experience, nor does it mean you'll have a lack of postpartum support and healthcare. What it does mean is that a state, overall, has areas that need to be improved. It means you might have to budget more for maternity care and less care providers per capita can impact quality of care.
Pennsylvania – my home state – ranks 50th out of 51 (50 states plus the District of Columbia) in this study. Yet, I was fortunate to have four positive and affordable birth experiences. However, according to this study, it isn't necessarily the most common outcome for women in my state.
#1 Worst State To Have A Baby: Mississippi
Mississippi ranks as the worst state to have a baby. This state ranked 51st in the healthcare category meaning it has high pre-term birth rates, high infant mortality rates and less healthcare professionals per capita. Mississippi has the highest infant mortality rate in the US.
While ranking 51st in healthcare overall and infant mortality, it doesn't have the lowest pediatricians per capita, or the lowest midwives/obstetricians per capita which means there are areas of healthcare this state needs to work on.
#2 Worst State To Have A Baby: Pennsylvania
My home state ranks as the second worst state in the entire country. To be honest, when I read this I really wondered how. I had four certified nurse midwife attended births with great outcomes, adequate postpartum support and access to pediatric care for my children. However, statistics don't lie.
We have one of the lowest numbers of pediatricians per capita – evident in our local mother to mother boards where finding a great pediatrician and getting into the practice is like hitting the lottery. As an at will employment state, obtaining maternity leave can be a stressful situation for the many mothers that need to return to work after having a baby. In fact, when it comes to being baby-friendly we rank as the worst state (including the District of Columbia).
#3 Worst State To Have A Baby: West Virginia
When looking at the budget category, West Virginia is comparable to the best states, ranking thirteenth. However, the lower budget doesn't translate to better healthcare outcomes or a baby-friendly environment. It ranks 50th for baby-friendly environment which means a lack of social support in the postpartum period. West Virginia also has one of the highest infant death rates in the US, ranking 47th.
What Does This Mean For Me?
Chances are this information isn't going to result in you uprooting your life before having your next baby. What it can do is help you budget for your next baby. It's also important to realize that while you can't change your state's ranking, you can make decisions that can improve your chance for a positive birth experience and outcome. The maternity care provider you choose, where you choose to give birth and being an active participant in your healthcare can help you and your family grow in the healthiest way, regardless of where you live.
The US has a long way to go when it comes to maternity care. We have wonderful models, such as New Zealand's model of maternity care and with this information we can hope each state – and the country as a whole – takes a look at what needs to change.