Choosing the Best State to Have a Baby: A Healthcare Comparison

Pregnancy and childbirth represent one of life’s most significant medical experiences. Access to quality physicians, specialists, and comprehensive medical infrastructure directly impacts outcomes for both mother and newborn—yet this access varies dramatically across the United States. Recent research from Harris Poll revealed a concerning reality: only 42% of pregnant women felt they had access to optimal medical care during pregnancy, and merely 44% reported adequate care during delivery. Geographic location fundamentally shapes this experience, with some states offering vastly superior maternal and infant health outcomes, while others face critical shortages in obstetric care and elevated health risks.

Where to Find the Best State to Have a Baby: Top Five Destinations

Understanding which regions support the safest childbirth outcomes can guide family planning decisions. Forbes Advisor’s comprehensive analysis examined all 50 states across critical metrics to identify where pregnant women receive the highest standard of care.

Vermont: The Safest Choice for Childbirth

Vermont emerges as the best state to have a baby in America. The state boasts the nation’s lowest infant mortality rate at 3.33 deaths per 1,000 live births, alongside an exceptionally low maternal mortality rate of 4.69 deaths per 100,000 live births. By 2030, Vermont is projected to have the second-highest availability of obstetricians and gynecologists relative to population needs (111.1% coverage). Median costs for uninsured or out-of-network childbirth average $25,819.10—the 10th lowest nationwide.

Rhode Island: Abundant Access to Specialists

Rhode Island ranks among the best states due to exceptional specialist availability. The state is projected to have the highest percentage of need met for obstetric care in 2030 at 111.8%. Infant mortality rates rank sixth lowest nationally at 4.05 deaths per 1,000 live births. Childbirth costs with health insurance average just $1,624—the 10th most affordable in the nation.

Massachusetts: Second-Best Infant Outcomes

Massachusetts delivers the second-lowest infant mortality rate in the country at 3.5 deaths per 1,000 live births. The state maintains the eighth-lowest maternal mortality rate at 15.3 deaths per 100,000 live births. Healthcare costs with insurance coverage average $1,431, representing the seventh-lowest expense nationally.

New Hampshire and Maryland: Additional Top Performers

New Hampshire maintains competitive infant mortality rates (3.95 per 1,000 births) and maternal mortality rates (14.51 per 100,000 births). Maryland completes the top tier through affordability advantages, offering the second-lowest insured childbirth costs at $1,151 on average and projecting strong specialist availability at 110.8% of need by 2030.

Understanding High-Risk Areas: Where Challenges Emerge

Conversely, certain states present significantly elevated risks for expectant families, stemming from specialist shortages, higher mortality rates, and substantial out-of-pocket expenses.

Arkansas: The Most Challenging Environment

Arkansas faces the most severe maternal health crisis, with the nation’s highest maternal mortality rate at 43.5 deaths per 100,000 live births. The state simultaneously records the second-highest infant mortality rate at 7.88 deaths per 1,000 live births. By 2030, Arkansas is projected to experience the fifth-lowest percentage of obstetric specialist availability relative to population need, at just 66.7%.

South Dakota, Alaska, and Oklahoma: Cost and Access Barriers

South Dakota presents the third-highest childbirth costs for insured families ($2,577 average) and the sixth-highest infant mortality rate (7.05 per 1,000 births). Alaska imposes the fourth-highest uninsured childbirth costs at a median of $42,180—placing severe financial pressure on families without insurance coverage. The state also ranks seventh most expensive for insured births at $2,473.

Oklahoma compounds access challenges with the second-highest insured childbirth costs ($2,598) and the fourth-lowest projected specialist availability by 2030 (66.1%). These factors collectively produce the 11th-highest infant mortality rate and 11th-highest maternal mortality rate.

Tennessee: Mortality and Cost Concerns

Tennessee demonstrates the third-highest maternal mortality rate at 41.7 deaths per 100,000 live births, alongside the fifth-highest childbirth costs with insurance at $2,507 on average—creating a double burden for expecting families.

Key Metrics Behind State Rankings

The best state to have a baby determination relies on five weighted factors:

Infant Mortality Rate (25% weight): Measures deaths per 1,000 live births, using CDC data averaged across 2020-2022.

Maternal Mortality Rate (25% weight): Reflects pregnancy-related deaths per 100,000 live births, using CDC data from 2018-2021.

Specialist Availability (20% weight): Based on U.S. Department of Health and Human Services 2021 projections for obstetrician-gynecologist availability by 2030.

Insured Childbirth Costs (15% weight): Average expenses with health insurance coverage, using Health Care Cost Institute 2020 data.

Uninsured Childbirth Costs (15% weight): Median out-of-pocket expenses without insurance or with out-of-network providers, using Fair Health 2022 data.

Health Insurance Guidance for Expecting Parents

Securing appropriate health insurance before pregnancy represents a critical priority. Comprehensive plans should cover doctor visits, hospital care, prescription medications, and crucially—pregnancy, maternity, newborn care, and pediatric services including vision and dental coverage.

Affordable options exist for budget-conscious families. Importantly, pregnancy cannot serve as grounds for insurance denial or premium increases. Special enrollment periods following childbirth may provide additional coverage opportunities beyond standard open enrollment windows.

Shopping across multiple plans enables families to identify coverage balancing affordability with the specific needs of pregnancy and early parenthood, directly influencing the quality and safety of the childbirth experience.