Ranking the Best & Worst States to Have a Baby in the U.S. in 2024

Having a baby is a rewarding yet challenging journey, and finding the right place in the vast U.S. to raise a child can be daunting.

To assist in this decision, we analyzed all 50 states, ranking them based on key metrics related to the cost and health aspects of childbirth. Our findings revealed significant variations across states.

Take Mississippi for example, which loses over 3 times more babies than North Dakota, with 9.39 infant deaths per 1,000 births compared to North Dakota’s 2.77. Out-of-pocket spending for childbirth shows significant state-by-state differences, averaging $983 in Michigan to $2691 in Nebraska.

Sadly, Arkansas mothers tragically die at a rate of 43.5 maternal deaths per 100,000 births, over 9 times higher than Vermont’s rate of 4.7.

For single-parent families it’s a whole other story, childcare consumes up to 27.4% of the median income in Massachusetts, compared to a lower 23.7% in South Dakota.

The study provides valuable insights into the health and cost factors that influence the experience of having a baby across the United States. Discover your state’s standing in our 50-state ranking for valuable insights.

Key Findings

• The best 3 states to have a baby are North Dakota, Utah, and South Dakota, exemplifying top healthcare and affordability.
• Conversely, the worst 3 states are Mississippi, South Carolina, and Tennessee, indicating significant room for improvement in many areas.
• North Dakota, Vermont, and Massachusetts have the lowest. In contrast, the Infant Mortality Rate (Per 1000 births) in Alabama, Arkansas, and Mississippi are the highest.
• Oregon, Rhode Island, and Vermont sadly have the lowest Fertility Rate (Per 1000 births), while South Dakota, North Dakota, and Alaska have the highest.

The Best and Worst States in the U.S. to Have a Baby (Infographic) 

Ranking the Best & Worst States in the U.S. to Have a Baby

Infant Mortality Rate (Per 1000 births)

Fertility Rate (Per 1000 births)

Annual Cost of Child Care (Per Child)

Maternal Mortality Rate Per 100,000 Live Births

10 Best States to Have a Baby

Let's dive into the top 10 U.S. states for having a baby in 2024, each of which has been chosen for their outstanding affordability, healthcare, and support.

#1. North Dakota

North Dakota reigns supreme and takes the top spot as the best state to have a baby. It boasts an exceptional health score of 9.00, indicating excellent healthcare conditions, and a cost score of 9.00, making it financially manageable for new parents.

With a low infant death rate (2.77 per 1000 births) and a maternal mortality rate of 24.2 per 100,000 live births, it provides a safe and healthy environment for childbirth.

The annual cost of childcare per child is $8,624, and the state has a low percentage of preterm births at 9.56%. All these factors contribute to North Dakota's impressive final score of 85.0.

#2. Utah

Utah ranks at a close second as an excellent state for childbirth. It has a health score of 8.45 and a cost score of 8.15, indicating high-quality healthcare and relatively affordable childcare costs, alleviating at least some of those financial burdens.

Utah boasts a low infant death rate (4.58 per 1000 births) and a maternal mortality rate of 16.1 per 100,000 live births. The annual cost of childcare per child is $8,268, making it accessible to many parents. With a final score of 78, Utah offers a favorable environment for starting a family and will give you peace of mind if you decide to move there.

#3. South Dakota

South Dakota secures the third spot among the best states to have a baby. It has a slightly lower health score of 7.70, a cost score of 7.88, and a final score of 73, offering good healthcare conditions and reasonable childcare costs. Despite a lower score don’t be put off, this is a very good score that reflects a suitable state for starting a family.

The state has a low infant death rate (6.07 per 1000 births) and a maternal mortality rate of 28.5 per 100,000 live births. The annual cost of childcare per child is $6,677, and the percentage of preterm births is 10.53%. So this already beats North Dakota and Utah on the financial side, allowing you to purchase a few more treats for your newborn.

#4. Iowa

With a final score of 71, Iowa ranks fourth as a favorable state for childbirth. It has a health score of 8.22 and a cost score of 7.28, indicating high-quality healthcare and relatively affordable childcare costs, much like the previous three.

Iowa also boasts a low infant death rate (3.99 per 1000 births) and a maternal mortality rate of 20.2 per 100,000 live births. The annual cost of childcare per child is $9,322, and the percentage of preterm births is 10.03%. Although childcare might be costlier you’ll still find plenty of happy families there.

#5. Idaho

In fifth position, we have Idaho, with a total score of 67.80, a health score of 8.07, and a cost score of 6.81. The state's infant mortality rate of 5.13 per 1000 births and a maternal mortality rate of 18.3 per 100,000 live births indicate a good healthcare environment.

Idaho's fertility rate of 60.7 per 1000 and its balance of healthcare quality and affordability make it a desirable state for families and somewhere you should put on your wishlist.

#6. Kansas

Kansas scores a total of 67.40, with a health score of 7.66 and a cost score of 6.98. The infant mortality rate is 5.30 per 1000 births, and the maternal mortality rate is 22.0 per 100,000 live births.

The state's fertility rate is 61.0 per 1000, and it offers reasonable child care and childbirth costs. Kansas' focus on healthcare and its economic policies make it a suitable place for raising a family that is home to many thriving and happy families.

#7. Wyoming

Wyoming secures the seventh spot for having a baby, boasting a health score of 7.29, a cost score of 7.14, and a final score of 67. It provides good healthcare conditions and relatively affordable childcare options.

Wyoming maintains a low infant death rate (5.45 per 1000 births) and a maternal mortality rate of 15.7 per 100,000 live births. The annual cost of childcare per child is $8,236, making it an attractive choice for new families.

#8. Delaware

Delaware's total score is 67.08, putting it in eighth place with a health score of 7.26 and a cost score of 7.15. The state has an infant mortality rate of 4.77 per 1000 births and an encouraging maternal mortality rate of 19.0 per 100,000 live births.

Delaware's fertility rate is 56.5 per 1000, and it offers manageable child care and childbirth costs. The state's investment in healthcare and affordability contribute to its high ranking.

#9. Missouri

Ranking ninth, Missouri has a total score of 65.80, a health score of 6.71, and a cost score of 7.26. The infant mortality rate is 5.85 per 1000 births, and the maternal mortality rate is 25.7 per 100,000 live births.

Missouri's fertility rate is 58.4 per 1000. The state's balance of healthcare services and cost of living makes it a favorable option for families, despite a higher maternal mortality rate.

#10. New Hampshire

And finally, with a total score of 65.76, New Hampshire has a health score of 7.70 and a cost score of 6.70. The infant mortality rate is 3.96 per 1000 births, and the maternal mortality rate is 14.5 per 100,000 live births, one of the lowest in the nation.

New Hampshire's fertility rate of 49.9 per 1000 and its focus on high-quality healthcare, despite higher costs, make it a commendable choice for families. So if you’re willing to pay a little extra for safety then this is the place for you.

10 Worst States to Have a Baby

In contrast, these ten states present the most difficulties for new and expecting parents. These rankings highlight areas where improvement is crucial for better family welfare.

#50. Mississippi 

Mississippi sadly ranks the lowest with a total score of 40, a health score of 4, and a cost score of 4.71. The state faces significant challenges with the highest infant mortality rate of 9.39 per 1000 births and a high maternal mortality rate of 43.0 per 100,000 live births. Many people lead happy lives here but unfortunately, there is a higher risk of danger.

The fertility rate is 60.7 per 1000, indicating a high birth rate despite the healthcare challenges. The annual cost of child care per child is $5,439, and the average out-of-pocket childbirth cost is $1,906.

#49. South Carolina

South Carolina is ranked 49th with a total score of 41.50, a health score of 5.56, and a cost score of 4.08. The state has an infant mortality rate of 7.26 per 1000 births and a maternal mortality rate of 32.7 per 100,000 live births.

The fertility rate is 57.5 per 1000. Child care costs $9,932 annually per child, and out-of-pocket childbirth costs $1,342. With childcare costs like this you may be hoping for a significantly safer place to start your family.

#48. Tennessee

Tennessee, ranking at 48, has a total score of 42.13, a health score of 5.79, and a cost score of 4.05. The state's infant mortality rate is 6.18 per 1000 births, and the maternal mortality rate is 41.7 per 100,000 live births, which is considerably high.

The fertility rate is 59.8 per 1000, with annual child care costing around $8,759, and the out-of-pocket childbirth cost coming in at $2,510. Not the worst but definitely not the best.

#47. West Virginia

West Virginia is ranked 47th with a total score of 42.29, a health score of 5.82, and a cost score of 4.06. The infant mortality rate is 6.80 per 1000 births, and the maternal mortality rate is 25.4 per 100,000 live births, boasting less than favorable results.

The state's fertility rate is 54.7 per 1000. Child care costs $8,320 annually per child, and out-of-pocket childbirth costs $2,200. So this state might not be the home you’re looking for.

#46. Alabama

Alabama stands at 46th with a total score of 42.39, a health score of 5.00, and a cost score of 4.53. The infant mortality rate is 7.56 per 1000 births, and the maternal mortality rate is 41.4 per 100,000 live births, so there is significant room for improvement.

Alabama's fertility rate is 59.5 per 1000. The annual child care cost is $7,280, and the out-of-pocket childbirth cost is $2,001. Here’s hoping these numbers only get better each year.

#45. Arkansas

Arkansas ranks 45th with a total score of 43.13, a health score of 4.98, and a cost score of 4.66. The state has an infant mortality rate of 8.59 per 1000 births and a maternal mortality rate of 43.5 per 100,000 live births.

The fertility rate is 61.7 per 1000. Child care costs $6,575 annually per child, and out-of-pocket childbirth costs $2,310. Child care is less than in some other states but not enough to ignore the other healthcare concerns.

#44. Louisiana

Louisiana is at rank 44 with a total score of 43.90, a health score of 5.38, and a cost score of 4.56. The infant mortality rate is 7.24 per 1000 births, and the maternal mortality rate is 39.0 per 100,000 live births.

The state's fertility rate sits at a firm 62.7 per 1000. Annual child care costs $7,800, and out-of-pocket childbirth costs $2,124.

#43. North Carolina

North Carolina stands at rank 43 with a total score of 47.62, a health score of 6.33, and a cost score of 4.61. The infant mortality rate is 6.72 per 1000 births, and the maternal mortality rate is 26.5 per 100,000 live births.

The fertility rate is 58.1 per 1000. The annual child care cost is $9,350, and the out-of-pocket childbirth cost is $2,330.

#42. Georgia

Georgia ranks 42nd with a total score of 48.48, a health score of 5.62, and a cost score of 5.14. The state's infant mortality rate is 6.25 per 1000 births, and the maternal mortality rate is 33.9 per 100,000 live births.

Georgia's fertility rate is 55.9 per 1000. Child care costs $7,630 annually per child, and out-of-pocket childbirth costs $2,333.

#41. Massachusetts

Massachusetts, at rank 41, has a total score of 48.54, a health score of 7.69, and a cost score of 4.00. Despite a lower infant mortality rate of 3.23 per 1000 births and a maternal mortality rate of 15.3 per 100,000 live births, the state's lower ranking is influenced by high living and child care costs.

The fertility rate is 49.0 per 1000. Annual child care costs $16,781, and out-of-pocket childbirth costs $1,434. With childcare costs like this, it adds considerable strain so you’d hope for a much better ranking than this.

Methodology

In our analysis, we thoroughly examined all 50 U.S. states based on a set of 9 criteria to rank which state would be the best for having and nurturing babies. Each criterion scored 40 to 100, indicating its relative importance in the assessment. We applied a normalization process to ensure a fair and comparable analysis across all criteria. This process standardized the scores for each criterion to a standard range while preserving their relative differences.

After normalizing the scores, we calculated each state's overall performance. To achieve this, we aggregated the individual scores, considering their respective weights based on their importance in the assessment. By applying appropriate weights to the normalized scores, we generated a composite score for each state. The final composite score, ranging from 40 to 85 (for easier interpretation), provides a statistically meaningful evaluation of the overall performance of each state.

We have retained the individual scores for each criterion in our dataset rather than storing only the feature values.

The criteria for evaluation are as follows:

1. Fertility Rate
   General fertility rate per 1,000 women aged 15–44.
   Data is taken from the Centers for Disease Control and Prevention of the latest year (2021) available. 
2. Infant Mortality
   The number of infant deaths per 1,000 live births.
   Data is in accordance with the Centers for Disease Control and Prevention of the latest year (2021) available. 
3. Percentage of Preterm Births
   Defined as the percentage of babies born before 37 weeks of pregnancy (gestation) according to the source of data in the Centers for Disease Control and Prevention for the year 2021 (latest available).
4. Percentage of Babies Born with Low Birthweight
   Babies born weighing less than 2,500 grams or 5 lbs. 8oz. Data is from the Centers for Disease Control and Prevention, the latest year available (2021).
5. Maternal Mortality Rate Per 100,000 Live Births
   As defined in the Centers for Disease Control and Prevention’s report, maternal deaths include deaths of women while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
   
   The data takes into account deaths in the year 2018-2021.
6. Average Out of Pocket Spending Per Childbirth ($)
   The out-of-pocket cost associated with childbirth accounts for delivery expenses only, not including prenatal or postpartum expenses or other costs such as newborn care.
   
   The data is taken from Health Care Cost Institute’s report for the latest year available, 2020.
   
   * Note: Missing data for Alabama was replaced with the average of all the other states.
7. Annual Cost of Child Care Per Child ($)
   The average annual costs in USD for the care of a single four-year-old child at a child care center.
   
   Data is taken from World Population Review for the year 2023.
8. Child Care Cost Percentage In Single-Parent Median Income
   What portion of a single parent’s median income is spent on annual child care costs?
   Data is taken from World Population Review for the year 2023.
9. Child Care Cost  Percentage In Double-Parent Median Income
   What portion of a double parent’s median income is spent on annual child care costs? Data is taken from World Population Review for the year 2023.

How the weights are distributed

The weights assigned to each criterion reflect their importance in assessing a state's suitability for having and nurturing babies.

Positive weights, like the fertility rate, highlight favorable conditions for family planning. Negative weights, seen in criteria like infant and maternal mortality rates, emphasize undesirable outcomes crucial for evaluating healthcare effectiveness.

Higher weights for health-related factors underscore their critical impact.

The cumulative weights are normalized to ensure a standardized assessment, with the total absolute weights adding up to 1, providing a balanced evaluation of factors contributing to a conducive environment for successful childbirth and early child development.

1. The actual scores are padded to 40-80 to get more realistic-looking scores.
2. Weights for each feature are as below and are taken to be a bit more subjective:

Grouped Scores

Health Score Group: Features 1 - 5 from the table above
Cost Score Group: Features 6-9 from the table above

The weights are kept the same as the table while the features are in groped mode.

The scale is changed in this mode - rather than padding to 40-85, the normalization scale is applied in the 4-9 range (in the calculation, padded for readability), or can be viewed as scores ranging from 1-10.