Mississippi’s active public health emergency over rising infant deaths is even more urgent following the release of a study showing the state has the highest preterm birth rate in the U.S.
March of Dimes, a nonprofit focused on ending preventable maternal and infant health risks, released its annual report card Monday. Based on 2024 numbers, the country as a whole received a D+ grade with a national preterm birth of 10.4%, meaning nearly 380,000 babies were born too soon last year. Mississippi received an F grade with a preterm birth rate of 15%. Stark racial disparities were also highlighted in the study with Black babies in Mississippi 1.5 times more likely to be preterm than all other babies.
Other states to get F grades were Arkansas, Louisiana, Alabama, Georgia, South Carolina, Kentucky, and West Virginia. U.S. territory Puerto Rico also received an F.
Dr. Michael Warren, the chief medical officer for March of Dimes, said while many of the states that received failing grades have similar barriers that continue to threaten the health of mothers and babies, Mississippi’s largest battle is a significant gap in access to healthcare – specifically in rural areas.
“First and foremost, we have to think about access, and there are a couple of things that come to mind there,” Warren said. “It’s making sure that regardless of where women live in Mississippi that they have access to prenatal care, and they have access to a place where they can have a safe and high-quality delivery. We also can’t have this conversation without talking about the need to expand Medicaid.”
Mississippi is one of 10 states that has consistently decided not to opt into the Affordable Care Act, which extends Medicaid coverage to adults with incomes of up to 138% of the federal poverty level. While Mississippi lawmakers openly debated in 2024 the prospect of opting into the mostly federally funded model, this year’s legislative session was void of any real movement as the GOP-led legislature was waiting to see what President Donald Trump would do to change government-provided insurance.
Over the summer, at the behest of Trump, both chambers of Congress passed his self-proclaimed “One Big Beautiful Bill.” In it, there were dozens of provisions impacting Medicaid. While the federal government will still offer to pay 90% of the total cost of expansion for states and maintain the FPL standards that have been intact since the ACA was fully implemented in 2014, the bill created incoming changes such as a work or community service requirement of at least 80 hours a month and mandatory eligibility redeterminations every six months, projected to affect coverage for millions and their families.
Of the seven states to receive an F grade from March of Dimes, three (Mississippi, Alabama, and Georgia) have not fully expanded Medicaid, showing there’s no silver bullet fix to maternal and infant health challenges, Warren explained. While Mississippi has extended coverage to women for one year postpartum, he believes full expansion, doula reimbursement, and paid family leave would all be beneficial.
“We have known the drivers of preterm birth – delayed prenatal care, chronic disease, unequal access to care – for years,” he reiterated. “…We must deepen our commitment to research, expand maternity care access, and push for better policies that protect moms and babies.”
Warren hopes the March of Dimes report card will serve as a renewed alarm – or at least make for a louder alarm – for lawmakers as they continue to work during the offseason on ways to buck Mississippi’s troubling trends when it comes to maternal and infant health.
In August, the Mississippi State Department of Health declared a public health emergency as the state battles its highest infant mortality rate in over a decade: 9.7 deaths per 1,000 lives births. According to the Centers for Disease Control and Prevention, preterm births are strongly connected to infant mortality, with prematurity being the leading cause of newborn death.
On Nov. 6, the House and Senate Health Committees held a joint meeting at the capitol to discuss potential solutions following the declaration of the public health emergency. While the MSDH has already begun the process of activating an obstetrics system of care – a more organized approach to ensuring pregnant women, no matter where they live, receive proper care through an expedited transfer system – lawmakers discussed ways to further educate families on safe sleep practices to reduce preventable deaths.
Lawmakers and health leaders also heard from Dr. Mona Hanna, the founder of a program called Rx Kids that started in Michigan and offers financial relief to moms during and in the months after pregnancy. She said during the meeting that $2 million in private money is available for a pilot in Mississippi and is awaiting a state match.
Dr. Dan Edney, the state health officer and executive director of MSDH, was pleased with movement made in the meeting and is optimistic lawmakers will put all options on the table when it comes to saving lives.
“Declaring this a public health emergency has set the wheels in motion to move more quickly to save lives,” State Health Officer Dr. Dan Edney said. “Mississippi knows the resources and the resilience to change this story. It will take all of us – policymakers, healthcare providers, communities, and families – working together to give every child the chance to live, thrive, and celebrate their first birthday.”