A recent report from the Birth Injury Lawyers Group reveals significant disparities across the United States in maternity care quality, costs, and maternal health policies. Louisiana tops the rankings with an impressive overall score of 90.0 out of 100, while South Dakota ranks last at just 13.5.
The analysis evaluated ten key indicators — including childbirth costs, Medicaid coverage, mental health policies, and service availability — to score each state’s maternity care performance. Data were compiled from reputable sources such as the National Academy for State Health Policy, Kaiser Family Foundation, FAIR Health, and The Policy Center for Maternal Health.
Top Performers in Maternal Healthcare
Louisiana achieved the highest ranking, driven largely by the nation’s lowest childbirth expenses. The state’s average in-network non-C-section delivery costs stand at $8,923, significantly below the national average. Louisiana also distinguishes itself by maintaining a maternal mental health task force alongside mandated prenatal and postnatal mental health screenings — a combination found in only three states.
Oklahoma follows closely with a score of 84.9. The state boasts the fifth-lowest in-network delivery rate nationally at $10,681 and shares Louisiana’s comprehensive approach to maternal mental health policy.
California ranks third with a score of 80.2 despite high average birth costs of $17,791 per delivery. The state compensates with extensive Medicaid coverage, including postpartum benefits, and robust mental health initiatives linked to childbirth.
Other states rounding out the top ten include Maryland (65.9), Illinois (65.3), Ohio (64.0), Arizona (59.3), Massachusetts (58.1), Oregon (57.7), and Pennsylvania (55.3). These states generally combine moderate delivery costs with supportive Medicaid policies and varying degrees of maternal mental health programming.
States Struggling with Maternal Care
At the lower end of the spectrum, South Dakota scored the poorest overall. While its vaginal delivery costs are moderate ($13,294 in-network), the state lacks critical maternal health supports such as Medicaid expansion, postpartum coverage, mental health commissions, and screening mandates.
Following South Dakota are Alaska (16.4) and Nevada (19.8), both of which score low on policy provisions despite differences in childbirth costs. Several other states in the bottom ten — including Wisconsin, Arkansas, New Hampshire, Texas, Idaho, Utah, and Kansas — also lag significantly in Medicaid coverage and maternal mental health initiatives.
Expert Commentary
Bob Goldwater of the Birth Injury Lawyers Group emphasized the importance of addressing maternal mental health across the country:
“Maternity care has made important advances over the past three decades, particularly in postpartum mental health. However, the variation between neighboring states remains stark. For example, California leads with strong mental health policies, while Nevada lacks Medicaid expansion and maternal mental health screening requirements.
“Only five states require postnatal mental health screenings under Medicaid, and just seven mandate prenatal checks. With one in eight women experiencing postpartum depression, expanding these screenings nationwide is essential. Promoting open dialogue on perinatal mental health will reduce stigma and help ensure mothers receive necessary support.”
Related Topics
