Having a baby is both a joyful and stressful occasion – but the stress side is more amplified in 2022 with the continued presence of the COVID-19 pandemic. Pregnant women might have an increased risk of severe illness or birth complications due to coronavirus, according to the CDC. Luckily, it is safe for pregnant women to receive the COVID-19 vaccine.
Aside from the difficulty of giving birth during a public health crisis, new mothers will also have to worry about the cost. One of the biggest expenses to keep in mind is medical bills. The average conventional delivery in the U.S. costs over $3,000 with insurance, and without insurance it could cost over $10,000.
Birthing costs, however, won’t hit your wallet as badly in some states as they will in others. Expenses can vary significantly, considering the wide disparities in cost of living. They can also differ from one pregnancy to another, given that some women experience delivery complications. But there’s more to think about than just cost. Some states provide better quality health care service and better environments in which to care for children.
To determine the most ideal places in the U.S. to have a baby, WalletHub compared the 50 states and the District of Columbia across 32 key measures of cost and health care accessibility, as well as baby- and family-friendliness. Our data set ranges from hospital conventional-delivery charges to annual average infant-care costs to pediatricians per capita.
Main Findings
Best States to Have a Baby
| Overall Rank | State | Total Score | Cost | Health Care | Baby-Friendliness | Family-Friendliness |
|---|---|---|---|---|---|---|
| 1 | Massachusetts | 71.11 | 34 | 2 | 5 | 1 |
| 2 | Vermont | 69.28 | 30 | 1 | 25 | 3 |
| 3 | Rhode Island | 67.11 | 36 | 3 | 3 | 11 |
| 4 | Minnesota | 66.17 | 23 | 6 | 9 | 4 |
| 5 | New Hampshire | 65.78 | 3 | 4 | 42 | 6 |
| 6 | Connecticut | 64.73 | 38 | 5 | 12 | 7 |
| 7 | Washington | 62.11 | 39 | 11 | 2 | 8 |
| 8 | District of Columbia | 60.08 | 22 | 28 | 1 | N/A |
| 9 | Hawaii | 59.19 | 24 | 8 | 4 | 23 |
| 10 | Utah | 58.87 | 11 | 19 | 17 | 13 |
| 11 | Maine | 57.86 | 20 | 7 | 26 | 17 |
| 12 | New York | 57.86 | 47 | 16 | 24 | 2 |
| 13 | North Dakota | 57.78 | 7 | 35 | 20 | 9 |
| 14 | Iowa | 57.75 | 15 | 12 | 36 | 12 |
| 15 | New Jersey | 57.01 | 45 | 21 | 6 | 10 |
| 16 | Oregon | 56.80 | 27 | 9 | 7 | 25 |
| 17 | Maryland | 56.03 | 4 | 13 | 38 | 20 |
| 18 | Nebraska | 55.17 | 25 | 26 | 41 | 5 |
| 19 | Montana | 53.93 | 10 | 29 | 11 | 22 |
| 20 | Pennsylvania | 53.24 | 5 | 18 | 40 | 21 |
| 21 | Colorado | 52.72 | 41 | 22 | 13 | 19 |
| 22 | Illinois | 52.48 | 35 | 17 | 31 | 16 |
| 23 | Wisconsin | 51.87 | 42 | 24 | 23 | 14 |
| 24 | Virginia | 51.30 | 29 | 20 | 35 | 18 |
| 25 | California | 50.84 | 51 | 15 | 8 | 24 |
| 26 | South Dakota | 50.45 | 33 | 27 | 37 | 15 |
| 27 | Delaware | 50.15 | 21 | 10 | 34 | 29 |
| 28 | Idaho | 49.57 | 9 | 23 | 10 | 34 |
| 29 | Kansas | 47.66 | 31 | 32 | 15 | 27 |
| 30 | Alaska | 47.07 | 43 | 14 | 22 | 32 |
| 31 | Ohio | 45.36 | 1 | 33 | 43 | 31 |
| 32 | Michigan | 44.60 | 12 | 34 | 27 | 35 |
| 33 | Wyoming | 44.24 | 37 | 38 | 21 | 26 |
| 34 | Kentucky | 43.18 | 8 | 43 | 16 | 38 |
| 35 | New Mexico | 42.83 | 13 | 25 | 14 | 49 |
| 36 | Missouri | 42.72 | 14 | 42 | 45 | 28 |
| 37 | Texas | 40.79 | 49 | 30 | 39 | 30 |
| 38 | Indiana | 40.41 | 19 | 45 | 33 | 33 |
| 39 | Arizona | 39.89 | 26 | 39 | 18 | 40 |
| 40 | Tennessee | 39.41 | 40 | 40 | 19 | 36 |
| 41 | North Carolina | 37.21 | 48 | 31 | 47 | 37 |
| 42 | Florida | 36.82 | 44 | 37 | 29 | 39 |
| 43 | Nevada | 36.73 | 32 | 36 | 30 | 42 |
| 44 | Oklahoma | 35.21 | 18 | 44 | 32 | 46 |
| 45 | West Virginia | 34.77 | 16 | 41 | 51 | 45 |
| 46 | Arkansas | 33.86 | 6 | 50 | 28 | 44 |
| 47 | Georgia | 32.08 | 28 | 46 | 48 | 41 |
| 48 | Louisiana | 29.62 | 2 | 48 | 46 | 48 |
| 49 | South Carolina | 26.31 | 46 | 47 | 49 | 47 |
| 50 | Mississippi | 25.34 | 17 | 49 | 50 | 50 |
| 51 | Alabama | 24.89 | 50 | 51 | 44 | 43 |
Note: With the exception of “Total Score,” all of the columns in the table above depict the relative rank of that state, where a rank of 1 represents the best conditions for that metric category.
- Lowest
- 1. Maryland
- 2. New Hampshire
- 3. North Dakota
- 4. West Virginia
- 5. Utah
- Highest
- 33. Colorado
- T-34. New Jersey
- T-34. Nevada
- T-34. California
- T-34. Florida
- Lowest
- 1. North Dakota
- 2. New Hampshire
- 3. Maryland
- 4. Nebraska
- 5. Vermont
- Highest
- T-33. New Jersey
- T-33. California
- T-33. New York
- T-33. Florida
- T-33. Nevada
- Lowest
- 1. Mississippi
- 2. South Dakota
- 3. Arkansas
- 4. Missouri
- 5. Kentucky
- Highest
- 47. Connecticut
- 48. Rhode Island
- T-49. Washington
- T-49. Massachusetts
- T-49. District of Columbia
- Lowest
- 1. Vermont
- 2. California
- 3. Massachusetts
- 4. New Jersey
- 5. New York
- Highest
- 47. South Dakota
- 48. Arkansas
- 49. Louisiana
- 50. West Virginia
- 51. Mississippi
- Most
- T-1. Delaware
- T-1. Montana
- 3. Vermont
- 4. Connecticut
- 5. New Hampshire
- Fewest
- 47. Oklahoma
- 48. Mississippi
- 49. Missouri
- 50. Louisiana
- 51. Kansas
- Most
- 1. Alaska
- 2. Vermont
- 3. New Hampshire
- 4. Delaware
- 5. Minnesota
- Fewest
- 47. West Virginia
- 48. Washington
- 49. Utah
- 50. Kansas
- 51. Louisiana
- Most
- T-1. Vermont
- T-1. Colorado
- T-1. Montana
- T-1. Tennessee
- 5. Alaska
- Fewest
- 47. Washington
- 48. Texas
- 49. West Virginia
- 50. Nevada
- 51. Utah
Ask the Experts
Parenthood readiness requires financial preparedness. To help expectant parents with the planning process and provide policy insight to local governments, we asked a panel of experts to weigh in with their thoughts on the following key questions:
- When planning to have a child, what financial considerations should parents take into account?
- What is the biggest financial mistake that prospective parents make?
- What can local authorities do to make their cities more baby-friendly?
- What makes low-income children in some cities do better than those in other cities?
- What drives the birth rate to be in a continuing downward trend in the U.S?
Ask the Experts
Chair of Sociology & Anthropology and Associate Professor – Fordham University
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Ph.D. – Associate Professor of International Studies – Rhodes College
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Professor of Sociology, Senior Demographer, Carsey School, University of New Hampshire, Andrew Carnegie Fellow
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Ph.D., ABPP, Professor and Chair of Psychology, Department of Psychology, Roosevelt University
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Ph.D., CFLE, LMFT, Professor – College of Allied Health and Nursing, Minnesota State University, Mankato
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Ph.D., M.S.W., Assistant Professor – University of Iowa School of Social Work
Read More
Methodology
In order to determine the best and worst states to have a baby, WalletHub compared the 50 states and the District of Columbia across four key dimensions: 1) Cost, 2) Health Care, 3) Baby-Friendliness and 4) Family-Friendliness.
We evaluated those dimensions using 32 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the most favorable conditions for expectant parents and newborns.
Finally, we determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order our sample.
Cost – Total Points: 20
- Hospital Cesarean-Delivery Charges: Full Weight (~2.86 Points)
- Hospital Conventional-Delivery Charges: Full Weight (~2.86 Points)
- Average Annual Cost of Early Child Care: Full Weight (~2.86 Points)
- Average Health-Insurance Premiums: Full Weight (~2.86 Points)
- Current Status of Medicaid Expansion Decision: Full Weight (~2.86 Points)
Note: We included this metric because Medicaid Expansion helps cover a greater amount of birthing costs. - Cost of Babysitter/Nanny: Full Weight (~2.86 Points)
- Cost of Newborn Screening: Full Weight (~2.86 Points)
Health Care- Total Points: 40
- Percentage of Residents Who Are Fully Vaccinated Against COVID-19: Double Weight (~4.38 Points)
- Infant Mortality Rate (per 1,000 Live Births): Full Weight (~2.19 Points)
- Maternal Mortality Ratio (per 100,000 Live Births): Full Weight (~2.19 Points)
- Rate of Low Birth-Weight: Full Weight (~2.19 Points)
- Rate of Preterm Births: Full Weight (~2.19 Points)
- Low or Very Low Food Security for Babies: Full Weight (~2.19 Points)
- Share of Children with All Seven Recommended Vaccines: Full Weight (~2.19 Points)
Note: “Recommended vaccines” include the following: DTaP vaccine; polio vaccine; measles, mumps and rubella (MMR) vaccine; Haemophilus influenzae type b (Hib) vaccine; varicella (chicken pox) vaccine; hepatitis B (HepB) vaccine; and pneumococcal conjugate vaccine (PCV). “Children” include the population aged 0 to 35 months. - Quality of Women’s Hospitals: Full Weight (~2.19 Points)
Note: This metric is based on U.S. News & World Report’s “Best Hospitals for Gynecology” score. - Quality of Pediatric Neonatology Facilities: Full Weight (~2.19 Points)
Note: This metric is based on U.S. News & World Report’s “Best Hospitals for Pediatric Neonatology” score. - Midwives & Obstetrician-Gynecologists per Capita: Full Weight (~2.19 Points)
- Pediatricians & Family Doctors per Capita: Full Weight (~2.19 Points)
- Fertility Clinics per Capita: Quarter Weight (~0.55 Points)
- mPINC Survey Score: Full Weight (~2.19 Points)
Note: The mPINC (Maternity Practices in Infant Nutrition and Care) survey is a national survey conducted by the Centers for Disease Control and Prevention “to monitor and examine changes in practices over time at all hospitals and birth centers with registered maternity beds in the United States and Territories.” - Prenatal Care Access: Full Weight (~2.19 Points)
- Share of Children Aged 9-35 Months who Received Developmental Screening using a Parent-Completed Screening Tool: Full Weight (~2.19 Points)
Note: A parent-completed screening tool is a survey given to parents that may help identify developmental delays in their children. - Rate of Postpartum Depression: Full Weight (~2.19 Points)
Note: This metric measures the percentage of women with a recent live birth who reported experiencing depressive symptoms. - State Medicaid Policy for Maternal Depression Screening in Well-Child Visits: Full Weight (~2.19 Points)
Note: This binary metric measures if a state has or does not have a policy regarding maternal depression screening in well-child visits. - State Policy for Medicaid-Covered Dyadic Treatment: Full Weight (~2.19 Points)
Note: This binary metric measures if a state has or does not have a Medicaid-covered dyadic (parent-child) treatment.
Baby-Friendliness - Total Points: 20
- Parental-Leave Policy Score: Double Weight (~5.71 Points)
- Mom Groups per Capita: Full Weight (~2.86 Points)
- Child-Care Centers per Capita: Full Weight (~2.86 Points)
- Share of Nationally Accredited Child-Care Centers: Full Weight (~2.86 Points)
- Birth Rate: Full Weight (~2.86 Points)
- State Policy for Medicaid-Covered Parenting Programs: Full Weight (~2.86 Points)
Note: This binary metric measures if a state has or does not have a Medicaid-covered parenting programs.
Family-Friendliness - Total Points: 20
- Family-Friendliness: Full Weight (~20.00 Points)
Note: This metric is based on WalletHub’s “Best & Worst States to Raise a Family” ranking.
Sources: Data used to create this ranking were collected from the U.S. Census Bureau, Bureau of Labor Statistics, Healthcare Cost and Utilization Project, U.S. News & World Report, Centers for Disease Control and Prevention, Association of Public Health Laboratories, Data Resource Center for Child & Adolescent Health, The National Academy for State Health Policy - Healthy Child Development State Resource Center, National Center for Children in Poverty, Child Care Aware of America, Kaiser Family Foundation, Indeed, United Health Foundation, National Partnership for Women & Families, ZeroToThree.org, BabyCenter.com and WalletHub research.
Supporting Video Files:
- YouTube - National (for web embedding)
- YouTube - Massachusetts (for web embedding)
- Raw video files (for editing into clips)
UPDATE: On Aug 8th at 8pm ET we corrected the "Percentage of Residents Who Are Fully Vaccinated Against COVID-19" metric, which changed the rankings. Instead of the smallest percentage awarding more points, the largest percentage now leads to a better score.