Having a baby is both a joyful and stressful occasion – but the stress side is more amplified in 2021 during 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 around $4,500 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 31 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 | 71.70 | 35 | 2 | 3 | 1 |
| 2 | Minnesota | 66.90 | 22 | 6 | 11 | 2 |
| 3 | District of Columbia | 66.79 | 19 | 10 | 1 | N/A |
| 4 | New Hampshire | 66.57 | 4 | 3 | 43 | 6 |
| 5 | Vermont | 65.99 | 39 | 1 | 25 | 5 |
| 6 | North Dakota | 64.40 | 2 | 18 | 23 | 3 |
| 7 | Connecticut | 62.10 | 46 | 5 | 13 | 9 |
| 8 | Washington | 61.41 | 43 | 12 | 4 | 8 |
| 9 | New York | 58.05 | 41 | 15 | 22 | 4 |
| 10 | Hawaii | 57.99 | 31 | 13 | 2 | 20 |
| 11 | Rhode Island | 57.83 | 36 | 4 | 5 | 24 |
| 12 | Iowa | 57.72 | 10 | 17 | 33 | 12 |
| 13 | New Jersey | 57.51 | 49 | 25 | 7 | 7 |
| 14 | Oregon | 57.11 | 24 | 16 | 8 | 21 |
| 15 | Maine | 57.05 | 18 | 8 | 24 | 18 |
| 16 | Utah | 55.99 | 8 | 41 | 16 | 10 |
| 17 | Colorado | 55.66 | 45 | 24 | 6 | 15 |
| 18 | Maryland | 55.31 | 5 | 14 | 35 | 22 |
| 19 | Montana | 54.94 | 9 | 27 | 14 | 19 |
| 20 | Illinois | 54.88 | 34 | 7 | 32 | 16 |
| 21 | Virginia | 53.99 | 26 | 19 | 28 | 17 |
| 22 | Wisconsin | 53.64 | 40 | 23 | 19 | 14 |
| 23 | Nebraska | 52.22 | 25 | 29 | 45 | 11 |
| 24 | Alaska | 52.06 | 29 | 9 | 9 | 33 |
| 25 | Michigan | 50.85 | 6 | 21 | 26 | 31 |
| 26 | Pennsylvania | 50.78 | 11 | 22 | 44 | 23 |
| 27 | South Dakota | 49.99 | 27 | 36 | 39 | 13 |
| 28 | California | 49.88 | 51 | 20 | 10 | 25 |
| 29 | Idaho | 48.58 | 14 | 28 | 12 | 34 |
| 30 | Delaware | 48.38 | 21 | 11 | 40 | 32 |
| 31 | Ohio | 48.27 | 3 | 26 | 37 | 30 |
| 32 | Kentucky | 45.08 | 12 | 37 | 17 | 37 |
| 33 | Kansas | 43.79 | 33 | 34 | 31 | 29 |
| 34 | Texas | 42.35 | 48 | 30 | 38 | 28 |
| 35 | Indiana | 42.18 | 20 | 38 | 34 | 35 |
| 36 | Wyoming | 42.09 | 50 | 40 | 21 | 26 |
| 37 | Missouri | 41.85 | 13 | 48 | 41 | 27 |
| 38 | Tennessee | 41.08 | 38 | 32 | 20 | 39 |
| 39 | New Mexico | 40.73 | 17 | 31 | 15 | 50 |
| 40 | Florida | 38.91 | 47 | 39 | 27 | 36 |
| 41 | Arizona | 38.82 | 28 | 43 | 18 | 42 |
| 42 | North Carolina | 36.94 | 42 | 35 | 47 | 38 |
| 43 | Georgia | 36.30 | 30 | 42 | 42 | 40 |
| 44 | West Virginia | 35.31 | 23 | 33 | 51 | 48 |
| 45 | Oklahoma | 35.01 | 15 | 45 | 36 | 46 |
| 46 | Nevada | 34.84 | 32 | 46 | 29 | 41 |
| 47 | Arkansas | 34.01 | 7 | 51 | 30 | 45 |
| 48 | Louisiana | 33.34 | 1 | 47 | 48 | 47 |
| 49 | South Carolina | 31.94 | 44 | 44 | 49 | 43 |
| 50 | Alabama | 28.95 | 37 | 49 | 46 | 44 |
| 51 | Mississippi | 28.11 | 16 | 50 | 50 | 49 |
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.
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?
- Will children born today do better economically as adults than their parents? How much does location matter?
- What measures can local authorities take to ensure the quality and safety of care for prospective mothers during the current crisis?
Ask the Experts
Ph.D. – Assistant Professor, Human Development and Family Sciences, College of Human Sciences – Texas Tech University
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Ph.D. – Certified Family Life Educator; Professor Emerita, Human Development and Family Studies – Purdue University
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Associate Professor, School of Human Ecology, La Follette School of Public Affairs – University of Wisconsin-Madison
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Ph.D., MSW – MSW Program Director & Associate Professor, School of Social Work – University of Memphis
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Ph.D. – Professor of Psychology Emerita, Psychology Department – University of Notre Dame
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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 31 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
- Positive COVID-19 Testing Rate in the Past Week: Triple Weight (~6.58 Points)
Note: This metric refers to the positive COVID-19 testing rate in the state between June 19, 2021 and June 25, 2021. - 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 19 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. - 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, CELR (COVID-19 Electronic Lab Reporting) and WalletHub research.