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a cce s s H ea l t h N ews . n e t Fe b r u a ry 2 0 2 6 Volume 11 | Issue No. 104 17 Both hospitals took personnel action. Franciscan Health Crown Point fired the doctor and nurse involved in Wells's care. Dallas Regional Medical Center said the employee involved with Jones is no longer employed at the facility. But the incidents reflect deeper systemic failures that March of Dimes has documented year after year—failures that help explain why the grade has not improved. What the Grade Actually Measures The D+ reflects the national preterm birth rate, defined as babies born before 37 weeks of pregnancy. Preterm birth is the leading cause of infant death in the United States and contributes to long-term health complications. March of Dimes set a goal of an 8.1% preterm birth rate. The current 10.4% rate means the country is falling nearly 30% short of that target. One in 10 babies born in America is born too early. That translates to more than 370,000 preterm births in 2023. The infant mortality rate rose to 5.6 deaths per 1,000 live births in 2023, up from 5.4 the previous year, representing the largest jump in more than two decades. More than 20,000 babies died before their first birthday. The maternal mortality picture shows similar stagnation. While the overall rate decreased to 18.6 deaths per 100,000 live births in 2023, down from a pandemic high of 32.9 in 2021, the rate remains higher than it was in 2018. According to the Centers for Disease Control and Prevention (CDC), more than 60% of pregnancy-related deaths are preventable. The Drivers That Won't Change March of Dimes identifies consistent factors driving poor outcomes, and those factors have worsened rather than improved over the past four years. Inadequate prenatal care reached its highest level in a decade in 2023. The rate rose to 15.7%, meaning nearly one in six pregnant women either received care starting after their fifth month of pregnancy or had less than half of the recommended visits. The rate was even higher among Black and American Indian/Alaska Native communities. Research shows that lack of adequate prenatal care is linked to a 9% increase in the rate of preterm birth compared to those who receive adequate care. March of Dimes calls for expanding and extending Medicaid coverage, increasing access to quality prenatal care and establishing environmental safeguards to protect at-risk communities.