September 28, 2026
FOR IMMEDIATE RELEASE
WOODLAND PARK, NJ – Fronzuto Law Group analyzed data from the CDC and found that birth-related health challenges are heavily concentrated in the American South, home to 19 of the 20 U.S. counties where mothers and babies face the greatest risks during pregnancy and delivery. The study scores 362 counties on a custom composite index built from CDC WONDER natality data for 2020 through 2024, drawing on four indicators: preterm birth, low birth weight, late or no prenatal care, and C-section delivery rates.
In 2024, more than 3.6 million babies were born in the United States. Most pregnancies progress without major complications, but hundreds of thousands of families each year face deliveries that carry a higher-than-normal risk. Preterm birth, low birth weight, and delayed prenatal care can each signal a higher-risk pregnancy and may carry lifelong consequences for a child, while the C-section rate can reflect the complexity of a delivery as well as appropriate medical care.
Caddo Parish, Louisiana, ranks first among the 362 counties analyzed, with an index score of 81.58, a preterm birth rate of 17.8%, and a C-section rate of 37.1%. Hinds County, Mississippi, ranks second at 81.19, recording the highest preterm birth rate in the study at 18.0%. Clayton County, Georgia; Montgomery County, Alabama; and St. Louis city, Missouri, round out the top five.
Among the highest-ranked counties, Georgia appears most frequently, followed by Louisiana. Some counties stand out on a single measure: Yuma County, Arizona, and Washington County, Arkansas, reported exceptionally high rates of late or no prenatal care, at 17.6% and 16.2% respectively, more than double the national figure. Nationally in 2024, preterm births accounted for 10.4% of deliveries, 8.52% of babies were born at a low birth weight, 7.3% of mothers received late or no prenatal care, and 32.4% of births were delivered by C-section. Counties ranking high in the analysis tend to exceed several of these figures at once.
The challenge is not limited to rural areas. Several top-ranked counties, including St. Louis city, Shelby County, Philadelphia County, and Bronx County, are major urban centers that also report high rates of late or no prenatal care. According to the study, the common thread is not solely geography but economic conditions and a shortage of local obstetric providers. For rural mothers, limited access to nearby obstetricians is linked to more missed appointments, and many urban areas are losing obstetric services as well, making it harder to identify and manage complications before birth.
To build the index, researchers included only counties with at least 10,000 births over the five-year period, a threshold set to reduce volatility in the rates, leaving 362 counties. The index weighted preterm birth and low birth weight at 30% each because both directly indicate infant health risk, late or no prenatal care at 25%, and the C-section rate at 15%, since a Cesarean can reflect medically necessary care as well as delivery complexity.
Although New Jersey performs near the national average on several measures, the study found substantial differences within the state. Essex County, home to Newark, is the only New Jersey county to rank among the national top 50, placing 47th. It also tops the state's own index, at 92.92, far above the lowest-scoring county, Ocean, at 53.02. Passaic County ranks second in New Jersey, with a C-section rate of 39.7%, followed by Cumberland, Camden, and Mercer counties. Essex and Passaic are densely populated urban centers, while Cumberland and Essex are among the counties with the highest poverty rates in the state, a pattern the study ties to the same disparities in economic conditions and access to care seen nationally.
"Where a mother lives should not determine whether her pregnancy is safe, but this data shows it often does," said Ernest P. Fronzuto, Managing Partner of Fronzuto Law Group. "While many of the locations cited in the study are rural areas where prenatal care is hard to reach, and labor and delivery units have closed, there are others in urban areas - like Newark or Paterson, New Jersey - where the resources are more expansive, but the rate of inadequate prenatal care remains too high. Sadly, the delivery of quality care is not based solely on geography, but also the socioeconomic conditions of the patient population. When a mother in one of these places does receive substandard care, the margin for error is already gone, and a child can suffer the consequences for the rest of their life."
A county's ranking reflects population-level health indicators and does not establish that medical negligence occurred in any individual case.
The full study can be viewed on Fronzuto Law Group's website here: https://www.fronzutolaw.com/research-studies/the-50-us-counties-facing-the-greatest-birth-related-health-challenges/
About Fronzuto Law Group
Fronzuto Law Group is a New Jersey law firm serving clients in New Jersey and New York in medical malpractice matters, with a primary emphasis on birth injury and pediatric malpractice cases. The firm offers free consultations. Learn more at fronzutolaw.com.
About Ernest P. Fronzuto
Ernest P. Fronzuto is the Managing Partner of Fronzuto Law Group. Mr. Fronzuto has been Certified by the Supreme Court of New Jersey as a Civil Trial attorney since 2006. His practice (and that of the Firm) is dedicated exclusively in representing individuals injured as the result of medical malpractice, with a primary emphasis on birth injury and pediatric malpractice cases. Over the course of his career, he has counseled hundreds of families with children that have suffered birth related injuries.
Media Contact:
Samantha Kessler
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