Seven years ago, at 30 weeks into a seemingly low-risk pregnancy, I unexpectedly began to bleed. Doctors diagnosed me with complete placenta previa. Then, while on bed rest at 32 weeks, my placenta suddenly ruptured, leading to an immediate emergency cesarean section.

I became one of about 10% of women giving birth in Nigeria to experience a preterm birth, which means before 37 weeks of pregnancy.

Now, as a maternal and child health researcher in the U.S., I’m struck by the stubbornly high preterm birth rate here. According to the most recent March of Dimes Report Card on maternal and infant health, released on Nov. 17, 2025, 10.4% of babies in the U.S. were born prematurely in 2024.

Preterm birth is the second-leading cause of infant deaths in the U.S., contributing to over 20,000 infant deaths each year. Some who survive are at increased risk of immediate and long-term health problems, with substantial emotional and financial tolls.

That rate has not budged for three years, according to the report – and it is consistently higher than in many other countries, particularly those in the Global North. That’s also true for other crucial aspects of maternal and infant health, such as cardiovascular diseases and mental health needs.

One key factor underlying the problem of preterm birth in the U.S. is extensive disparities in health care access for expectant mothers. In Texas, where I conduct my research and where I managed the state’s maternal mortality and morbidity review committee in 2023 and 2024, this issue plays out very clearly.

The March of Dimes report scored the U.S. overall a D grade on preterm birth rate at 10.4%, but states differ dramatically in their scores. New Hampshire, for example, scored an A- with 7.9% of infants born prematurely, while Mississippi, where 15% of infants are born prematurely, scored an F.

Texas’ rates aren’t........

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