Vermont has earned an extraordinary distinction for its commitment to maternal and infant health, becoming the only state in the nation to receive an “A” grade on the . This achievement reflects the state’s ongoing efforts to improve outcomes for birthing parents and babies, setting a new standard for quality care across the country.
A Commitment to Healthy Beginnings
The March of Dimes Report Card evaluates maternal and infant health in all 50 states, using such key indicators as preterm birth rates, access to prenatal care, and the availability of resources for maternal and infant health. Vermont’s “A” grade is a clear indication of its exceptional performance in these areas, showcasing the state’s proactive approach to reducing disparities and ensuring that all birthing parents and babies receive the care they need for a healthy start.
Key Achievements Driving Vermont’s Success
Several factors have contributed to Vermont’s top grade, including the following:
Preterm Birth Rate - Vermont’s preterm birth rate of 7.7 percent in 2023 is notably lower than the national average. As one of the most critical indicators of maternal and infant health, Vermont’s efforts to reduce this rate have had a significant impact on improving birth outcomes.
Infant Mortality - With an infant mortality rate of 4.9 deaths per 1,000 live births, Vermont ranks among the best in the nation. While the national infant mortality rate has increased in recent years, Vermont has remained a leader in keeping infants healthy, with birth defects and preterm birth accounting for the majority of infant deaths in the state.
Low-Risk Cesarean Births – Vermont’s rate of low-risk cesarean births was 23.7 percent in 2023, well below the national average of 26.6 percent. This demonstrates the state’s efforts to ensure that births are as safe as possible by avoiding unnecessary cesarean sections, which can lead to complications for both mothers and babies.
Progressive Health Care Policies - Vermont has adopted several policies that support maternal and infant health, such as Medicaid expansion, which improves access to preventive care, and a paid family leave policy, which helps families during parental leave. These initiatives ensure that all families have the support they need to thrive during pregnancy and beyond.
Early Recognition and Outreach
A crucial component of Vermont’s success in maternal and infant health is the early recognition of high-risk pregnancies. Hospitals across the state are trained by experts from the to identify and manage conditions, such as preeclampsia, hypertension, diabetes, and substance use disorders. This outreach not only helps health care providers recognize the risks early but also increases awareness among birthing parents about the factors that can lead to high-risk situations.
“Clinicians in the division of neonatal-perinatal medicine participate in outreach and skills trainings on site at all birthing hospitals in the state, teaching the newest methods for neonatal resuscitation and stabilization to improve outcomes,” said neonatologist Deirdre O’Reilly, M.D., M.P.H., Larner associate professor of pediatrics. “The VCHIP NeoSim program is aimed at providing community hospitals with a direct line of communication with the physicians and advanced practice providers that staff the NICU to guide their care when unexpected circumstances around the birth of an infant arise.”
A Comprehensive Approach to Preventive Care
The and the ̽̽ Health Network have been instrumental in promoting pre-pregnancy care, which includes preconception counseling, lifestyle modifications, and education on environmental exposures. In addition, Vermont’s midwifery policy is integrated into obstetric practices across the state. Certified nurse midwives have been shown to improve birth and maternal outcomes, further solidifying Vermont’s comprehensive approach to maternal and infant health.
Overcoming Rural Health Care Challenges
One of the most impressive aspects of Vermont’s success is its ability to achieve these outcomes despite a large rural population. Access to care in underserved rural areas can be challenging, but the coordinated efforts of VCHIP and the ̽̽ Health Network have helped overcome these barriers. Through a well-organized referral network and outreach programs, the state ensures that all patients, regardless of location, can access the best possible care.
The Importance of Post-Pregnancy Care
Maintaining maternal and infant health doesn’t end at birth. Experts like Marjorie Meyer, M.D., division director of maternal fetal medicine at the ̽̽ Medical Center and professor of obstetrics, gynecology, and reproductive sciences at the Larner College of Medicine, emphasize the importance of post-pregnancy care, particularly for those planning subsequent pregnancies. While the March of Dimes Report Card does not specifically address post-pregnancy care, Meyer underscores its importance as a vital part of the reproductive care continuum within Vermont’s health care system.
“Research over the last few years has underscored the importance of excellent maternal health prior to pregnancy to optimize pregnancy outcomes,” stated Meyer. “Vermont has maintained expanded Medicaid coverage in general and extended coverage to a year after birth. Pregnancy care for the healthiest pregnancy really starts before conception.”
A Model for the Nation
Vermont’s “A” grade on the March of Dimes Report Card stands as a testament to the outstanding work of organizations like the Larner College of Medicine at ̽̽, VCHIP, and the ̽̽ Health Network. These institutions have set a new benchmark for maternal and infant health, not just in Vermont, but across the United States. While challenges remain in other states, Vermont’s success proves that comprehensive health care policies, community involvement, and environmental considerations can drive significant improvements in health outcomes.
While Vermont has made tremendous progress, both O’Reilly and Meyer agree that the work is far from complete. The state remains committed to further reducing disparities in maternal and infant health, addressing the social determinants of health, and continuing to expand access to care for all families. Vermont’s “A” grade is not just a reflection of its past achievements but a foundation for future improvements, ensuring healthier lives for generations to come.