Adam McCann, Financial Writer

Aug 10, 2020

Having a baby is both a joyful and stressful occasion – but the stress side is more amplified in 2020 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. In addition, due to social distancing, some mothers may receive less after-birth support from friends and family.

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 over $10,000. Whether or not you have insurance naturally plays a big role as well.

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 32 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. Read on for our findings, expert insight from a panel of researchers and a full description of our methodology.

Main Findings

Best States to Have a Baby

Overall Rank

(1 = Best) State Total Score ‘Cost’ Rank ‘Health Care’ Rank ‘Baby-Friendliness’ Rank ‘Family-Friendliness’ Rank 1 Massachusetts 68.81 28 2 4 2 2 Minnesota 66.70 21 6 6 1 3 Vermont 64.50 36 1 22 4 4 North Dakota 64.19 1 14 23 3 5 Rhode Island 63.35 29 5 2 14 6 New Hampshire 63.15 4 4 48 5 7 District of Columbia 61.20 14 29 1 N/A 8 Maine 60.15 22 3 14 18 9 Washington 59.46 43 13 3 10 10 Connecticut 59.32 40 7 15 9 11 Oregon 56.11 11 8 7 27 12 New Jersey 55.32 49 32 5 7 13 Hawaii 55.26 23 10 9 23 14 Colorado 54.93 42 11 10 15 15 Iowa 54.88 16 16 31 12 16 New York 54.62 48 15 24 6 17 Utah 52.32 10 36 13 19 18 Nebraska 52.26 26 28 46 8 19 South Dakota 51.69 37 19 37 11 20 Illinois 49.86 33 17 38 16 21 Michigan 49.35 8 18 20 34 22 Montana 49.32 20 23 26 22 23 Wisconsin 49.14 47 30 25 13 24 Wyoming 48.99 50 24 11 21 25 Maryland 48.59 6 26 28 30 26 Pennsylvania 48.37 5 21 47 24 27 Virginia 48.34 30 20 39 20 28 Ohio 48.13 3 27 33 28 29 California 47.66 51 35 8 17 30 Idaho 47.39 13 34 12 29 31 Delaware 46.79 24 9 40 31 32 Kentucky 46.44 9 31 17 36 33 Kansas 45.82 34 25 29 25 34 Alaska 45.60 35 12 19 35 35 Indiana 41.07 18 40 36 32 36 Missouri 40.82 31 38 44 26 37 New Mexico 38.76 15 33 16 50 38 West Virginia 37.77 17 22 49 47 39 Tennessee 37.65 41 37 21 37 40 Arizona 36.88 25 45 18 41 41 Texas 36.51 39 43 34 33 42 Nevada 35.74 32 41 30 40 43 Oklahoma 35.11 19 44 35 44 44 North Carolina 34.31 45 39 43 38 45 Florida 34.09 46 42 32 39 46 Arkansas 33.01 7 51 27 45 47 Georgia 30.17 27 47 42 42 48 Louisiana 29.02 2 50 45 48 49 Mississippi 27.82 12 49 41 49 50 South Carolina 27.21 44 46 50 43 51 Alabama 25.25 38 48 51 46

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?

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 32 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

WalletHub “States with the Best Health Infrastructure for Coronavirus” Score: Triple Weight (~5.65 Points)

Note: This metric is based on WalletHub’s “ States with the Best Health Infrastructure for Coronavirus ” ranking.

Positive COVID-19 Testing Rate of Last 4 Weeks: Triple Weight (~5.65 Points)

Note: This metric represents the average weekly positive COVID-19 testing rate of last 4 weeks per 100,000 population.

Infant Mortality Rate (per 1,000 Live Births): Full Weight (~1.88 Points)

Maternal Mortality Ratio (per 100,000 Live Births): Full Weight (~1.88 Points)

Rate of Low Birth-Weight: Full Weight (~1.88 Points)

Rate of Preterm Births: Full Weight (~1.88 Points)

Low or Very Low Food Security for Babies: Full Weight (~1.88 Points)

Share of Children with All Seven Recommended Vaccines: Full Weight (~1.88 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 (~1.88 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 (~1.88 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 (~1.88 Points)

Pediatricians & Family Doctors per Capita: Full Weight (~1.88 Points)

Fertility Clinics per Capita: Quarter Weight (~0.47 Points)

mPINC Survey Score: Full Weight (~1.88 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 (~1.88 Points)

Share of Children Aged 9-35 Months who Received Developmental Screening using a Parent-Completed Screening Tool: Full Weight (~1.88 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 (~1.88 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 (~1.88 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

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, The COVID Tracking Project, Indeed, United Health Foundation, National Partnership for Women & Families, ZeroToThree.org, BabyCenter.com and WalletHub research.

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