Alabama continues to have one of the nation’s highest rates of babies being born too early, according to a recent report by March of Dimes.

The annual report, which looks at preterm births and other maternal health outcomes, again gave Alabama an F grade. The state ranked 49th of 52 in the rankings, which include Puerto Rico and Washington D.C.

“Every baby deserves the chance for a healthy start, yet the data continue to show unacceptable health outcomes for far too many families,” said Cindy Rahman, the interim president and CEO of March of Dimes, in a press release.

The state’s preterm birth rate was 12.9% in 2023, according to the report. The national average is 10.4%.

The preterm birth rate measures how many babies were born too early due to factors like pregnancy complications, chronic medical conditions or socioeconomic circumstances.

The report also found a high maternal mortality rate in Alabama – 38.6 deaths per 100,000 births. That’s significantly higher than the national average of 23.2 deaths.

Alabama also had a higher percentage of low-risk cesarean births at over 28%, compared to 26.6% nationally.

And 18.1% of women in Alabama reported inadequate access to prenatal care compared to 15.7% nationally.

The March of Dimes report found that Alabama can improve health outcomes for moms and babies by expanding Medicaid to allow for greater access to preventative care during pregnancy, and by implementing more supportive midwife and doula policies.

More than half of the state’s counties — 38 out of 67 — don’t have hospitals providing obstetrics services, like labor and delivery. All of those counties are rural.

Federal government officials were in Centreville in Bibb County on Thursday to meet with mothers and doctors about solutions to the maternal health care crisis.

A roundtable discussion, hosted by the U.S. Department of Health and Human Services, focused on federally funded initiatives in the state, like the Maternal, Infant, and Early Childhood Home Visiting program and a maternal mental health hotline.

The home visit program sends trained professionals to help families in all 67 counties of Alabama, free of charge. The professionals help with education, health screenings, evaluating their social support needs, and helping them access local services.

Alabama received $8.2 million dollars this year to support the program.

The roundtable also touted the success of Cahaba Medical Care, a federally funded clinic that provides care to uninsured and underinsured patients in West Alabama.

“I live about 30 to 40 minutes away [from a hospital], but having everything here, it’s a one stop shop, it has made my experience so so easy,” said Madison Panther, who got care at Cahaba.

She said her newborn and her toddler can get treatment at the clinic, as well.

“All three of us can be seen so I’m not running around to different doctor’s offices,” Panther said, “and just knowing they’ll actually listen to you makes it worth it.”

Michael Warren, the associate administrator at the maternal and child bureau of HHS, said he expects these programs to continue after the Trump administration begins in January.

“These are long standing programs that have sustained throughout multiple administrations and have had a lot of success in places like Alabama,” he told AL.com.

Other stakeholders at the discussion included Dr. Scott Harris, Alabama’s state health officer, doctors from the University of Alabama at Birmingham, members of the state’s Maternal Health Taskforce, and representatives from Tuskegee University’s Research Center for Maternal, Child and Family Equity.

“When we look at how to close the gaps in maternal health care, the only way we can is if we all collaborate and work together,” said Dr. Claudette Poole, the medical director at UAB’s Family Clinic.