It is a statistic that feels like it belongs in another century. For decades, we watched the numbers slide down, a slow but steady march toward better health for the tiniest among us. Then, things stalled. Now, they’re actually ticking back up. The infant mortality rate of America rose by 3% in 2022, marking the first significant increase in over twenty years.
It’s jarring.
Honestly, in a country that spends more on healthcare than any other nation on earth, you’d expect us to be leading the pack. Instead, the U.S. often lags behind other wealthy nations like Japan, Norway, or even Slovenia. When people talk about American exceptionalism, this isn't usually what they have in mind.
The numbers aren't just cold data on a spreadsheet. We are talking about 5.6 deaths per 1,000 live births. It sounds small until you realize that adds up to thousands of families dealing with the unthinkable every single year.
What the numbers actually tell us about the infant mortality rate of America
When the CDC’s National Center for Health Statistics dropped the 2022 data, it sent a shockwave through the medical community. For a long time, the rate hovered or dipped. Seeing it jump from 5.44 to 5.60 per 1,000 births was a wake-up call that something in the system is fundamentally breaking.
Why now?
The "why" is complicated. It isn't just one thing. It's a messy mix of maternal health complications, access to care, and systemic issues that have been simmering for a long time.
If you look at the causes, complications related to the placenta, umbilical cord, and membranes saw a massive 8% spike. Bacterial sepsis in newborns also jumped by 14%. These aren't just "bad luck" scenarios; they are often indicators of the quality of prenatal and immediate postnatal care.
Dr. Danielle Ely, a health statistician at the CDC and lead author of the report, noted that this increase was statistically significant. That’s science-speak for "this isn't a fluke."
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The maternal health connection
You can't talk about babies without talking about moms. The two are inextricably linked.
Maternal mortality in the U.S. is also on a terrifying trajectory. If a mother enters pregnancy with untreated chronic conditions—think hypertension or diabetes—the risk to the infant skyrockets. We’re seeing more "maternity deserts" pop up across the country. These are counties where there isn't a single hospital offering obstetric care, nor is there a single OB-GYN.
If you have to drive two hours for a checkup, you’re probably going to skip a few. That’s where the trouble starts. Small problems that could have been caught in the first trimester turn into life-threatening emergencies by the third.
Breaking down the disparities: It’s not an even playing field
The infant mortality rate of America is not a monolith. It varies wildly depending on who you are and where you live. This is perhaps the most uncomfortable part of the conversation.
Black infants are more than twice as likely to die before their first birthday compared to white infants. This gap has persisted for decades, regardless of the mother’s income or education level. A Black woman with a master's degree is still more likely to lose her baby than a white woman who didn't finish high school.
It’s a systemic failure.
- American Indian and Alaska Native families also face significantly higher rates.
- Geography matters. States in the South generally see much higher rates than those in the Northeast or the West Coast.
- Socioeconomic status plays a role, but it doesn't explain everything.
In Mississippi, the rate has historically been one of the highest in the nation. Meanwhile, in Massachusetts, the numbers look much more like what you’d see in Western Europe. We are essentially living in fifty different countries when it comes to infant health.
Sudden Unexpected Infant Death (SUID)
About 3,400 infants die suddenly and unexpectedly each year in the U.S. These are categorized as SUID, which includes SIDS (Sudden Infant Death Syndrome), accidental suffocation, and unknown causes.
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While we’ve made huge strides since the "Back to Sleep" campaign in the 90s, the progress has leveled off. Safe sleep education is vital, but it’s hard to follow "safe sleep" guidelines if you’re living in unstable housing or working three jobs and can't afford a proper crib.
Comparing the U.S. to the rest of the world
It’s kinda embarrassing when you look at the global rankings.
According to the OECD, the U.S. ranks near the bottom of developed nations. Countries like Finland and Japan have rates closer to 2 per 1,000. Why the massive gap?
In many of these countries, healthcare is a right, not a workplace perk. Home visits from nurses are standard. Paid parental leave isn't a luxury; it’s a given. In the U.S., we often expect moms to head back to work two weeks after a C-section while navigating a labyrinth of insurance paperwork and astronomical daycare costs.
Stress kills. It sounds dramatic, but the physiological toll of poverty and lack of support manifests in birth outcomes.
The role of premature births
The U.S. has a high rate of preterm births. Babies born before 37 weeks have a much harder time surviving.
Advancements in NICU technology are incredible—we can save babies today who wouldn't have stood a chance twenty years ago. But technology is a band-aid. It doesn't solve the problem of why so many babies are being born too early.
Factors like maternal age, IVF (which can lead to multiples), and high rates of obesity and stress contribute. But there’s also the issue of medical intervention. Sometimes, induced labors or scheduled C-sections happen for convenience rather than medical necessity, which can slightly nudge a baby into the "late preterm" category.
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Policy changes and the future of the infant mortality rate of America
If we want to fix this, we have to look at policy.
Expanding Medicaid has been shown to have a direct impact. In states that expanded Medicaid under the Affordable Care Act, infant mortality rates dropped more significantly than in states that didn't. This isn't a political talking point; it's a statistical reality. Coverage matters.
There are also "community doula" programs making a massive dent. By providing continuous support to at-risk mothers, these programs help navigate the healthcare system, provide nutritional advice, and offer emotional support that a busy doctor simply can't provide in a 15-minute appointment.
What can be done right now?
We can't wait for the entire healthcare system to rewrite itself. There are actionable steps that make a difference today.
- Prioritize Preconception Health. Managing blood pressure and blood sugar before getting pregnant is huge.
- Universal Access to Prenatal Care. We need to eliminate the barriers—transportation, cost, and childcare—that keep women from getting to their appointments.
- Support for Mental Health. Postpartum depression and anxiety aren't just "baby blues." They affect a mother's ability to care for herself and her child.
- Invest in Midwifery. In many high-performing countries, midwives handle the majority of low-risk births. This model often leads to fewer interventions and better outcomes.
Actionable insights for a path forward
The infant mortality rate of America is a mirror. It reflects our social priorities, our economic disparities, and the gaps in our compassion.
If you are an expectant parent or someone advocating for change, here is what actually moves the needle:
- Seek early and consistent prenatal care. If you're struggling to find or afford care, look for Federally Qualified Health Centers (FQHCs) which provide services on a sliding scale.
- Advocate for yourself. If something feels "off" during pregnancy or after birth, don't let a provider brush you off. Maternal intuition is backed by biology.
- Focus on safe sleep. Follow the ABCs: Alone, on their Back, in a Crib. No pillows, no blankets, no stuffed animals.
- Support local legislation that funds maternal health programs and expands postpartum Medicaid coverage. Many states have recently moved to extend postpartum coverage from 60 days to a full year, which is a massive win.
We have the technology. We have the resources. What we need is the collective will to ensure that a baby’s zip code or race doesn't determine their chance of seeing their first birthday.
The rise in 2022 was a warning. It’s time to listen.
To improve outcomes, focus on the immediate postnatal period—the "fourth trimester." This is when many complications arise and when families are most vulnerable. Ensuring a follow-up visit within the first week of returning home can catch issues like jaundice or feeding problems before they become critical. Additionally, communities should prioritize creating "safe sleep" awareness campaigns that are culturally sensitive and provide actual resources, like free pack-and-plays, to those in need.