Durham is moving in the right direction.
While maternal and infant health outcomes across the nation continue to worsen, the newest March of Dimes Report Card suggests something different may be happening here at home. Durham’s preterm birth trend is stabilizing — and early signals point to gradual improvement. Why? We believe it’s because Durham is one of the only counties 8 years into implementing the Ten Steps to a Breastfeeding Family Friendly Community.
Here’s what the new report card reveals about North Carolina — and why Durham’s local systems may be making a measurable difference.
North Carolina: Persistent Challenges
Statewide, the 2025 report shows:
- Preterm birth: 10.7% (unchanged)
- Infant mortality: 6.9 deaths per 1,000 births
- Severe maternal morbidity: 91 per 10,000 hospital deliveries
- Maternal mortality: 29.8 deaths per 100,000 births
March-of-Dimes-North-Carolina-C…
North Carolina continues to face wide disparities in prenatal care. Only 72.3% of families begin care in the first trimester, and rates of inadequate prenatal care range from 13% among White families to 33.9% among Pacific Islander families.
Durham: A Different Trend
Durham County’s trend line over recent years shows something important:
- 2022: Preterm birth at 10.3%
- 2023: 10.7%, mirroring the state average
- 2024–2025: Early local indications suggest stabilization, with key partners reporting more consistent access to lactation support, doula care, CHW outreach, and coordinated postpartum follow-up.
While final county data are not yet published, community partners across Durham note improvements in care continuity, feeding support, and parent engagement — all protective factors for maternal and infant health.
Why Might Durham Be Improving?
Durham is not simply “holding steady.” The county has spent years building a coordinated ecosystem for families:
- A Human Milk Feeding Strategic Plan
- Robust collaboration through Breastfeed Durham, NCBC, and ICO4MCH
- Strong networks of doulas, CHWs, IBCLCs, and peer counselors
- Increasing breastfeeding-friendly workplaces and childcare centers
- Cross-sector alignment on supporting families before, during, and after birth
Many local leaders believe these efforts align directly with the Ten Steps to a Breastfeeding Family Friendly Community — a framework designed to improve maternal-infant health at the population level.
The Equity Story
Even with signs of progress, significant inequities remain:
- Black infants and birthing people continue to face disproportionately high risks.
- Access barriers and chronic stress still shape outcomes for many families.
Durham’s growing strengths do not erase these inequities — but they create a foundation for addressing them more directly.
What Comes Next
Durham is preparing for its next chapter in maternal-infant health systems work, including:
- Strengthening emergency-prepared infant feeding systems
- Expanding free and low-cost lactation clinics
- Increasing business and childcare center engagement
- Supporting workplaces to adopt lactation-protective policies
- Deepening the Human Milk Feeding Strategic Plan with county partners
Durham’s early improvements show that local systems change matters — and that the Ten Steps may be one of the most important tools we have for protecting families.