MONTGOMERY, Ala. – Alabama’s infant mortality rate rose slightly to 7.4 deaths per 1,000 live births in 2025, the Alabama Department of Public Health announced Thursday.
Out of the 57,192 babies born in Alabama last year, 422 died before their first birthday. That’s up from 414 deaths in 2024, which made for a rate of 7.1 deaths per 1,000 births. The change from 2024 to 2025 was not statistically significant, the ADPH said in a news release.
Alabama’s infant mortality rate remains high above the national average. The U.S. had a provisional rate of 5.4 in 2025.
Continuing a longstanding trend, the state’s infant mortality rate varied greatly by race last year, with a rate of 13.1 for Black infants, compared with 5.5 for white infants. The “other” racial group also had a rate of 5.5. That means Black infants born in Alabama in 2025 were more than twice as likely to die before their first birthday than babies of any other race.
While the rates for white babies stayed roughly the same and the rate for other groups fell between 2024 and 2025, the rate of 13.1 for Black babies in 2025 was an 11% increase from 2024’s rate of 11.8 for the same group.
State Health Officer Scott Harris said that the state must address factors that negatively impact the health of mothers and babies.
“Reducing infant mortality remains a challenge. Racial disparities persist in birth outcomes; the Black infant mortality rate is disproportionally higher than that of white infants,” Harris said in a statement. “Lack of access to care, closure of labor and delivery services, poverty, poor nutrition, and chronic disease play significant roles in the health of mothers and infants.”
Residents of Washington County in southwest Alabama had the highest infant mortality rate in the state, with 44.6 deaths per 1,000 births. Hale and Sumter counties had the next highest rates at 18.3 and 18.2, respectively. There was no birthing hospital in any of these three counties, according to the ADPH. There were only 42 active birthing hospitals in Alabama in 2025.
Though infant mortality rates ticked up between 2024 and 2025, the percentage of births with adequate prenatal care climbed from 73.9% to 75.7%, and the share of births with no prenatal care fell from 3.1% to 2.8% in the same period.
Rural areas as a whole had a rate of 7.5 last year, compared with urban areas’ rate of 7.3. The ADPH’s Office of Maternal and Child Health defined urban counties as those with a population of 100,000 or more and rural counties as those below that threshold. Alabama had 13 urban and 54 rural counties in 2025.
Though Medicaid covered 35% of all births in 2025, 49% of infants who died before their first birthday had deliveries paid for by Medicaid. Thirty-nine percent of infant deaths were to mothers covered by private insurance, which paid for 56% of all births last year.
The three leading causes of death for Alabama infants were congenital malformations, deformations and abnormalities; issues related to premature births and low birth weight; and sudden infant death syndrome, the ADPH said.
Alabama also has a maternal mortality rate nearly double the national average, which led the ACLU of Alabama to call it the “most dangerous” state in the country to be pregnant or give birth in. Alabama’s maternal mortality rate is 65 deaths per 100,000 births, according to the advocacy organization. That rate was even higher – 100 deaths per 100,000 births – for Black Alabamians.
Outside of the mortality rate, Alabama also marked a historic low in total births to mothers between the ages of 10 and 19 across all racial groups. The share of births to teenagers also hit a historic low of 5.4% in 2025. The total number of live births in Alabama fell from 57,909 to 57,192 between 2024 and 2025.