6 Alarming Facts About South Dakota’s Maternal Health Crisis

South Dakota ranks among the worst states in the country for rural maternal and infant health, and the situation is deteriorating fast. Here’s what the data—and South Dakota families—are revealing.

1. Dozens of South Dakota mothers have died in the past decade

From 2014 to 2023, 79 women died during or shortly after pregnancy, according to the South Dakota Department of Health. That’s a rate of 68.7 deaths per 100,000 live births, nearly double the national average (South Dakota Department of Health, “2024 Infant Mortality Report”).

2. Native American women face a death rate five times higher than white women

The Department of Health reports a maternal mortality rate of 184.6 deaths per 100,000 live births for American Indian women, compared with 39.0 per 100,000 for white mothers (“2024 Infant Mortality Report,” SD DOH).

3. Infant mortality is nearly triple in Native communities

South Dakota’s overall infant mortality rate was 7.8 per 1,000 live births in 2022–2023, according to provisional state data. But in Native American communities, that figure jumps to 20.5 per 1,000 (SD DOH, “2024 Infant Mortality Report”).

4. Most counties have no labor and delivery services

According to the March of Dimes’ 2023 Maternity Care Deserts Report, 56.1 percent of South Dakota counties qualify as maternity care deserts—places with no birthing hospital, birth center, or OB-GYN. That’s compared to a national average of 32.6 percent. The South Dakota Office of Rural Health confirms that only 17 of the state’s 49 rural hospitals still provide labor and delivery care.

Expectant mother Sophie Hofeldt was forced to travel more than 90 miles round trip for prenatal visits after Winner Regional Health closed its OB unit in early 2025. “My main concern is having to give birth in a car,” Hofeldt told Northern Plains News in April 2025.

5. Rural families face compounding risks

The state’s own health department notes a cluster of red flags in its 2022 data:

– 7.1 percent of babies born underweight

– 2 percent of pregnant women received no prenatal care

– 10 percent of infants admitted to NICUs

– 30 percent of mothers relied on Medicaid or Indian Health Services

(South Dakota Department of Health, “2024 Infant Mortality Report”)

6. The state has a task force—but no policy fixes yet

The South Dakota Department of Health launched a Maternal and Infant Health Task Force and published the 2024 Infant Mortality Report to guide future improvements. However, as of June 2025, no legislation has been introduced to address Medicaid reimbursement, rural hospital support, or maternity transport systems. That’s according to DOH public records and S.D. Legislative Research Council, 2025 session archives.

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