Babies who come into the world just three weeks pre-term often face a number of challenges. Their lungs and brains aren't fully developed and they may be sicker than full-term babies.
That realization among doctors nationwide has lead to a slow, downward shift in the trend of scheduling early births for convenience, rather than medical emergency.
Dr. Alan Fleischman, medical director for the March of Dimes, said, "Every baby now is being looked at carefully to make sure there aren't elective inductions or unnecessary c-sections."
The March of Dimes just released its annual "Premature Birth Report Card." The United States earned a "C" grade.
In 2009, the nation's birth rate was 12.2 percent, a decrease from a high of 12.8 percent in 2006.
"We believe we can bring that rate down to 9.6 percent by 2020."
The March of Dimes credits the overall improvement in the nation's preterm birth rate in part to fewer elective early deliveries.
But the March of Dimes has also noted a decrease in smoking and an increase in health care coverage among women of childbearing age.
Vermont was the only state to receive an "A."
"All of the hospitals in Vermont have collaborated in a robust quality improvement program to make sure that every birth is indicated and there are no early births except those that are medically necessary."
Three states earned an "F." These states are Alabama, Louisiana and Mississippi.