Texas might be a family friendly state, but it certainly isn't baby friendly, according to a new WalletHub study.

Texas earned a dismal rank as No. 45 in WalletHub's 2026 report "Best and Worst States to Have a Baby," which compared all 50 states and the District of Columbia based on 31 "baby friendliness" metrics, such as affordability, health care accessibility, infant care costs, and others.

The top five best states to have a baby, in order, are: Massachusetts, Minnesota, North Dakota, Rhode Island, and New Hampshire.

Texas ranked 7th worst overall in the U.S. because of how expensive it is to have a child in the state, and because of its low prevalence of healthcare professionals for mothers and children relative to other states.

Across the four main categories in the report, Texas landed 47th nationally for its medical costs, 42nd in healthcare quality, and its baby- and family-friendliness both ranked 34th best in the country.

WalletHub says the average cost for a conventional delivery in the U.S. comes out to more than $15,700, and families with health insurance have an average out-of-pocket cost of about $2,600. The report doesn't break down state-by-state charges, but it ranked Texas 35th and 36th respectively in the national comparisons of states with the lowest costs for hospital cesarean and conventional deliveries.

The cost of childcare is another factor bringing down the state's overall performance, as WalletHub says Texas has the 23rd "best" annual cost of early childcare on average.

Here's how the report broke down the rest of Texas' ranking:

• No. 27 – Parental leave policy score
• No. 27 – Infant mortality rate
• No. 28 – Rate of low-birth weight
• No. 44 – Midwives and OB-GYNs per capita
• No. 36 – Pediatricians and family medicine physicians per capita
• No. 33 – Childcare centers per capita

"[The best states] also continue to be good environments for parents even long after the birth, with high-quality pediatric care, affordable and accessible child care, and a strong economic environment that makes providing for a child easier,” Lupo said.

Mississippi (No. 51), Alabama (No. 50), Florida (No. 49), New Mexico (No. 48), Nevada (No. 47), and South Carolina (No. 46) all join Texas at the bottom of the list as the worst states to have a baby.