HUNTSVILLE, Ala. (WHNT) – While most Alabama families embrace the thought of bringing a baby into the world, some might get a second opinion.

Personal finance and analytics website “WalletHub” came out with a new ranking — calling Alabama the worst state to have a baby.

The list uses 32 key measures, including the cost of living, health care accessibility, and baby-friendliness. Final listings put Alabama 46th in both maternal and infant mortality, 49th in low birth weights and 50th in pre-term births. The state also lagged in parental leave policy options and average health insurance premiums.

“There are not enough OBGYNs and Pediatricians per capita in Alabama, to begin with,” said WalletHub Analysts Jill Gonzalez. “They have this retention issue and recruitment issue to getting OBGYN’S there specifically especially in the past couple of months with recent federal changes to the policy.”

One big challenge Alabamians face is immediate access to health care. While it’s easier to find a hospital in booming areas in parts of North Alabama, people who live in some rural eastern cities have to drive hours to get to the nearest clinic.

ADPH District Medical Officer Dr. Wes Stubblefield noted that one of the state’s biggest shortcomings is access to care. “As a state, we have very large geographic areas who have very few providers in some of our rural areas. And in some of our metropolitan areas like the Huntsville Madison area or the Shoals or the Birmingham area, we have plenty of providers.”

For those with access to hospitals for childbirth, medical bills become the next hurdle. The WalletHub report says the average annual cost to give birth with insurance is $3,000. Without it, parents can pay up to $10,000 out of pocket.

Recruiting more physicians, nurse practitioners and midwives falls on hospitals or private institutions; but WalletHub analysts say the study goes beyond the delivery room.

To help counteract the state’s current ranking, ADPH officials say they are working with Medicaid to increase pregnant women’s postpartum coverage to a full year after delivery and expand home visiting programs.