(CNN) -- When it comes to babies being carried to full term, the United States is improving, according to the most recent March of Dimes report card.
This year the United States achieved a C grade, a grade higher than the D grade of 2010.
Each year, the March of Dimes compares each state's pre-term birth rate with the goal birth rate. The report says 40,000 fewer babies were born prematurely in the United States between 2006 and 2009.
"We set a goal of 9.6% by 2020, and it's a realistic goal we can get to and it would be a tremendous accomplishment," says Douglas A. Staples, senior vice president of strategic marketing and communications for the March of Dimes. This year the state of Vermont was the only state to achieve that goal. The current nationwide rate is 12.2%.
"I think we absolutely want to all be As. It's a step in right direction," says Dr. George Macones, chair of the American College of Obstetricians and and Gynecologists committee on obstetrics practice. "I really think poverty, access to care, social structure and anything that goes along with that," are responsible for the numbers not being better, says Macones. "That's going to be hard for us to overcome without some big changes."
In the report, 16 states received a B, 19 received a C, 11 states along with the District of Columbia were given a D, and three states and Puerto Rico failed.
A baby born before 37 weeks is considered premature and at serious health risk.
Being born earlier than 37 weeks is the leading cause of newborn death in the United States, costing more than $26 billion each year, according to the report. While the United States ranks first in health care spending, it is 39th in infant mortality, according to a 2006 report.
A lot more can be done to help babies be born healthy and not premature, says Staples. More access to health care, prenatal care, getting women to stop smoking, reducing the number of early scheduled C-sections for non-medical reasons, and reducing the number of multiple births through fertility treatments, would be helpful in continuing to reduce the number of pre-term babies, adds Staples.