The health of pregnant women and children has improved substantially since the 1960s. In the past decade, however, progress in preventing infant deaths, reducing the incidence of low-birth-weight infants, and ensuring first trimester prenatal care has slowed. African-American infants suffer a significantly higher risk of poor pregnancy outcome. Immunization rates for preschoolers remain low. Changing social conditions including a rising child poverty rate, a high teenage birth rate, an increased rate of births to unmarried women, and higher levels of unintended pregnancy may be contributing to stalled progress.