Infant mortality and cognitive and physical morbidity is greatly heightened for pre-term and very low birth weight babies. The US has very high infant mortality and other indicators of poor birth outcomes. Much biological science is being developed to stall pre-term births to give more time for growth but this is an expensive and partial solution. Psychosocial factors are also in play and social work has the capacity to significantly reduce the contribution of these factors by working with a range of providers to ensure better health, housing, nutrition, cognitive appraisals of the pregnancy event, intimate partner violence, and other contributing factors.