The crash happened just before 9 p.m. on West Newport Pike (Route 4) near Gregg Avenue.
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Police say 19-year-old Ariel Williams, of Wilmington, was driving a Buick Rendezvous westbound in the left lane when she crossed over into oncoming traffic.
Her car then slammed head-on into a Toyota Corolla coming in the opposite direction.
Police say the 29-year-old woman driving the Toyota was eight months pregnant. She was taken to the hospital in critical condition.
Her baby was delivered at the hospital and also is in critical condition.
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Two other passengers, a 6-year-old girl and a 4-year-old boy, were also taken to the hospital.
The 6-year-old, identified as Milani Carrasco, was pronounced dead while the 4-year-old is being treated for non-life-threatening injuries.
Everyone in the Toyota was wearing a seatbelt, police say.
Williams is facing a long list of charges including Vehicular Homicide and Driving Under the Influence of the Combination of Alcohol and any Drug.
Neighbor Carl Jones says the whole community of Newport is broken up over what's happened.
"It sounded like terror. Boom. You knew someone wasn't ok. It's just horrific," said Jones.