First Steps (maternity and infant care)

Find information about First Steps, including Maternity Support Services (MSS), Infant Case Management (ICM), and Childbirth Education (CBE).

Services provided through First Steps

First Steps is a program that helps low-income pregnant individuals get the health and social services they may need and covers a variety of services for pregnant individuals and their infants. First Steps is available as soon as an individual knows they are pregnant and is covered by Washington Apple Health (Medicaid). First Steps services include medical, enhanced, drug and alcohol and other services:

Medical services

  • Prenatal care
  • Medical, vision, and dental care
  • Delivery
  • Post pregnancy follow-up
  • One year of family planning services post pregnancy
  • One year of full medical for newborns

Enhanced services

Expedited Alcohol and Drug services

  • Alcohol and drug assessment
  • Alcohol and drug treatment

Other services

  • Expedited eligibility determination
  • Outreach
  • Transportation
  • Interpreter services

What to do if you don’t qualify for pregnancy medical through First Steps:

If you don't qualify because you have too much income, there are other resources to help you.

Please call the WithinReach Family Health Hotline at 1-800-322-2588. They are able to link you to resources in your county.

Maternity Support Services (MSS)

Maternity Support Services (MSS) are preventive health and education services to help an individual have a healthy pregnancy and a healthy baby. Individuals can receive MSS through the First Steps Program if they are pregnant and receiving Apple Health. MSS is offered in addition to medical and prenatal care.

A pregnant individual can receive MSS during pregnancy and 60 days postpartum. Services can begin any time during the pregnancy, delivery or postpartum period. However, pregnant individuals are encouraged to enter the program as early as possible during their pregnancy to improve birth outcomes.

Maternity Support Services may include:

  • Pregnancy and parenting information.
  • Screening for possible pregnancy risk factors.
  • Brief counseling for identified risk factors.
  • Referral to community resources.

Services are provided by a team that includes:

  • Nurses.
  • Dietitians.
  • Behavioral health specialists.
  • Community health workers (some locations).

Services can be provided in a:

  • Clinic or office.
  • Home setting.
  • Community setting.

Where can you find an MSS provider in Washington?

You can find MSS providers listed by county in the First Steps Provider Directory or call WithinReach at 1-800-322-2588.

Infant Case Management (ICM)

Sometimes there are family situations that place infants at higher risk of having problems. Infant Case Management (ICM) can help families learn about, and how to use, needed medical, social, educational, and other resources in the community so the baby and family can thrive.

ICM may start any time after Maternity Support Services ends (usually when the baby is about 3 months old) and can continue up to the last day of the month of the baby’s first birthday.

Services may be provided in the provider’s office, the family’s home, or an alternate location.

Where can you find an ICM provider in Washington?

You can find ICM providers listed by county on the First Steps Provider Directory or call WithinReach at 1-800-322-2588.

Childbirth Education (CBE)

Eligible pregnant individuals and their support person(s) can attend group Childbirth Education (CBE) classes, at no cost, when the classes are taught by a Health Care Authority-approved CBE educator who accepts Apple Health. CBE usually starts during the third trimester and the topics include:

  • How to have a healthy pregnancy.
  • Warning signs in pregnancy and what to do.
  • Nutrition.
  • Breastfeeding.
  • Birthing plan.
  • What to expect during labor and delivery, how to manage pain and a hospital tour.
  • Newborn care and changes to expect at home after baby is born.
  • Safe sleeping position, car seat safety, and well-child care.

Where can you find a CBE provider in Washington?

You can find CBE providers listed by county on the Childbirth Education Provider Directory or call WithinReach at 1-800-322-2588.