Pregnancy services

Why is pregnancy-related care important?

Prenatal care is the health care you receive from a family practice physician, midwife, or obstetrician (OB/GYN) throughout your pregnancy. Getting early and regular prenatal care is important for you and your baby’s health. Regular prenatal care has been shown to reduce the chances your baby will be born preterm/premature or underweight.

Apple Health (Medicaid) provides comprehensive pregnancy and 12 months of postpartum coverage for individuals who qualify based on income, regardless of citizenship or immigration status.

Pregnancy-related covered services

In addition to basic covered services, Apple Health's First Steps program covers the following pregnancy services:

• Prenatal care: regular office visits and associated services from your provider of choice.
• Mental health services.
• Substance use disorder services.
• Dental services.
• Delivery in a hospital, birthing center, or home birth.
• 12 months of comprehensive postpartum care for the birthing person.
• Continuous enrollment in Apple Health from birth up to age 6.
• Abortion care and pregnancy loss.
• Additional preventive services covered through Maternity Support Services (MSS), Infant Case Management (ICM), and Childbirth Education (CBE).

Contact your managed care plan for questions about your pregnancy, delivery, or postpartum follow-up care. Your plan can also answer questions about breast pumps and where you may be able to deliver your baby. The plan may also offer additional benefits to pregnant or postpartum clients, some of which are described under maternity support in the Washington Apple Health Managed Care Plan Comparison Guide.

If you are pregnant and on Apple Health without a managed care plan, your pregnancy, delivery, and postpartum follow-up care will be paid for directly by Apple Health using your ProviderOne services card. Apple Health covers manual and electric breast pumps without prior authorization (PA), with the limit of one per client every three years. Hospital grade breast pumps are covered under specific criteria and require PA.

Apple Health covers deliveries provided by a licensed midwife, nurse midwife or physician. Apple Health covers planned home births and births in birthing centers or hospitals. To determine what the best option is for you, talk with your maternity care provider.

Apple Health for pregnant individuals includes physical and behavioral health services. Find out if you are eligible. Learn about Apple Health benefits and covered services.

After-Pregnancy Coverage (APC)

If you are enrolled in Apple Health coverage and are pregnant, you can receive up to 12 months of postpartum coverage once your pregnancy ends. Learn how by visiting our APC webpage.

First Steps Enhanced Services (MSS, ICM, and CBE)

Through the First Steps program, individuals who are covered through Washington Apple Health and are pregnant are eligible for additional preventive and education services through Maternity Support Services (MSS) and Childbirth Education (CBE). Parents of covered infants may be eligible for preventive services through Infant Case Management (ICM). Learn more about First Steps MSS, ICM, and CBE services.

Substance Using Pregnant People (SUPP) Program

Individuals who are pregnant, covered through Washington Apple Health, and have a substance use disorder may be eligible to receive SUPP services provided by a SUPP provider. Learn more about SUPP.

Pregnancy care options

Type of care provider

Birth doulas

Birth doulas are trained nonmedical professionals who provide physical, emotional, and informational support to pregnant people and their families before, during, and after pregnancy.

Learn more about birth doulas by visiting the Apple Health birth doulas webpage or read the birth doulas FAQ.

Certified nurse midwife

Certified nurse midwives (CNM) deliver babies in the hospital setting, some birth centers, and at planned home births.

The midwifery model of care views pregnancy and birth as a normal physiological process. Midwives generally care for birthing people who are expected to have an uncomplicated birth. Uncomplicated refers to births at full term instead of preterm or early and vaginal instead of surgical or C-section.

If a pregnancy becomes more medically complex, a CNM may partner with an obstetrician or transfer care to an obstetrician.

Learn more about certified nurse midwives.

Family practice physician

Family practice physicians (FP) deliver babies in the hospital. Their focus is on caring for patients throughout the lifespan.

A family practice physician who does delivery may also care for other family members or care for the baby after birth. Some family practice physicians do cesarean sections while others would refer to an obstetrician (OB/GYN) if the need arose.

Learn more about family practice physicians.

Licensed midwife

Licensed midwives (LM) attend births in birth centers or at planned home births. As with CNMs above, they focus on birth as an essentially normal process rather than a medical one. Home and birth center births typically require patients to be expected to have an uncomplicated birth.

Learn more about the different types of midwives.

Obstetrician

Obstetricians (OB/GYN) deliver babies in the hospital setting. They are experts in managing more complicated and medically risky pregnancies.

Type of birth setting

Hospital birth

Birth in a hospital can be attended by a certified nurse midwife, family practice physician, or obstetrician depending on the provider and hospital you choose.

This is a good choice for more medically complex pregnancies or if you know you want an epidural for pain control during your delivery. Surgical deliveries (C-sections) only happen in the hospital setting.

Birth centers

Birth centers provide a more home-like environment for birth. Birth centers typically provide more hands-on birth support and do not provide epidural pain relief. Birth center births are typically attended by a licensed midwife or certified nurse midwife.

This setting is most appropriate for those expecting to have an uncomplicated birth.

Apple Health only covers delivery in Department of Health (DOH) licensed birth centers.

Planned home birth

Home births take place in your home. This experience is individualized for your needs and preferences. They are attended by a licensed midwife or a certified nurse midwife.

This setting is most appropriate for those expecting to have an uncomplicated birth.