This legislators' guide outlines state maternal health programs and strategies and offers states options for improving their maternal and child health services. The introductory chapter 1 is followed by an overview of maternal and child health status in the United States in chapter 2. Costs associated with the failure to provide adequate prenatal health care services are considered. Chapter 3 describes federal programs that provide health services to pregnant women and children. Recent congressional changes to the Medicaid program are covered. Chapters 4 and 5 describe state initiatives to improve maternal and child health. Chapter 4 discusses state initiatives to enhance the provision of perinatal health care services through changes to the state Medicaid program. Chapter 5 covers other state initiatives for improving maternal and child health services. These include options for use of maternal and child health block grant funds; the Women, Infants, and Children program; and Early Periodic Screening Diagnosis and Treatment services for children under Medicaid. Chapter 6 offers a framework that state policymakers can use to develop state strategies to improve maternal and child health services. The appendix includes a checklist for policymakers to use in identifying gaps in state maternal and child health programs. (RH)