This report describes Maternity Support Services (MSS) utilization from 2009 to 2018 and assesses the effects of prenatal MSS on health behaviors and birth outcomes. Washington State’s legislatively mandated program change in 2009 resulted in a decrease of overall MSS utilization from 69% in 2009 to 43% in 2018. Clients receiving prenatal MSS had improved health and birth outcomes during 2017-2018. After adjusting for demographics and clients’ risk factors during pregnancy, prenatal MSS was significantly associated with a reduction in smoking during pregnancy, a reduction in preterm birth, and an increase in initiation of breastfeeding. Clients receiving both prenatal MSS and prenatal care during pregnancy had stronger improved health and birth outcomes comparing to those receiving no MSS or prenatal care.
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