Each year, more than 250,000 American babies are born prematurely or with a low birthweight. Every two minutes a baby is born with a birth defect. These conditions cause and contribute to more than 40,000 infant deaths annually. Early and regular prenatal care is proven effective in reducing the risk of low birthweight. Given the importance of prenatal care, the March of Dimes advocates the availability of maternity care for all pregnant women. This article outlines the March of Dimes public affairs program, its involvement in the successful expansion of Medicaid coverage for poor pregnant women and infants, and the opportunity for continued advocacy to improve maternal and child health care.