The Strong Start for Mothers and Newborns initiative aims to improve maternal and infant outcomes for Medicaid and CHIP beneficiaries through three models of enhanced prenatal care: maternity care homes, group prenatal care, and birth centers. Common elements across approaches are an emphasis on relationship-centered care, psychosocial support and education. Preliminary evidence suggests participants experience better birth outcomes compared to national benchmarks, including lower rates of Caesarean section and labor induction, higher rates of vaginal birth after cesarean, higher rates of breastfeeding, and in some cases lower rates of preterm births. Moreover, participants express overwhelming satisfaction with their prenatal care.