American women have children at varied stages of their reproductive years and need to be healthy throughout in order to do so successfully. When the average American woman is interested in childbearing, she has specific health care needs and faces pregnancy associated risks. While steps to improve maternal and infant health have been taken, many American women continue to fare poorly in this domain.  While our pregnancy associated death rates have been worsening, infant mortality,contrast, has declined because of advances in neonatal care. Yet, disparities by race and geography persist here as well. Infant death rates can be more than twice as high for black mothers as for white mothers, with rates highest in the South.  Meanwhile, rates of preterm birth and low birth weight have risen and are now the highest they have been in more than three decades. Babies born too early or too small are at higher risk for death, and for both short- and long-term health problems. Existing health insurance coverage is not preventing this situation. The health insurance program for low-income women—Medicaid—expands its eligibility criteria to cover pregnant women with incomes up to 200 percent of the poverty level. But access to care for this high-risk group of women ends with the postpartum visit. Women who have private insurance or work for small firms exempt from the Pregnancy Discrimination Act often have health plans that exclude pregnancy-related care and treatment for complications of pregnancy. Men’s health is also an important part of healthy reproduction. Men can affect fertility and pregnancy outcomes by spreading sexually transmitted diseases, smoking, and engaging in other risky behaviors as well as having health conditions that directly affect their fertility. In addition, men influence important life decisions on contraception, abortion, pregnancy and childbirth, and infertility. A new national health plan should link prenatal, family planning and medical care as part of a seamless continuum of care for women.