American women are not receiving the health care they need — and it is not just their health that is suffering. Compared to other developed nations, the United States has high infant mortality rates, as well as low life expectancy rates for women. The country must improve how it cares for women, not just for the sake of women themselves, but because evidence shows that a woman’s wellbeing prior to conception can significantly impact her baby’s health. The problem is urgent. Throughout the 20th century, this country steadily reduced the number of infant deaths; but over the past 10 years, rates have stagnated. Moreover, experts say that our rates of premature birth, and of infants born with developmental disabilities, are also too high. Over the past 25 years, understanding the importance of helping women stay healthier during their childbearing years has led to the development of a new approach known as “preconception” care, which aims to provide health education, screening, and interventions to all women of reproductive age, to improve health and help them have healthy babies when and if they choose. The new health reform law, the 2010 Affordable Care Act (ACA), offers a crucial opportunity to expand this comprehensive strategy, and to improve women’s health and the health of their infants. The law will strengthen public health and prevention, and will ensure that millions of previously uninsured women of childbearing age have adequate health coverage. It will also improve coverage for many women who now have inadequate health insurance, and create programs to provide extra care and guidance for women who are likely to have health problems related to pregnancy.