OBJECTIVES: Early, periodic maternity care is important in managing risk for delivering low birth weight (BW) babies. Keys to Your Care^® (K2YC) is a Pennsylvania-based maternity engagement program that helps pregnant members schedule maternity checkups, provides evidence-based resources for improved self-care, and connects high-risk members to maternity care management. METHODS: Outreach to pregnant Medicaid managed care members was followed by enrollee engagement in English or Spanish up to twice weekly through text messaging and login to a mobile-optimized website. Gift cards, baby supplies, and portable cribs were sent to participating members who met the appropriate engagement criteria throughout the length of the program. Primary outcome measures included percent of members with a claim in first trimester (PPC1) and postpartum care 21–56 days post-delivery (PPC2), frequency of ongoing pregnancy care making ≥81% of recommended visits (FPC), and frequency of low BW events. RESULTS: Between April 2 and December 31, 2016, 2,654 subjects [median age, 27 years; interquartile range (IQR), 23–31 years] had claims for 9,049 prenatal and postpartum visits (median, 11 visits/subject; IQR, 8–14 visits; 1,426 deliveries). Importantly, 6.5% of participants enrolled in K2YC before their first prenatal claim. The median gestation ages were 23.1 weeks and 39.3 weeks during opt-in and delivery periods, respectively. Median infant BW was 3,203 g (IQR, 2,892–3,515 g); 55.9% delivered at normal BW (range, 2,500–3,999 g) versus 52.7% in the nonparticipating control cohort (N=3,948). High-, low-, and very low-BW babies accounted for 3.4% (≥4,000 g), 5.8% (1,500–2,499 g), and 1.1% (<1,500 g), respectively (control: 4.1%, 6.5%, and 2.8%, respectively). Other performance measures were: PPC1, 82.68%; PPC2, 59.78%; and FPC, 56.46% (control: 73.98%, 62.24%, and 48.52%, respectively). CONCLUSIONS: K2YC alerted care managers of pregnancies (often before first member claim), increased the number of maternity checkups and BWs of delivered babies.