["The Milbank Quarterly, EarlyView. ", "\n\n\n\nPolicy Points\n\nThe development of maternal and child health and family planning policies were driven by poverty and civil rights, established to realize the potential for “longer term economic development,” each continuing as an adaptive response to social needs, and medical and technological advancements.\nAddressing racial and ethnic disparities in maternal and infant morbidity and mortality must engage all system levels (micro‐, meso‐ and macro‐) by: 1) reconfiguring structures and flows; 2) re‐patterning relationships; and 3) aligning and coordinating toward whole system goals.\nImplementation of a public health prevention framework for sexual and reproductive health that incorporates quaternary prevention strategies and integrates services is needed for system transformation. Integration provides a wider range of services and enables patients to benefit from the deep expertise of multidisciplinary teams (inclusive of Title X) practicing in clinical settings.\nAlignment of legislative authorities, funding streams, and accountability requirements is necessary to remove systemic silos (e.g., age, condition, disciplinary, data, communication) that support the status quo.\n\n\nContext\nPublic health prevention initiatives (inclusive of clinical care/services) concerning women have historically pursued two relatively independent tracks: a maternal and child health (MCH) track and a family planning track. While not so far apart from one another, their language, practice, and policy have kept MCH and family planning services in silos at the expense of providing a comprehensive continuum of care and services for sexual and reproductive health.\n\n\nMethods\nMCH and family planning trajectories were examined as complex adaptive systems through policy examples, their intended and unintended impacts on population health, and the emergence of recent strategies that provide a vision for a more integrated system of care that promotes whole‐person health.\n\n\nFindings\nMCH and family planning policies were driven by poverty and civil rights, established to realize the potential for “longer term economic development.”The development of each track was, and continues to be, an adaptive response to social needs, and medical and technological advancements. An emerging “new order” that recognizes the importance of a whole‐person approach to address the impact of social determinants on health is needed. Such systems transformation is driven by focused commitment to transform functions and structures to respond to a changing environment. Integration provides a wider range of services and enables patients to benefit from the expertise of multidisciplinary teams.\n\n\nConclusions\nMitigating disparities requires a comprehensive systems transformation that promotes quaternary prevention and supports better alignment and integration of MCH/sexual and reproductive health. The process of establishing practice based on system thinking, in service of health equity, must become the new normal.\n\n"]