PhilHealth underscored on Wednesday that most pregnancy-related complications in the Philippines could be avoided with early and consistent medical care, as the agency rolled out sweeping reforms to expand maternity coverage and clarify where high-risk pregnancies must be managed.
“Majority — nine out of 10 — of the complications in pregnancy are preventable if proper care or proper management is provided early,” Dr. Laurence Sabido said in an interview.
“Every woman should make sure their pregnancy is properly checked so any risk factor can be managed right away,” the medical specialist added.
Sabido explained that conditions such as gestational diabetes, hypertension, infections, and bleeding disorders often develop silently and may progress into severe complications when prenatal visits are irregular.
Early detection crucial
She said early detection is the key reason PhilHealth is strengthening maternal benefits under two new issuances.
Circular 2026-0005 increases case rates for hospital-based maternal and gynecologic services, raising the benefit for normal spontaneous delivery in Level 1 to Level 3 hospitals to P29,000.
Coverage for medically indicated Cesarean sections now reaches up to P62,000, while reimbursement for dilatation and curettage, often needed after miscarriage or heavy bleeding, has been increased to as much as P36,500.
The circular also expands mandatory coverage for prenatal and postpartum services, including laboratory tests, micronutrient supplementation, and ultrasound examinations, aligning these benefits with DoH and World Health Organization clinical practice guidelines.
Circular 2026-0006, meanwhile, broadens maternity coverage outside hospitals. Prenatal checkups, postpartum assessments, routine laboratory screening, ultrasound services and low-risk deliveries in birthing facilities are now reimbursable under clearer schedules.
Care coordinators introduced
The circular also introduces mandatory care coordinators in accredited maternity facilities to guide pregnant women through consultations, manage referrals, track high-risk cases, and ensure continuity of care from pregnancy through the postpartum period.
Despite the broader coverage for clinics and lying-in facilities, Sabido clarified that high-risk pregnancies remain restricted to hospital management.
