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 expanding maternity coverage and clarifying where high-risk pregnancies must be managed.
“Majority—nine out of ten—of the complications in pregnancy are preventable if proper care or proper management is provided early,” said Dr. Laurence Sabido.
“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.
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 ₱29,000.
Coverage for medically indicated Cesarean sections now reaches up to ₱62,000, while reimbursement for dilatation and curettage—often needed after miscarriage or heavy bleeding—has been increased to as much as ₱36,500.
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 WHO 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.
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 postpartum.
Despite the broader coverage for clinics and lying-in facilities, Sabido clarified that high-risk pregnancies remain restricted to hospital management.
“All first pregnancies and pregnancies at the fifth and beyond are considered high-risk. They should not be managed in a lying-in room. They should be managed in a hospital setting,” said Sabido.
She noted that the DOH and PhilHealth guidelines explicitly classify all first pregnancies and pregnancies on the fifth and beyond as high-risk because of well-documented medical vulnerabilities.
Meanwhile, outside hospitals, low-risk normal deliveries in accredited birthing homes are covered at ₱14,000 from ₱12,675.
The revised maternity package entitles pregnant women to eight prenatal visits and a full set of required laboratory tests, including blood typing, CBC, HIV testing, hepatitis B and syphilis screening, glucose tests, and at least one ultrasound.
PhilHealth also established reimbursement packages for emergency stabilization and transfers should complications arise during labor in non-hospital settings.
The agency said these reforms aim to reduce preventable maternal deaths in the country.
The Philippines currently records about 119 maternal deaths per 100,000 live births, according to the Philippine Statistics Authority.
Sabido said ensuring uniform access to essential maternal services is central to lowering this number.
“We want every pregnant woman in the country to have equal access to the services they need. This is how we prevent complications and reduce maternal deaths," Sabido said.