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Pregnancy-related hypertensive disorders can cause morbidity and mortality. Low-dose aspirin (LDA) reduces risk. This paper aims to assess Medicaid beneficiaries' risk factors for preeclampsia and their providers' clinical use of LDA in the federal Strong Start for Mothers and Newborns II initiative. Twenty-seven awardees with more than 200 care sites served almost 46,000 women. This mixed-methods analysis assesses rates of risks, incidence of pregnancy-related hypertensive disorders, and assessment of care teams' LDA knowledge and rep