The perinatal period is an excellent time to target for wellness interventions as women are more likely to interact with their physicians, are exposed to more screenings and often have increased motivation. Women who have certain unmodifiable risks however, are more likely to drop out or not engage in wellness interventions at all, even though they may be the ones who would benefit the most. This study examines the barriers to engagement between women with Medicaid (N=30) insurance versus Private (N = 60) insurance in a unique, evidence-based perinatal wellness intervention called the Vermont Family Based Approach (VFBA). Medicaid women had significantly less education, more adverse childhood experiences (ACES). They also had poorer nutrition. The results showed clear disparities in engagement due to financial barriers, logistical barriers and cultural/social barriers. It was concluded that poverty, and the interrelated risk factors that accompany poverty must be explored and attended prior to health promotion intervention disseminations in the future