Public policy decisions directly affect the health care of women and children and also affect the practice of maternal and child nursing. The past quarter century has seen a shift in nursing involvement in the public policy process. Heightened awareness of the collective power of nurses, greater independence of the nursing profession, the increasing capability for generating research to guide the formulation of public policy, and nurses better understanding of the political process have all contributed to the increasing influence of our nation's 2.6 million nurses. The passage of several significant pieces of legislation, such as expansions of the Medicaid program for pregnant women and children in the late 1980s, have opened up new opportunities for nurses to further shape the nation's health care agenda for women and children. Nurses can and should become more involved with the policy-making process at local, state, and national levels to assure that decisions are made that benefit this important population group. Leadership in the public policy arena will give nurses the best opportunities for putting forth the agendas that will accomplish these goals.