Aim: How frequently a pregnant woman attends prenatal care affects the morbidity of the mother and child and depends on many factors. These include socio-economic differences, the level of education and occupation. This study investigated whether and to what extent under present conditions with free access to health care such differences in the utilisation of prenatal care persist, and traced the developments over recent years. Method: The study is based on the perinatal survey data of the German state of Baden-Württemberg 1998—2002. Results: Deficiencies in standard prenatal care were found for pregnant trainees and students. Insufficient attendance was twice as high as that in women in high-salary positions in 1998, and 6.5 times as high in 2002. The percentage with insufficient antenatal care (2—5 consultations per pregnancy) and more frequent than usual care (>10 consultations) differed between the occupational categories to the same extent over the whole period. The frequency of insufficient care, for example, was twice as high in the unskilled workers than in the group of skilled workers and office clerks. Conclusions: Even with free access to prenatal care for all pregnant women in Germany, group-specific barriers and handicaps prevent women from adequately utilising prenatal care. Specific concepts, particularly work-related, to target the occupational and social groups with deficits in antenatal care should be drawn up.