Publications with empirical findings on health inequality have become more frequent in recent years, but an analysis of health inequality in the various fields of medicine is still lacking. Focussed on the utilization of antenatal care, the present study has investigated whether differences in preventive behaviour exist between social groups and whether such differences affect the frequency and severity of complications. The database was the Baden-Wuerttemberg perinatal survey (556,948 births, 1998—2003). Appropriate use of antenatal care leads to significant advantages in the outcome for the mother and the newborn child. Inadequate use of antenatal care was encountered significantly more frequently in psychosocially disadvantageous pregnancies. Pregnant women with particular social disadvantages had the highest increase in risk compared with that for the overall group of pregnant women [RR 11.69 (95 % CI 8.77—15.58)]. Lack of utilization of antenatal care had detrimental effects on psychosocially disadvantaged groups and collectives with lower levels of education. Analysis of puerperal complications and caesarean deliveries showed an increase in maternal risk, especially for certain groups. Groupspecific barriers and disadvantages seem to persist and prevent adequate care being provided in individual cases even though standardized medical care is available. The identification of disparities provides access points for intervention.
