Abstract A descriptive study with a convenience sample of 47 subjects drawn from two birthing houses was conducted in St. Petersburg, Russia, under the auspices of the World Health Organization Healthy Cities Project. Data were collected with a self-administered questionnaire given to women in birthing houses after delivery and prior to discharge. Subjects ranged in age from 16 to 38 years. Sixty-one percent of women began prenatal care within the 1st trimester, 35% within the 2nd trimester, and 2% received no prenatal care. Younger women were more likely than older women to start prenatal care in the 1 st trimester, but received less teaching by health care providers. Younger women also expressed more stress and need for counseling. In addition, 83% of low-birthweight babies were born to younger women. These findings indicate a focus by health care personnel on older pregnant women, although younger pregnant women were at higher risk for poor pregnancy outcome. The strongest statistically significant correlations were found among the patient satisfaction variables, indicating that satisfaction with prenatal services may influence when women begin prenatal care services.