OBJECTIVES: To describe the organizational characteristics of antenatal care and their relation to the utilization of health services and perinatal mortality in 13 European countries. METHODS: The main data source was a questionnaire on the organization and financing of antenatal care, filled out in 1995 by country representatives of a European Concerted Action. RESULTS: Thirteen systems for providing antenatal care were found. No clear grouping by organizational characteristics (uniformity, main care providers, integration, continuity of care, physical site, financing) emerged. Organizational characteristics and the utilization of antenatal services or perinatal mortality did not relate to each other. CONCLUSIONS: There is no single way to provide high-coverage services. Further studies are needed to relate organization characteristics to health impact, costs, and patient satisfaction.