In a presentation at the 1991 Berzelius Symposium in Sweden, a Population Council researcher described the limitations of healthcare systems, specifically during pregnancy, in terms of their effect on maternal health status. These limitations stem from an inability to improve health because of social conditions—poverty and illiteracy, overwork, inequality in sexual relationships—that cannot be solved by medical interventions. Maternal ill health originates before pregnancy and endures beyond it, whereas the window of contact with women during pregnancy is small. Nevertheless, recent evaluations suggest that the impact of prenatal care is in the caring process more than any specific aspect of care. The presentation concludes that wide extension of caregiving systems and access to some level of care may be more important than assessment and implementation of specific interventions for deprived populations who are in great need