Recent public health initiatives in the USA identify the improvement of maternal and infant health outcomes among ethnic minorities as a national priority. Prenatal care is emphasized in these initiatives as a crucial intervention for reducing the risks of adverse outcomes. We investigate the barriers to prenatal care and the adequacy of prenatal care among mainland Puerto Ricans using data from a follow-back survey of a representative sample of mothers. The results show that barriers to prenatal care and the adequacy of prenatal care cannot be reduced solely to financial problems or problems associated with migration. Rather, attention to the social and the psychological circumstances surrounding the pregnancy (e.g. pregnancy wantedness) is required.