Few studies of utilization and satisfaction with prenatal care services have been conducted internationally. In this study, utilization and satisfaction with prenatal care services in St. Petersburg, Russia were examined using Aday and Andersen's (1974) A Framework for the Study of Access to Medical Care. This study was conducted under the auspices of the European Region, World Health Organization (WHO) Healthy Cities Project, which promotes a community-based intersectoral approach to meeting health needs. The convenience sample included 397 women with uncomplicated pregnancies and normal deliveries, representing an 86% response rate. Multiple regression and path analysis found significant predictors of prenatal care utilization and satisfaction. They were different, however, from those posited in the theoretical model. This indicates that Aday and Andersen's health care services model is specific to the U. S. health care system, where it originated. The Russian health care system has been and remains different from that of the United States. If the reformed Russian health care system takes on aspects of the U. S. health care system, the utility of Aday and Andersen's theoretical model may change.