Conclusion
In this population-based birth cohort in Rotterdam, many inequalities in antenatal care initiation were observed, and many of these were socioeconomically driven. This is problematic because it may lead to sustaining or perhaps even exacerbating inequalities into the next generation. Importantly, our results suggest that hypothetically intervening on early pregnancy recognition may reduce, but not eliminate, these inequalities. Therefore, it is recommended that people at risk of unintended pregnancy and people from socioeconomically disadvantaged groups are supported in early pregnancy recognition, for example by providing free tests and education, which is also in line with promoting preconception care.