The World Health Organization initiative ‘Making Pregnancy Safer’ (2000) names working with individuals, families and communities in a health promotion and empowerment approach as key strategy for maternal and newborn health. As migrant women were found to have a higher risk than the average population of under-using prenatal care and of receiving inadequate care in the pre- and postnatal phase, the group is highlighted as of particular concern for health policies and programmes. Within the framework of a European hospital initiative (MFH) with 12 collaborating hospitals, two hospitals (in Austria and Italy) worked on the development and implementation of training courses for pregnant migrant/ethnic minority women. The courses, designed on the basis of a needs assessment with migrant women, focused on four quality dimensions: access, information, sensitivity to literacy levels and support of facilitators. Evaluation was based on post-course interviews with clients and staff, including ratings of the four quality dimensions and the effects on maternal literacy of participants. Main results in both countries showed that (1) women gave positive ratings on all quality dimensions and reported that their knowledge improved a lot; (2) staff members’ ratings concerning knowledge gain were less positive; (3) despite all efforts to make access to courses easy (no fees, transportation facilities, child care), participation was disappointingly low. Discussion and analysis of these results within the European project group indicate that (1) courses are a successful measure for women who attend; (2) the knowledge needs of clients are different from the perspectives of staff, something that should be investigated more fully; (3) closer co-operation with migrant communities and a better understanding of the role of men (husbands and relatives) and their integration into service planning are needed to increase the access rates of migrant/ethnic minority women to maternity care services.