Vulnerable clients are a challenge in antenatal care; in deprived areas they induce a high work strain on care professionals.
In a large Dutch region, professionals jointly selected improvement of care to vulnerable clients as research and care priority.
Objective vulnerability caseload was generally higher than estimated workload by unit professionals.
A high degree of structure of antenatal risk management was associated with a lower subjective burden.
Care for vulnerable women might benefit from a screening-like approach.