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Background Nearly a third of women* who give birth in England and Wales are migrants (born outside the UK). Preconception health inequalities exist between underserved migrant women and UK-born women. In our recent study, migrant women in vulnerable situations were less likely to take folic acid preconception, and were more likely to have pre-existing diabetes and hepatitis b and to be underweight than non-migrant women. Migrant women are also less likely to access long-acting reversible contraceptives (LARC), and more likely to have an abortion. However, evidence from migrant women’s perspectives regarding reasons for inequalities is scant.We aimed to explore opportunities, needs and barriers to contraception and preconception health among underserved migrant women.Methods Focus groups and interviews were undertaken with underserved migrant women (asylum seekers, refugees, undocumented migrants and those with no recourse to public funds) and key stakeholders (GPs, sexual health doctors, health visitors, midwives and charity workers). Interviews and focus groups in non-English languages (Kurdish Sorani, Dari, Farsi, Arabic, Turkish and Punjabi) were undertaken either by MM with an interpreter, or by trained community researchers in their own language (SA and LK). Data were analysed thematically.Results Results from 19 interviews and 2 focus groups with migrant women (n=38) and 11 interviews with other stakeholders (n=11) indicate that underserved migrant women face many barriers to improved preconception health and contraceptive access including stigma associated with attending sexual health clinics or discussing contraception, language barriers, a need for increased awareness, and varying cultural expectations of pregnancy and childbearing. Both migrant women and other stakeholders talked about a reluctance to use hormonal contraception with many women recounting ‘scare stories’ from friends or family, and a preference for natural family planning. Healthcare professionals described disjointed services contributing to few options for preconception and contraceptive care, as well as lack of training on preconception health and care.Conclusion Preconception health and contraceptive access needs to be prioritised in this population with culturally appropriate and easily accessible support.*We’ve used the terms women/woman, but recognise that not all pregnant or birthing people identify as women