The incidence of HCV is rising among those under the age of 40. Effort to eliminate HCV transmission therefore requires strategies to identify and cure infection among younger people. Many women of reproductive age seek routine medical care from their obstetrician, and may only contact the care delivery system when they are pregnant and seeking antenatal care. Antenatal care settings may therefore be an excellent venue for routine HCV testing. Although there currently is no means of prevention of mother to child transmission, identifying HCV-infected mothers and HCV-exposed infants provides opportunity to link infected women and babies to care, and also to prevent HCV exposure during future pregnancies. We are developing a decision-analytic model of HCV testing in antenatal care which we will use to project clinical outcomes, cost, and cost-effectiveness of routine testing for HCV in antenatal care settings.