Maternal mortality and morbidity do not adequately represent women's healthcare experiences. Traditional clinical outcomes must be complemented with tools that assess patients' subjective experiences to provide a comprehensive view of care effectiveness. The proposed Antenatal Patient-Reported Experience Measures (PREM) tool, developed with input from women who have experienced maternity care, highlights relevant aspects for pregnant mothers and ensures reliability and cross-cultural validation. A multiphase study conducted in 15 Indian hospitals employed purposive sampling. Phase 1 involved forming an expert group, conducting focus group discussions, establishing a standard operating procedure, and creating the PREM Questionnaire. Phases 2 and 3 included a pilot study with 220 participants and a field study with 518 respondents. A PREM tool with 22 expert-sourced questions achieved an internal consistency value of 0.7205, indicating acceptable reliability. The mean content validity index was 0.998, demonstrating high validity, and the content validity ratio was 0.95. Experts deemed 21 out of 22 questions essential. The PREM tool displayed good reliability and strong content validity. The validated PREM enhances antenatal care outcomes by prioritizing women's perspectives.