Antenatal care (ANC) plays a vital role in reducing maternal and neonatal morbidity and mortality. However, in many developing nations, outdated paper-based systems hamper timely data access, hinder patient follow-up, and contribute to missed appointments. This study presents the design and implementation of a database-driven Antenatal Medical Records System integrating automated Short Message Service (SMS) alerts and real-time live support to improve ANC delivery. MySQL serves as the system’s core database management platform, structured to handle patient demographics, medical histories, appointment scheduling, SMS logs, and live chat records. The database schema was normalized to eliminate redundancy and enforce relational integrity, with security measures such as role-based access control and password encryption. The Agile development methodology facilitated iterative database and system enhancements based on user feedback from ANC providers. Testing confirmed substantial improvements in data retrieval speed, reduced duplication errors, and increased patient compliance through automated reminders. Findings revealed a 40% reduction in missed appointments and improved patient–provider engagement, validating the system’s potential to strengthen ANC service delivery in lowresource settings. The proposed solution demonstrates the pivotal role of robust database design in integrating medical records with communication modules, aligning with Sustainable Development Goal 3 (Good Health and Well-being).