Many current studies focus on the acceptability and utilization of biomedical antenatal care (ANC), neglecting indigenous African ways of providing ANC. Drawing on interviews with 30 health professionals, and consultations, focus groups, and storyboarding with 71 community-level key informants and adult caregivers, we critically examined how ANC is delivered and utilized in Mafararikwa in rural Zimbabwe. We found that families in Mafararikwa actively engage with and utilize ANC from traditional, faith-based, and biomedical health-care systems, usually concurrently, based on their quality-of-care perceptions and local sociocultural factors. Efforts to enhance ANC must consider families’ ANC preferences and promote collaboration between different ANC systems.