Objective. A pilot study to compare the rates of antenatal healthcare use in Birmingham, UK and Pretoria, South Africa, and identify differences in knowledge and perception of antenatal healthcare. Subjects. 62 women, 31 at each location <24 hours after delivery. Results. Women from Birmingham use healthcare services earlier (P ≤ .0001) and more often during pregnancy (P ≤ .0001). Women from Birmingham identified more conditions that may affect pregnancy (median 6 versus 3 reasons) and were less aware of HIV. In addition they perceived antenatal healthcare as relatively more important for advice and reassurance about pregnancy, whilst women from Pretoria had more problems with transport and clinic overcrowding. Conclusions. Increasing education on the importance of antenatal healthcare and medical problems during pregnancy may help improve antenatal healthcare use in Pretoria. Improving transport links and overcrowding in clinics in Pretoria may also help increase use. Measuring maternal outcomes and confirming these findings in a larger population are important for future studies.