This paper aims to advance the concept of medical pluralism in reproductive health in sub-Saharan Africa by exploring the multiplicity of antenatal practices in Villa Maria Mission Hospital in Uganda. Through analyzing various archival sources and oral history interviews, the paper zooms in on women’s experiences with providing and utilizing different antenatal care practices, and how and why different practices co-existed and changed over time. The paper examines the particular form that medicalization of antenatal care took in Villa Maria Hospital, other healthcare providers that local women could opt for, and tensions and cooperations between hospital staff and “traditional birth attendants” from the villages. This paper thus argues that acceptance and resistance to different practices and medicines available in the hospital and local communities influenced the way medical pluralism operated in this particular context but also pays attention to broader socioeconomic, cultural, colonial, and environmental factors that shaped its development.