This article examines the effect of introducing a new HIV/AIDS service—prevention of mother-to-child transmission of HIV (PMTCT)—on overall quality of prenatal and postnatal care. My results suggest that local PMTCT introduction in Zambia may have actually increased all-cause child mortality in the short term. There is some evidence that vaccinations may have declined in the short term in association with local PMTCT introduction, suggesting that the new service may have partly crowded out existing pediatric health services.