Achieving equitable antenatal care (ANC) is fundamental to China’s ‘Healthy China 2030’ agenda and its universal health coverage (UHC) commitments. Despite measurable national progress, substantial urban-rural and regional disparities in ANC access persist, driven by a complex interplay of financial, geographic, institutional, and digital barriers that disproportionately affect rural, low-income, and migrant populations. This analysis examines the current landscape of ANC in China, identifying core structural challenges including the enduring legacy of the hukou (household registration) system, a widening digital divide, and the maldistribution of healthcare resources. We contend that piecemeal interventions are insufficient to address these deeply rooted inequities. Instead, this Viewpoint advances an integrated ‘spatialtechnology-institutional’ strategy that synergizes innovations across three mutually reinforcing domains: optimizing tiered healthcare delivery through smart payment reforms, deploying geospatial tools for evidence-based resource allocation, constructing an inclusive digital ANC ecosystem, and establishing sustainable talent incentive mechanisms for grassroots healthcare workers. By implementing this coordinated, multi-pronged approach, China can systematically dismantle geographic inequities in maternal health and ensure equitable ANC access for all women.