Successful implementation of improvement projects is sometimes limited by healthcare provider and staff perception of value. This study describes neonatal intensive care unit (NICU) prescriber perceptions of antibiotic stewardship (AS) before and after the Optimizing Antibiotic Stewardship in California NICUs (OASCN) learning collaborative. Before the collaborative, prescribers reported "a lot" or "some" inappropriate antibiotic prescribing, namely due to fear of bad outcomes and reluctance to change practice. After the collaborative, openness to change prescribing practices increased, but the same challenges still existed.