Background: Maternal mortality remains as high as 567 deaths per thousand live births in Nigeria and 1, 549 deaths per 100,000 live birthsin the Northern regions of the country. Despite overwhelming evidence that maternal deaths can be averted with presence of a skilled attendant during delivery, most women in the rural communities in Northern Nigeria prefer to deliver at home. This study aimed at understanding women’s perception of place of delivery options and factors that influence and guide the choice of place of delivery amongst pregnant women.

Methods: A qualitative study, from a social constructionist viewpoint, was conducted in a rural community in Northeast Nigeria. Through purposeful sampling, women who recently delivered and those who were over 35 weeks of gestation participated in 12 in-depth interviews and 7 FGDs.

Results: Three themes emerged from this study: perception of facility healthcare services, especially delivery service, as less than adequate; health seeking behaviour was influenced by incidence of complications in pregnancy, husband and home environment; while social support and the opinion of the community influence women decision on place of delivery. Husband and in-laws took prime position in making key decisions; the role of the Traditional Birth Attendant (TBA) was not an important factor for making decision on place of delivery.

Conclusion: A combination of factors influenced women’s decisions on where to deliver. Future intervention should be context specific; individual and cultural context in relation to maternal health of women should be taken into account before formulating interventions, while community education can change perceptions of the risk associated with deliveries and the need for skilled attendant at delivery.

Keywords:  choice of place of delivery, skilled birth attendant, Nigeria.

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