OBJECTIVE(S): To analyze the possible factors contributing to women obtaining antenatal care services and to determine whether these services influence their decision regarding the place of delivery. METHOD(S): A cross-sectional survey of 7005 pregnant women was carried out in the sampled areas of 28 districts in 14 states. RESULTS : Since early reporting of pregnancy in rural areas is rare, a detailed ananlysis was carried out on 5344 pregnant women with a gestation of more than 4 months. Of these, 73.9% had at least one antenatal contact with a auxiliary nurse midwife (ANM) or had visited a Government Health Facility for antenatal services or problems. There was a statistically significant reduction in the proportion of women obtaining antenatal care services with increasing age, parity, and number of living children. No association was observed with outcome of previous pregnancy and presence of health facility in the village. Awareness of care during pregnancy and knowledge of pregnancy related complications were associated with increased utilization of antenatal care services. However, knowledge of serious complications was found to be lacking even in women who availed of the care. In both the groups – those who availed of antenatal care services and those who did not – about 14% had not decided about the place of delivery. 51.7% of the women with ante