Background: Many maternal deaths occur as a result of delivery that takes place in the home or late referral of women in labour to the health facility. This situation is further worsened in remote poor communities of the northern region of Ghana; where health care services are inequitably distributed. This study determined the factors in low income rural communities that are responsible for the high numbers of homebirths using the Bunkpurugu Yunyoo district as a case study.

Methods: The study employed mixed method study that used both qualitative and quantitative methods. Three hundred women who delivered within the last one year were made to respond to a research questionnaire while four health care workers (three midwives and a general registered nurse) were engaged in an in-depth interview.

Results: The study identified poor road network, inequitable distribution of health facilities, inadequate family support during labour, cultural factors like taboos and the stigma associated with FGM to be responsible for the high numbers of home deliveries. Even though women intended to give birth in the health facility during pregnancy, they are unable to do so as labour occurs when they were not expecting it.

Conclusions: The study recommended the use of equipment like the ultrasound during the first trimester of pregnancy to measure accurately the expected date of delivery of each pregnant woman so as to enable them plan for birth.