The costs of skilled maternal and newborn care are major obstacles to access. This cross-sectional study of 1,200 married women, who had a live birth in the previous year, analyzed the costs incurred by a household for maternal and newborn care in selected areas of rural Bangladesh. In Nilphamari since most mothers enjoy free ANC services from BRAC Shasthya Karmis, there was higher utilization with zero cost to households. Utilization of home delivery by unskilled providers is pro-poor, while public and private facilities are largely utilized by richer households. Costs of delivery care varied considerably by type of treatment and place of delivery. Out-of pocket spending was a major source for delivery care whilst spending out of savings was higher in Nilphamari. Cost as a barrier to seeking skilled delivery care was reported by more mothers in areas where BRAC MNCH interventions are not in place. Mothers who did not obtain delivery care from skilled attendants or facilities reported preferring public facilities if affordable and their anticipated cost at their preferred place was higher than those who have actually used those facilities. The number of households with catastrophic expenditure for obstetric care is quite low as most home deliveries and unskilled care attendants had a low level of payment. If mothers have at least three ANC visits and obtain skilled delivery care from a facility the number of households making catastrophic payments would be higher. Attempts should be made to encourage able households to save for obstetric care. Informing them of the fee charged can help mothers to form a correct impression of the total costs of skilled care. Reducing the cost of obtaining obstetric care, particularly for the poor, can help to increase the utilization of skilled care. Extreme poor households will continue to need financial support.