Journal of Gynecology and Obstetrics 2014; 2(1): 1-6 Published online March 20, 2014 (http://www.sciencepublishinggroup.com/j/jgo) doi: 10.11648/j.jgo.20140201.11 Place of delivery after antenatal care: the case of Fogera district, Amhara region, North West, Ethiopia; 2013 Endalkachew Desalegn, Alemtsehay Mekonnen, Gedefaw Abeje Bahir Dar University, College of Medicine and Health Sciences Email address: endalk111@gmail.com (E. Desalegn), alemtsehay21@yahoo.com (A. Mekonnen), abejegedefaw@gmail.com (G. Abeje) To cite this article: Endalkachew Desalegn, Alemtsehay Mekonnen, Gedefaw Abeje. Place of Delivery after Antenatal Care: the Case of Fogera District, Amhara Region, North West, Ethiopia; 2013. Journal of Gynecology and Obstetrics. Vol. 2, No. 1, 2014, pp. 1-6. doi: 10.11648/j.jgo.20140201.11 Abstract: Back ground: Increasing the proportion of institutional deliveries with a skilled attendant is a key intervention for reducing maternal morbidity and mortality. However remarkable difference is observed between the proportion of antenatal care clients and facility delivery utilisation. In Ethiopia, little is known about the factors that affect women’s place of delivery after utilization of antenatal care service. Objective: To identified women’s place of delivery and associated factors after antenatal care (ANC) service in Fogera district, North West Ethiopia. Method: Community based cross sectional study was conducted from January to March, 2013 on randomly selected sample of 399 women who had antenatal care visit and delivered one year before the survey. Pre-tested and structured interviewer administered questioner was used to collect the data. The data were analysed using SPSS version 16 and multiple logistic regression was used. Results: A total of 399 women who had at least one antenatal care (ANC) follow up and delivered one year prior to the survey was interviewed. Only 126(31.6%) of mothers gave birth in the health facilities. Multivariate analysis showed that residence AOR= 4.6, 95%CI; (1.3, 15.9), privacy during antenatal care (ANC) AOR =4.6, 95%CI :( 2.2,9.2), respect during ANC AOR =2.9, 95%CI:( 1.5,5.9) and quality of antenatal care counseling were important predictors of place of delivery after antenatal care (ANC). Conclusion: Institutional delivery after ANC utilization was low. Maternal education, absence of privacy and low quality of antenatal care counseling during ANC visit were important predictors. Women friendly care and quality of counseling during ANC visit have a great role on facility delivery. Keywords: Antenatal Care, Delivery, Labour, Fogera 1. Introduction Three core health sector strategies for reducing maternal and early neonatal deaths include comprehensive reproductive health care; skilled care for all pregnant women, especially during delivery; and emergency obstetric care for all women and infants with life threatening complications [1]. Maternal mortality remains high in the developing world , comparison of the lifetime risk of maternal death in industrialized countries (1 in 8000) versus in Sub-Saharan Africa (1 in 22) and Asia (1 in 59) presents a particularly stark picture of persisting global disparities in maternal health [2]. The lifetime risk of death due to pregnancy- related complications is 250 fold higher among women in developing than in developed countries [3]. Globally about 585,000 women die each year due to conditions related to pregnancy and child birth; 99% of which occur in developing countries. Over three quarter of global maternal deaths are due to causes directly related to pregnancy and childbirth [4]. WHO estimated that 34% of the mothers deliver with no skilled attendant; this means there are 45 million births occurring at home without skilled health personnel each year [5]. These deaths could be avoided if preventive measures were taken and adequate cares available particularly during pregnancy, childbirth and postpartum period. More than 60% of maternal deaths occur immediately following delivery, with more than half occurring within a day of delivery, it could be prevented if the delivery attended by skilled provider [4-6]. Global experiences show that ANC use is higher than delivery by a professional in the large majorities of countries in the developing world. While an estimate of 97% of the pregnant women in developed countries receive ANC and 99% use skilled obstetric service at delivery, 65% and