The utilization of perinatal services in Uganda remains low, with correspondingly high unskilled home deliveries, which can be life-threatening. We explored psychosocial and cultural factors influencing birthing choices for unqualified home delivery among postpartum women in rural southwestern Uganda. 

We conducted in-depth qualitative face-to-face interviews with 30 purposively selected women to include adult women delivered from their homes and health facility within the past three months. 

Eighteen women preferred to deliver from home. Women’s referent birth location was mostly intentional. Overall the themes presented that due to existing gender and traditional norms, women have limited ability and freedom to make family or health decisions. 

The study concluded that women’s psychosocial and cultural understandings of pregnancy and childbirth, their established traditions, birth expectations, and perceptions of control, need, and maternity care quality at a particular birthing location influenced their past and future decisions to pursue home delivery. Interventions to address healthcare utilization barriers through a multipronged approach could help to debunk misconceptions, increase perceived need, and motivate women to seek facility delivery. Further studies are required to explore the women’s choice to deliver at home.