Aim: To study the effect of various determinants of home delivery in Nepal.Methods: Prospective descriptive study among women who after being delivered at home were admitted inNepal Medical College Teaching Hospital (NMCTH), a tertiary care hospital situated at suburban area ofKathmanduResults: Of 114 women, majority were between the ages of 20-24 yrs. Most of the women were multipara(64%). Majority had no formal education accounting for 68.4 %. Lasheta (Lama, Sherpa , Tamang) was themost common ethnic group. Most (30.1%) of their spouses also were illiterate or had only primary leveleducation. Majority of the husbands of the respondents were laborers (63.2%). Regarding attendance ofantenatal care (ANC); at least 84 (73.7%) women had attended ANC once and half of the women hadattended 4 more visits. Home delivery was planned by 67 (58.8%) women; whereas only 47 (41.2%) hadchosen hospital delivery and delivered at home due to various reasons. Financial problem was the mostcommon reason followed by ignorance and transportation problem. Among all the women, only 5.3% wereattended to by a professionally trained provider (doctor, nurse, and midwife). A disturbingly high proportionof women (87.6%) were attended by an untrained family member, friend or neighbor, and 7% of womendelivered completely unattended. Women were brought to the hospital by family member 59.6% other thanhusband and 8.8% were accompanied by neighbors/friends. Most of these women were brought with retainedplacenta, primary post partum hemorrhage.Conclusion: In this study area, usage of the antenatal care was high, but the opportunity to deliver athospital was not fully utilized. This study has highlighted some of the factors affecting the choice of place ofdelivery among mothers in a semi urban settlement in Nepal namely mothers educational level, husband'seducation and occupation, financial constraints, lack of transportation and ignorance. Majority of thedeliveries took place at home and unsupervised by a skilled attendant thus aggravating the risk of the highperinatal and maternal morbidities and mortalities in the study area.Key words: Home delivery; determinants; antenatal care; delivery attendanceDOI: 10.3126/njog.v4i1.3329Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 30-37