ABSTRACT
This study investigated the reasons for high perinatal deaths among newborns delivered in health facilities in rural northwest Ethiopia. Qualitative in-depth interviews were conducted with 11 survivors of obstetric complications and 11 normal home deliveries. The interviews were audio recorded and transcribed verbatim. Open code qualitative 3.6 software was used for managing data and analysis. The primary reasons attributed to high mortality among health-facility-delivered babies were delay in recognizing danger signs of labor and delay in decision to seek care. Most women arrive to health institutions late with seriously complicated labor. Lack of transport, finance, and perceived poor quality of services are additional reasons to delayed seeking of health care during labor. Increasing public education on danger signs of labour, improving quality of emergency obstetric care in the nearby health facilities, and facilitating affordable referral mechanisms are critical to enhance prompt household decisionmaking and decreasing perinatal deaths in rural communities.