Pakistan is one of the countries with highest maternal mortality rate and a big share of this percentage is concentrated around the child birth process that takes place at home with help of untrained birth attendants that eventually leads to increased morbidity and mortality. This study was planned to find out the determinants of the decision that women should give birth to a child at home. A cross sectional study was carried out in rural areas of Punjab, Pakistan from March 2017 to June 2017.A total of 350 married women, between 20 to 45years of age, who had given birth to their last child at home were enrolled through a non-probability, convenient sampling method. They were interviewed by Lady Health Workers during their routine visits in community after written informed consent through a pre-designed, pre-tested questionnaire. The obtained data was then analyzed using SPSS 22. Results showed that 82% of participants thought that home delivery is more comfortable, 58% did not find it important to prefer institutional delivery over home delivery. 42.5% thought that labor is easy at home, 38.2% had transportation problems and in around one third cases family refused institutional delivery. The study showed that in addition to improvement in health care infrastructure efforts must also be done for better women education and empowerment.