We investigated the factors that influence mothers use of medically trained services for childbirth in a rural district in the Eastern Region of Ghana using a cross-sectional study. Structured questionnaires were administered to 350 women with children under one year. Key informants who were community opinion leaders and Senior Midwives at health care facilities in the study district were also interviewed qualitatively. Cross tabulation and Chi-square test were the main statistical processes used in analysing the relationships between the study variables. The result showed that the use of antenatal services by the mothers was important for the choice of where to deliver their babies. Mothers who attended antenatal services three times or more were more likely to deliver at the health facilities than those who used lesser antenatal care. Delivery at a health facility was highest among the women who had the autonomy to decide where to deliver. Access factors in terms of economic cost and distance to a health facility also played significant roles in influencing mothers delivery behavior. We recommend additional social policies to address maternal health issues in the study district