Objectives: To assess the birth preparedness and utilisation of services in an urban union council where only the private sector provided any healthcare.

Methods: Descriptive study design was adopted which had two components: 1) a cross-sectional community survey on birth preparedness and utilisation of services and 2) a provider survey with census of all eligible healthcare facilities. Door to door survey was conducted by visiting every tenth household. All allopathic healthcare facilities in the selected union council were visited for collecting information about the available services and amenities.

Results: Knowledge regarding danger signs during pregnancy and delivery was low. Sixty four percent women received some ante natal care while 45% deliveries were conducted at home. Among those having to seek emergency care during pregnancy, delivery or postpartum, 39% approached a health facility. Lack of preparation in terms of transport was reported in 83% cases. Two of the health facilities had a skilled birth attendant while four provided ante natal care services. Health education was provided by four; deliveries were conducted at one; while family planning services were provided by five facilities.

Conclusion: Women and their families are not sensitised to prepare for safe deliveries. There is a need to improve the essential maternal and newborn health care services at the health facilities. The role of private health sector towards improving MNH; especially birth preparedness in the country needs to be explored at a larger level (JPMA 59:302; 2009).