This is a Cross-sectional analytical community based study on determinants of a birth place among reproductive aged women in their last delivery in Mtaa location, Kwale County. The specific objectives of the study were to establish demographic, socio-cultural, environmental, and economic and health institutional factors associated with the choice of a birth place. The influence of the mother’s knowledge, attitude and practice on choice of place of birth was also explored. Maternal and child health is a component of the SDGs. The study randomly sampled 231 mothers as participants. A pretested semi-structured questionnaire was used for quantitative data collection. Data were analyzed using the Statistical Package for Social Scientists (SPSS. 22). The key conclusions were that; the proportion of home delivery in Mtaa location was 74% while the national indicator is 36%; thus higher comparatively. Health facilities were located far from the community and there was a positive association between the number of children a woman had, and the choice of a birth place. The influence of cultural practices was noted to have played a negative influence on hospital delivery. Among the recommendations were that; men should be put on board when deciding maternal issues, health facilities should be placed closer to the community and an all inclusive approach should be instituted to curb the negative cultural belief influence. Results may be used to improve quality of delivery care for mothers, to inform on policy and to promote health education for service providers.