In 2008, 358,000 women died globally due to complications during pregnancy and childbirth. 99% of these maternal deaths occurred in low-income countries. India has the highest number of live births in the world being 27 million. It has also recorded the world's highest number of maternal deaths in 2008 at 63,000. Maternal deaths do not take place only due to medical reasons. There are economic and social reasons also behind it. Research has proved that besides medical reasons there is link between poverty and maternal deaths in low and middle income countries. Cost to be paid by the poor people to access maternal health care is very high and unpredictable which is a barrier the utilization of maternal health care. Gender inequality and women's low social status also has an impact on women's health, maternal health, and overall demand for maternal health care services. Various policies and programs to improve and expand services, as well as reduce the burden of cost for low-income women, have been taken up from time to time but these actions alone will not help to reduce MMR. Gender inequality may still limit access and prevent women from utilizing the services. Therefore, efforts to improve maternal health care utilization and outcomes must also find ways to empower women and overcome gender inequality. This paper examines how poverty and gender inequality pose obstacles in accessing maternal health care and its utilization which in turn impacts MMR. Gujarat Government's efforts in mitigating these obstacles have also been examined.