In many sub-Saharan African countries, including Nigeria, pregnancy and childbirth complications are among the leading causes of mortality and morbidities among women of reproductive age especially in rural communities. This paper examined how women in rural Benue State prepare for births especially as it relates to utilization of maternal healthcare services to avoid potential pregnancy and childbirth related complications. It specifically investigated the factors that hinder rural women from birth preparedness and complication readiness (BPCR). The study which was anchored on Rational Choice Theory utilized intra method triangulation to elicit qualitative data from women of reproductive age (15-49), Woman leaders and community health personnel from 6 rural communities drawn from 3 local government areas in Benue State. Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) were the main instruments used for data collection in order to capture the nuances involved. Findings indicate that utilization of maternal health services in preparation for births among rural women is poor. Cost of transportation, poor knowledge and concerns over cost of service were key barriers to BPCR. The study recommends that policy makers and all stake holders should intensify awareness on the needs and importance of BPCR, and that government should consider complete removal of user-fees on maternal healthcare services in order to improve BPCR.