Despite concerted efforts by national and local governments, and by nongovernmental and international organizations, the utilization of maternal health services in developing countries is far from universal and varies strongly within and between countries.1 Moreover, income disparity in access to maternal care is widening across and within countries, with poor women receiving fewer services than those who are better off. 2-5 Antenatal visits have multiple benefits-early detection of pregnancy complications, anemia and related health problems, as well as an increased chance of further health care utilization and contraceptive use-and delivery at a health center significantly reduces maternal and infant deaths. 6-9For these reasons, universal access to sexual and reproductive health was integrated as one of the key targets of the MDGs in 2006. India's progress toward universal access to sexual and reproductive health is of global significance, as India accounts for 17% of the world's population and more than one-fifth of all maternal and child deaths.10,11 Empirical evidence suggests that maternal care has improved in India over the last two decades, but progress has been slow overall and uneven within the country. For example, the proportions of women in India who received at least three antenatal visits for their last pregnancy and medical assistance at delivery increased between 1992 and 2006, from 44% to 51% and from 35% to 49%, respectively; 12 however, the rich-poor ratio (i.e., the ratio of the richest to the poorest wealth quintile) for use of antenatal care remained at 3.3 over the period, while the ratio for use of medical assistance at delivery declined from 5.1 to 4. and 2006 that were delivered in a heath center varied from 18% for women with no education to 86% for those with 12 or more years of schooling. 12In the last two decades, research has contributed to the understanding of economic disparities in health and health care utilization. Many studies used data from Demographic and Health Surveys (DHS) and analyzed inequalities in maternal and child health by household wealth, controlling for other social and demographic confounders. [13][14][15][16][17][18] In addition, some outlined the contextual determinants of maternal and child care in different Indian states. 19-22Although such research has demonstrated that household wealth plays a key role in health inequality, little attention has been paid to understanding the linkages between multiple dimensions of deprivation and health care utilization.