The study looked at why many women in urban Muzaffarnagar, India don't use health facilities when giving birth. They found that lack of awareness, high costs, corruption, poor communication, poverty, and low education levels are major barriers. Even though more trained health workers are available, many births still happen without their help in Southern Asia and Sub-Saharan Africa. This shows that more needs to be done to make sure women have access to safe and affordable maternal healthcare services.