Ntoimo LFC, et al. - In view of the available evidence inferring that often Primary Health Care Centres in Nigeria are not used by pregnant women in rural communities for skilled care, researchers sought for the reasons of not using PHC for skilled pregnancy care in rural Nigeria. They obtained qualitative data from 20 focus group discussions carried out with women and men in the marital union. The analysis revealed four broad categories of reasons for non-use: 1) accessibility factors – poor roads, trouble with transportation, great distances, and facility not always open; 2) perceptions relating to inadequate quality of care, comprising inadequate drugs and consumables, abusive care by health providers, providers not in sufficient numbers and not always available in the facilities, long waiting times, and inappropriate referrals; 3) high costs of services, which include the inability to pay for services even when costs are not excessive, and the introduction of informal payments by staff; and 4) Other comprising partner support and misinterpretation of signs of pregnancy complications. They recommend addressing these factors through adequate budgetary provisions, programs to reduce out-of-pocket expenses for maternal health, adequate staffing and training, innovative methods of transportation and male involvement to increase rural women’s access to skilled pregnancy care in primary health care centers in the country.