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Objectives: Despite efforts made by the Government of Nepal to reduce maternal and newborn mortality nationally, the rate is still significantly higher in remote mountain areas. This research aimed to fill a gap by asking women about socio-cultural factors influencing childbirth outcomes in remote mountain areas of Nepal.

Methods: This study used a qualitative approach guided by the principles of social constructionist and feminist critical theories to derive factors influencing women’s experiences of giving birth and childbirth outcomes. In-depth interviews were conducted with 25 pregnant and postnatal women. A thematic approach was used for data analysis.

Results: Childbirth outcomes in remote areas are influenced by the broader social determinants; specifically, physical access to hospital services; remoteness, poverty, and food insecurity; and disconnect between policy, practice, and reality.

Conclusions: Women’s voices highlight the influence of critical determinants in determining childbirth outcomes, a situation which requires an immediate policy shift to a social determinants approach to improve maternal and newborn survival rates.