Maternal mortality remains high because of low use of skilled delivery care. While governments try to lower access barriers, little is known about women's preferences. This study combines data from a survey and a choice experiment in Tanzania to compare women's preferences with real choices of delivery care. We find that less empowered women and women who delivered their latest pregnancy outside a health facility find the technical quality of care less important, which indicates that their lower use of delivery care is partly induced by their preferences. Access barriers for poor women are particularly severe with delivery complications. © 2012 Elsevier Ltd.