Background: The COVID-19 is an infectious disease caused by a newly discovered coronavirus. The World Health Organization (WHO) on March 11, 2020, has declared the novel corona virus (COVID-19) outbreak a global pandemic.

Objective: To assess maternal health care service utilization amidst COVID-19 pandemic in West Shoa Zone, Ethiopia, 2020.

Methods: a Community-based cross-sectional study was conducted from July 1 to September 30, 2020 among 844 pregnant women and those who gave birth in the last 6 months in. Simple random sampling method was used to select the study participants. The data were collected through face-to-face interview using a semi-structured questionnaire. Logistic regressions were performed to identify the presence of significant associations, and adjusted odds ratio with 95%CI was employed for the strength and directions of association between the independent and outcome variables. A P-value of <0.05 was used to declare statistical significance.

Result: All 844 study subjects were participated in the survey. The prevalence of mothers who used ANC was 64.8%. The odds of maternal health service utilization was higher among mothers who had primary (AOR=2.16, 95% CI: 1.29-3.60), secondary (AOR=1.97, 95%CI: 1.13-3.44), and college and above education (AOR=2.89, 95%CI: 1.34-6.22) than those who could not read and write. Mothers who earn 1000-2000 (AOR= 3.10, 95%CI: 1.73-5.55) and > 2000 birr (AOR=2.66 95%CI: 1.52-4.64) had higher odds of maternal health service utilization than those who earn <500 birr. Similarly, the odds of utilizing maternal health service were higher among mothers who did not fear COVID-19 infection (AOR= 2.79, 95% CI: 1.85-4.20), who had not had to request permission from husband to visit the health facility (AOR= 7.24, 95%CI: 2.65-19.75), who had practice of COVID-19 prevention measure (AOR=5.82, 95%CI: 3.87-8.75), and used face mask (AOR= 2.06, 95% CI: 1.28-3.31) than the counterpart.

Conclusion and recommendation: -In this study, maternal health service utilization during the COVID-19 pandemicwas found low. Empowering mothers on prevention mechanism is recommended to improve maternal health service utilization during the COVID-19 pandemic.

Key points: COVID 19, maternal health service utilization,West shoa zone