Introduction: Twenty first century brought hostile face to many peoples across the globe. Starting from the day it was declared as outbreak on December 2019 in China and declared as pandemic in 11 March 2020 by WHO, the novel coronavirus disease (COVID-19) has been observed in almost all countries and costing the life of hundreds of thousands. Several preventive measures have been recommended to halt the spread of the disease and its associated mortality. The counter effect of these preventive measurements is believed to affect the health of many vulnerable populations including pregnant mothers. However, the potential effect of COVID-19 on the Level of Maternal Health service Utilizations are yet to be evaluated.

Objective: The aim of this study was to assess the potential effect of COVID-19 on the Level of Antenatal care service utilization and associated factors among reproductive age women in selected districts of East Wollega Zone, West Wollega Zone, and Horo Guduru Wollega Zone, West Ethiopia.

Methods: This a part of project on the impact of COVID-19 on health service delivery, health care utilization and mitigation ways of decreasing secondary impacts in Wollega Zones, Western Ethiopia. A community based cross-sectional study was carried out in selected districts of Wollega Zones to collect data from 845 of mothers who gave birth since covid-19 outbreak in Ethiopia. Systematic random sampling technique was used to select the study participants. Epi data version 3.1 and Statistical Package for the Social Sciences window (SPSS) version 25.0 were used for data entry and analysis respectively. Both bivariable and multivariable logistic regression was done to identify factors associated with the level of maternal health service utilization during this pandemic.

Results: The overall antenatal care service utilization was 54.41 (95%CI: 42.3-49.3%). More than two-third of those who did not attended ANC are due to COVID-19. Rural residence, Fear of Covid-19 infection, practice of covid-19 measures, belief that health facility is source for covid-19 infection, favorable attitude towards COVID-19 preventive measures were significantly associated with antenatal care utilization.

Conclusion and recommendation: The finding indicated that nearly half of women who gave birth recently did not attend the antenatal care services. Hence, prioritizing maternal health services amid COVID-19, and implementing the strategy to combat the fear and increase the level of practice should be emphasized more.

Key words: Antenatal care ,service utilization,  COVID-19, Ethiopia