Background: Despite policies and programmes designed to ensure safe motherhood, maternal morbidity and mortality rates have remained high in Nigeria. Household environment has been identified as crucial in maternal health; yet, little has been done to identify the environmental conditions that predispose women to morbidity and mortality in predominantly rural Northern Cross River State. This study investigated the role of household decision-making, domestic violence, access to and utilisation of maternal health facilities and socio-cultural practices that influence maternal health status. Methods: A sample of 823 respondents was drawn and used for the study. The study involved both qualitative and quantitative approaches. Twenty each of Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) were conducted among women of different ages, traditional birth attendants and elders were key informants. Results: Household environment is significantly related to maternal health (χ2=15.8; P<0.05). The likelihood of better maternal health was significantly higher among households that used flush toilet than pit/latrine (OR=3.2; P<0.05), pipe-borne water than stream water (OR=5.0 P<0.05), electricity/gas for cooking than firewood (OR=8.9, P<0.05). Toilet facilities, water sources and cooking environment were poor among many women thereby exposing them to various infections. Socio-economic status of women played a significant role in maternal health (χ2=13.8; P<0.05). Ever married women had better health status than those that were single (χ2=10.0; P<0.05); women who had their first babies earlier than 20 years of age had poorer health status compared to those who had them later (χ2=14.9; P<0.05). However, maternal educational qualification showed no significant relationship with maternal health. Household sanitation and hygiene behaviour were significantly related to maternal health status (χ2=10.5; P<0.05; χ2=16.5; P<0.05).Conclusion: Maternal health is the result of cumulative effects of household environment, cultural practices, attitudes and behaviours. Improving the household environment and behaviour could improve maternal health. This could be achieved through improvement of health services and information in the rural communities.