This paper delineates important considerations for having a better understanding of quality in maternity care. High quality requires providing a minimum level of care to all pregnant women and their new born babies and a higher level of care to those who need it; obtaining the best possible medical outcome of mother and baby; providing care which satisfies users and providers; and maintaining sound managerial and financial performance. While all these aspects are important, prioritizing among interventions to improve them will be influenced by cultural values, expectations and available resources.