Background Making perinatal care accessible to women in marginalised periurban areas poses a public health problem. Many barriers to utilisation of perinatal care can be overcome by social mobilisation and capacity building at the community level.

Objectives To determine the existing perinatal practices in two urban slums and to identify barriers to utilisation of health services by mothers.

Study design This is a cross-sectional descriptive study.

Setting and Participants The high-risk periurban areas of Nabi Nagar and Mehfooznagar, Aligarh has a population of 87 000 living in 10 480 households. Mothers delivering babies in September 2010 were identified. A total of 202 mothers were interviewed at home. Current perinatal practices and reasons f health services were the topics of enquiry. Statistical Analysis done by SPSS 18.

Results Analysis revealed that 80.4% of mothers had received antenatal care. However, this did not translate into safe delivery practices. Reasons for preferring home deliveries were mostly tradition (41.9%) or related to economics (30.7%). A total of 56% of the deliveries were conducted in the squatting position and in 25% of the cases, umbilical cord was cut using the edge of a broken cup. Inappropriate early neonatal feeding practices were common. Prelacteal feeds were given to nearly 50% of the babies and feeding was delayed beyond 24 h in 8% of the cases.

Conclusion Barriers to utilisation of available services leads to hazardous perinatal practices in urban slums.