The janani surakhya yojana (JSY), a flagship programme of the national health mission (NHM), was implemented to reduce maternal and neonatal mortality by promoting institutional delivery among marginalised pregnant women in India. This study provides an account of the challenges faced by tribal pregnant women in accessing reproductive health care services. Primary data was collected from various maternal health stakeholders and expectant mothers using qualitative methods. The study adopted data collection methods like focus group discussions (FGDs) and in-depth interviews regarding the programme implementation of JSY at Jaleswar. Secondary data were analysed to understand the effectiveness of government policy in improving maternal health. The study indicates that despite an elaborate programme of action, there is low community perception and trust in bio-medical (mostly) procedures among the tribal population. The government programmes rarely compliment the tribal cultural construction of pregnancy and child birthing with existing medical and professional discourse.