This study assessed attitudes and preferences regarding childbirth locations among postpartum women in Awka South Local Government Area. A descriptive cross-sectional survey design was used, with 390 postpartum women selected through simple random sampling from a population of 15,800. Data were collected via a structured, self-administered questionnaire and analyzed using SPSS version 22.0, with descriptive statistics including measures of central tendency. Results showed that the majority of respondents (41.3%) were aged 31–40 years. Private hospitals were the most preferred place of delivery (45%), followed by teaching hospitals and health centres, while traditional birth homes and personal residences were least preferred. Women expressed positive attitudes toward institutional healthcare settings (private, teaching, and general hospitals, and health centres) and negative attitudes toward traditional and home-based childbirth. Key factors influencing preference and attitude included perceived safety, cost, distance, fear, convenience, and spouse influence. The study concludes that while many women have strong preferences for institutional childbirth settings, various socio-economic and personal factors play critical roles. It recommends that maternal health services should incorporate women’s preferences to improve service utilization and outcomes.