Dissertation (MSc Midwifery)COVID-19 is one of the pandemic outbreaks the world ever experienced. The outbreak has caused serious effects on the health industry where the need for healthcare services is inevitable. However, there is sparing empirical data on the midwife preparedness on COVID-19 and its impact on maternal service utilization in Tanzania and even globally. This gap necessitated this study to assess the midwife preparedness on COVID-19 and its impact on maternal services utilization in Dodoma Region of Tanzania. A hospital-based cross-sectional study design was conducted using both quantitative and qualitative approaches. Data were collected through a self-administered questionnaire and focused group discussions. A total of 116 midwives and 384 postnatal women were sampled through two stages random sampling technique to participate in the study. Overall, 11.21% of the midwives in labor wards were adequately prepared and 54.31% had adequate knowledge on COVID-19. Further findings revealed that midwives with diploma/bachelor level of education (AOR = 2.62, p= 0.033), not married (AOR =2.38, p= 0.024), those working in urban health facilities (AOR =6.58, p <0.001), and those who attended training on COVID-19 once (AOR =3.65, p=0.033) or more than once (AOR= 4.98, p= 0.002) were significantly more likely to have adequate knowledge on COVID-19. The challenges facing midwives in providing care to mothers during the period of COVID-19 included midwives’ experiences on providing care during COVID19, lack of supportive work environment and emotional and mental health wellbeing problems brought by COVID-19.Social stigma and misconceptions. It was felt that COVID-19 led to massive isolation among midwives, patients, and the community. Additionally, the current married postnatal mothers (AOR =1.75, p=0.028), employed (AOR= 4.43, p= 0.001) and self-employed mothers (AOR = 1.65, p= 1.048) were significantly more likely to attend ANC services during COVID-19 pandemic. Besides, 47.4% of included postnatal mothers attended ANC services during COVID-19 pandemic. A significant difference in number of hospital deliveries before and during COVID 19 was observed (p= 0.042). Also, the average number of ANC visits per month during the pandemic was significantly lower (981.7) compared to the previous visits (1162.5) (T= -3.19, p= 0.033). Higher proportion of the Midwives from the selected health facilities were inadequate preparedness on COVID 19 and low level ANC services attendance among postnatal mothers during COVID-19 was observed. Few midwives received training, inadequate guideline and PPE in labour wards. Education level, marital status and number of COVID-19 training attended were significant predictors of COVID-19 knowledge among midwives. The number of ANC visits per month during the COVID 19 pandemic was lower as compared to before pandemic. Also, attendance of ANC service during COVID-19 among postnatal mothers was significantly associated with mother occupation and current marital status.