Attendance for intrapartum care in Thyolo District, Malawi, was studied following implementation of a locally valued, non-monetary incentive. The number of facility-based deliveries per month was compared between the fourth quarter of 2007 and the third quarter of 2009, before and after introducing the incentive that included soap, a baby blanket and a traditional baby wrap. The number of deliveries in health facilities increased by 78% over the 2-year period. The increase was larger in peripheral rural facilities compared with the district hospital (94% vs. 38%). Locally developed incentives may lead to more women receiving professional maternity care in Malawi, particularly in rural areas.