Maternal health is considered a key global priority by the World Health Organization, and several strategies are used to promote it. Especially in lower- and lower-middle-income countries, one widely used strategy employs financial incentives to motivate pregnant women to access available healthcare. While such interventions have been extensively empirically evaluated, their normative aspects appear to have received less attention. To address this gap, we systematically searched and reviewed normative and qualitative literature to map and analyze the ethical considerations of using financial incentives to promote maternal health. Twenty-three articles (four normative and 19 qualitative) were included in the review. We grouped ethical considerations under six categories, namely the program structure, promoting institutional births, of the ethical significance of cash, justifying conditionalities for maternal health, effects on individuals’ decision-making and the experiences of vulnerable groups. While incentives could be used for beneficent goals, we show how they may emphasize global rather than local solutions, impose unfamiliar sociocultural values, unfairly expect behavior change and disempower individuals and groups. We argue that future maternal health policy, especially those targeting vulnerable groups and minorities, would benefit from taking these normative considerations into account.