BACKGROUND:
The implementation of Midwifery Units (MUs) has been internationally recognised as a key strategy for improving the quality, safety, and humanisation of childbirth care. In the Portuguese context, however, MUs remain largely absent from the public health system.

OBJECTIVES:
This study aimed to explore the perceived barriers and facilitators to MU implementation in Portugal, with the goal of informing context-specific solutions.

METHODS:
Using a qualitative, exploratory-descriptive design, and following ethical approval from the hosting institution, semi-structured interviews were conducted with a purposive and snowball sample of stakeholders, including decision-makers, implementers, participants, and partners. Data were analysed thematically using the principles of Framework Analysis, in order to identify core categories shaping implementation readiness.

RESULTS:
Findings revealed a complex interplay of factors at organisational, professional, sociocultural, and policy levels. Key barriers included: limited institutional awareness of the midwifery model of care; the dominance of obstetric-led paradigms; ambiguous regulatory frameworks; and the low visibility of midwifery autonomy. Facilitators identified included: increasing interest in physiological birth; the presence of highly skilled midwives; support from selected professional groups; and growing public demand for respectful, woman-centred care.

CONCLUSIONS:
Based on these findings, this poster presents a set of strategic solutions to support the implementation of MUs in Portugal. These include: 1. Strengthening midwifery leadership and advocacy; 2. Promoting regulatory and policy reform; 3. Developing interprofessional collaboration frameworks; 4. Investing in midwifery education and public engagement; and 5. Piloting MU models within existing maternity services.

KEY MESSAGE:
These strategies aim to promote system-level change while respecting Portugal’s unique healthcare and sociocultural context. Implementing MUs is not merely a structural intervention, but a paradigm shift, towards care that is evidence-based, safe, and grounded in women’s needs and midwifery values. Poster session 4 (Group B)