PURPOSE:
In Japan, policy reforms are expanding public health insurance coverage for childbirth, prompting more women to reflect on what kind of care they wish to receive during pregnancy and childbirth. This project aimed to develop and implement a guideline to support women in making informed choices about midwifery care.

DISCUSSION:
Using the GIN Public Toolkit as a reference, we designed a three-stage process for guideline development with active participation from the public. Stage 1: The development team consisted of midwives and two laywomen with personal experience of pregnancy and childbirth but no medical training. Stage 2: From the 15 clinical questions (CQs) listed in the "Evidence-Based Midwifery Guidelines 2024" (developed via systematic review, meta-analysis, GRADE assessment, and consensus methods), members voted on which topics were most relevant to women. The top seven were selected based on average scores. Stage 3: The selected CQs were rewritten in plain language in a Q&A format, clearly explaining key terms such as the strength of recommendation and certainty of evidence. Background context and practical notes were also included to support understanding and application. For implementation, the guideline was published online to allow free access. We also conducted consultations with women to gather feedback on their expectations and information needs regarding pregnancy and birth.

EVIDENCE WHERE RELEVANT:
Involving women in the guideline development process respects their reproductive rights and promotes informed, autonomous decision-making. It also strengthens midwives’ ability to provide care that reflects women's preferences.

KEY MESSAGE:
This initiative contributes to a healthcare environment where midwifery care is recognized as a basic human right, and both women and midwives are empowered through shared knowledge and mutual respect. Poster session 4 (Group B)