BACKGROUND:
Midwifery-Led Units (MLUs) provide women-centred, respectful care, minimising medical interventions and enhancing birthing experiences, while integrating the midwifery model into existing health systems to improve maternal and newborn outcomes. In addition, establishing midwifery-led birthing centres will ensure respectful maternity care. In 2019, a tertiary hospital in South India established the first co-located MLU to integrate professional midwives into the healthcare system.

OBJECTIVES:
To showcase the impact of a co-located MLU on birth experiences, maternal and neonatal outcomes and highlight the need for such units across India.

METHODS:
A retrospective analysis was conducted from July 2019 to December 2024 to assess birth outcomes, transfer rates, and maternal birthing positions. We used a robust methodology, including data collection from patient records and employed descriptive statistics for analysis.

RESULTS:
Over the course of 65 months, 1,839 women received care at the MLU. Of these, 70% had spontaneous vaginal births. 30% required transfers to the Obstetric-Led Unit, where birth outcomes included 51.8% spontaneous vaginal births, 28% assisted vaginal births and 20% c-sections. Most common reasons for transfers were request for epidural analgesia, meconium-stained liquor and fetal bradycardia. 84.5% of women chose upright position, 11.8% opted left lateral position and 3.4% other positions (including all fours, squatting and standing). Perineal outcomes showed 48.3% had first-degree tears, 26.8% had second-degree tears, and 0.6% experienced third-degree tears. Additionally, 21.6% of women had an intact perineum, while 23% underwent an episiotomy. 354 mothers opted for water birth, and 704 opted for hydrotherapy.

CONCLUSIONS:
The MLU model is a safe, evidence-based option for low-risk pregnancies. Scaling this model across similar settings in India could transform maternity care and reduce unnecessary interventions.

KEY MESSAGE:
Midwifery-led care promotes positive birth experiences, including respectful and less-interventional births for low-risk women. This underscores the importance of our research and its potential impact on India’s maternal and neonatal health. Poster session 1 (Group A)