BACKGROUND:
Midwifery-led units (MLUs) are widely recommended by evidence-based guidelines as safe and beneficial for straightforward pregnancies. However, Croatia’s maternity care remains entirely obstetric-led, without access to continuity of care and with restricted midwifery autonomy. Although 447 qualified midwives possess the competencies to autonomously provide care during physiological births, their roles are underutilized. Implementing MLUs could improve maternal outcomes, support care continuity, reduce workload pressures, and lower costs. Determining the proportion of women eligible for MLUs is essential for planning and policy.

OBJECTIVES:
This study aimed to determine the proportion of women eligible for birth in MLU according to Icelandic MLU guidelines and assess the need for introducing MLUs into the Croatian healthcare system. Secondary aims included analysing the prevalence of contraindications and evaluating midwifery staffing needs.

METHODS:
A retrospective study was conducted at the General Hospital Pula, including all women who gave birth between January and December 2024and met the inclusion criteria.

RESULTS:
Out of 1,239 women included in the study, 604 (48.7%) met all the criteria for giving birth in a MLU and had no recorded contraindications. The most common contraindications were a gestational diabetes (20.3%), chronic medical conditions (20.0%) and previous caesarean section (10.3%). The least common contraindications were placenta previa (0.2%) and smoking (0.1%). Given the number of eligible births, 23 midwives would be needed to provide care in this setting.

CONCLUSIONS:
Nearly half of women giving birth could be cared for in MLUs, indicating strong potential for this model in Croatia. Frequent contraindications highlight the need for preventive health programs and cautious caesarean use. Establishing MLUs would enhance women’s autonomy, promote midwifery-led care, and align with maternity care standards.

KEY MESSAGE:
Integrating midwifery-led units into Croatian maternity care is clearly feasible and would be offering strengthened midwifery roles, enabling continuity of care, and greater support for women’s choice in childbirth. Poster session 2 (Group A)