PURPOSE:
This poster shares the experiences of four Norwegian midwifery students during a five-week exchange placement at a public maternity hospital in India. The purpose is to highlight the significance of midwifery-led care through our observations in a setting where midwives were absent, and all births were managed by doctors.

DISCUSSION:
During our clinical placement, we observed that maternity care was entirely physician-led, with no midwives or midwifery model of care present. As students trained in a system that prioritizes physiological, woman-centered care, this contrast was striking. The labour ward operated with high efficiency and focus on pathology. We observed frequent use of interventions such as episiotomies, fundal pressure, and oxytocin stimulation – often applied preemptively, even when labour progressed physiologically. We reflected on how the lack of midwives may have contributed to this medicalized approach, and questioned how care might have looked different with a stronger midwifery presence. The absence of a midwifery profession in this context revealed how systemic structures can shape the nature of care and the birthing experience for women.

EVIDENCE WHERE RELEVANT:
Evidence shows that expanding access to midwifery-led care improves outcomes for both mothers and newborns and reduces unnecessary interventions. Recent studies show that midwife-led care for low-risk pregnancies reduces the use of interventions such as emergency cesarean sections, episiotomies, and epidurals. It is also linked to fewer maternal complications, shorter hospital stays, and better neonatal outcomes, including reduced NICU admissions and lower rates of birth asphyxia (Hannula et al., 2024; Mohammadi et al., 2023).

KEY MESSAGE:
Midwives are crucial for ensuring respectful, physiological birth. Our experience underscored how the absence of midwives can lead to more medicalized births – even when women are healthy. Strengthening the midwifery profession globally is not only a question of numbers, but also of changing how maternity care is delivered. Poster session 2 (Group A)