BACKGROUND:
Welsh is an official language of Wales, deeply tied to its identity, history, and culture. While legislation mandates equal provision of Welsh and English in healthcare, implementing bilingual services remains challenging.

OBJECTIVES:
This study explores how the use of the Welsh language affects women's experiences of labour and birth. Additionally, it examines the use of Welsh by midwives caring for women in labour and the impact of language use on their sense of professional fulfilment and job satisfaction.

METHODS:
An ethnographic approach was undertaken in North Wales, where a single Health Board serves a linguistically diverse population, ranging from over 70% Welsh speakers in the West to under 30% in the East. Following ethical approval from the NHS Health Research Authority and Bangor University, data were collected through birthing room observations, postnatal interviews, a questionnaire to all midwives and focus groups with Welsh speaking midwives. A thematic analysis of the data was conducted.

RESULTS:
Six key themes were identified: "The feeling of receiving or providing care in Welsh," "The impact of that feeling," "Offer and choice of language," "Welsh-speaking Wales," "Women conforming to institutional behaviours," and "Time for change." Women described increased feelings of safety, dignity, and individualised care when supported in their mother tongue. Midwives expressed a deeper emotional connection and greater job satisfaction when able to use Welsh with service users.

CONCLUSIONS:
The study highlights the critical role of language in maternity care, which has previously been an afterthought. Having the Welsh language as an encompassing sphere around maternity care positively influences both service users and providers, demonstrating the need to prioritise language choice and provision.

KEY MESSAGE:
Language is not a preference—it is integral to safety, dignity, and personalised care. Whilst rooted in Wales, these findings have broader relevance worldwide in bilingual and minority-language maternity settings. Woman centered 1 (including three-minute presentation competition)