BACKGROUND:
Supportive Intrapartum Care, as defined by the World Health Organisation Labour Care Guide, encompasses the freedom to eat and drink, maternal mobility, access to pain relief, and effective communication with informed consent for women in labour without clinical contraindications. In Italy, its implementation remains poorly documented and inconsistent, with limited national data revealing regional disparities.

OBJECTIVES:
To examine women's experiences concerning six key aspects of supportive labour care across Italian macro-regions.

METHODS:
As part of the multicountry IMAgiNE Global survey, this cross-sectional study included women aged 18 and older who experienced a spontaneous vaginal birth in Italian healthcare facilities between March 2020 and April 2025. We assessed six key indicators of supportive intrapartum care—freedom of movement, choice of position during labour and birth, pain management, presence of companionship, clear communication, and shared decision-making—and stratified the results by geographic region. Bivariate analysis using the chi-squared test was employed to examine group differences.

RESULTS:
Among 24,235 respondents, 93.3% reported having freedom of movement during labour (range: 87.9–95.7%), and 74.9% during birth (range: 55.0–83.3%). 53.4% received some form of pain relief (range: 38.4–58.6%), and 58.0% had continuous companionship (range: 30.3–73.2%). 83.4% felt involved in clinical decisions, and 91.8% experienced effective communication with providers (range: 70.1–90.7% and 85.4–94.8%, respectively). Significant disparities remain between regions (p<0.001), particularly for pain relief and continuous companionship. The highest percentages across the six indicators were recorded in the North-East, whereas the lowest were observed in Southern Italy.

CONCLUSIONS:
Although freedom of movement and clear communication exceed 90% nationally, fewer than 60% of women in some regions benefit from pain relief or continuous companionship.

KEY MESSAGE:
National and regional strategies must address disparities and apply all indicators of supportive care during labour to ensure equitable and respectful labour care in Italy. Poster session 4 (Group B)