Introduction:
Midwives are primary healthcare providers for childbearing women worldwide. Studies showed that women receiving midwife-led care (MLC) were less likely to experience interventions and more likely to be satisfied with their care. Despite the positive effects of MLC, autonomy of Belgian midwives to guide labour and delivery is restricted. Additionally, Belgian data on MLC and midwifery support during childbirth is missing. Therefore, the Flemish Midwives Organisation started a registration on maternal/neonatal outcome of MLC.

Material and Methods:
Midwives registered anonymously perinatal outcomes about autonomously performed births in 2021 by completing an online form. In total, 31 midwifery practices with 108 independent midwives in Flanders and Brussels, reported 1587 registrations. Descriptive statistics was used for data-analysis.

Results:
In total 1587 labours, started at home and were initially planned to give birth under supervision of a midwife. Most deliveries were autonomously performed by midwives (83%, n=1311), either at home, in a birth centre, assisted intramurally or in a MLC unit. One fifth of the women (17%) needed an intrapartum transfer, ending in a delivery by the gynaecologist. Women receiving MLC opted mostly for hands—and-knees positions (43%), had a bath delivery (43%), intact perineum (41%) and no maternal complications. Also neonatal outcomes (e.g. Apgar) were good.

Conclusions:
These findings are in line with previous research, demonstrating the quality of MLC in Belgium, leading to good perinatal outcomes. It shows that midwives are the gatekeepers of physiological childbirth. Further efforts are needed to optimize the registration and visualize the work of primary care midwives.