In 2002–2003 an attempt was made to establish ‘normal birth’ rooms within the main delivery suite/labour ward of an inner city teaching hospital, with the aim of providing a less clinical environment for low-risk women to give birth in. The innovation formed part of an initiative to increase the normal birth rate at a hospital with a high caesarean section rate. The process of change, including the promotion of midwifery-led care within the unit was explored as part of a postgraduate research project. An action research approach was used to enable midwives to identify their needs for skills development appropriate to promoting normal birth and to facilitate the exploration of problems encountered. The project formed part of a process of change that has enabled a change in the culture of the unit, increasing the profile and value attached to normal birth and decreasing the caesarean section rate.