BackgroundChildbirth is a transformative experience, yet a considerable percentage of women worldwide encounter negative birth events, affecting maternal wellbeing and mental health. The choice of birth setting significantly impacts outcomes, with midwifery-led units often associated with lower intervention rates and higher satisfaction levels. The recent introduction of midwifery-led units in Spain presents a unique opportunity to explore the impact of this model within a medicalized healthcare context.AimTo capture the depth and diversity of women’s voices, understanding factors influencing their perceptions of childbirth experiences following the introduction of the first midwifery-led unit in the Spanish Healthcare System.MethodsA qualitative study with a phenomenological approach within the constructivist paradigm. Four focus groups were conducted including nineteen women who gave birth in a hospital with both an obstetric and a midwifery-led unit.FindingsThree main themes were identified; ‘Shaping birth expectations’, highlighting the influence of cultural and social contexts on women’s childbirth expectations; ‘The childbirth essentials’, incorporating fundamental characteristics related to the model of care; and ‘Navigating the protective factors’, considering the pivotal role of midwives in delivering compassionate and respectful care.ConclusionThese findings offer valuable insights into childbirth experiences, advocating for a transformation of the medicalized healthcare system in Spain through the integration of midwifery-led units. By prioritising women’s voices and addressing systemic inequalities, healthcare policymakers can enhance maternal care practices and foster positive childbirth experiences for all women.