This study investigates how legal frameworks, public health evidence, and midwifery practices shape access to and perceptions of midwifery-led care and home births across Europe. Using a comparative case study of the Netherlands and the Czech Republic, the research explores how state policy, legal regulation, and cultural narratives influence maternal autonomy and reproductive rights. Maternal health encompasses more than biomedical outcomes; it reflects a person’s full well-being across the reproductive cycle, including access to autonomy, quality care, and dignified treatment. The study aims to assess how these principles are supported or constrained in European healthcare systems, with particular attention to the regulation and legitimacy of home births.