Background: In Sweden, women often meet with different midwives during antenatal, intrapartum, and postpartum care, due to the structure of maternity care, with few alternatives which provide continuity. This study aims to explore women's interest in having a midwife they know present during labor and birth and to identify the characteristics of women who prefer this option.

Methods: A comparative study was conducted involving two Swedish nationwide cohorts of Swedish-speaking pregnant women. The first cohort included 3,061 women, and the second 1,812 women. Descriptive statistics and odds ratios were calculated.

Results: In total, 4,873 pregnant women completed the survey. Most participants were aged 25-35 years, living with a partner, and born in Sweden. Interest in having a midwife they know increased from 53% in 1999 to 76% in 2024. Key factors associated with this preference included primiparity (OR 3.80; 95% CI 3.27-4.40), being pregnant in 2024 (OR 3.21; 2.70-3.86), being born outside Sweden (OR 2.73; 2.11-3.54), and fear of birth (OR 2.03; 1.56-2.63).

Conclusions: Interest in having a known midwife during childbirth has grown significantly in Sweden, highlighting the need for policy changes that promote awareness and expand this option for women.