Background <p>Effective communication between midwives and mothers is an essential part of positive birth outcomes. Mothers and midwives are both important for building a communication environment during childbirth. This study was conducted to explore midwives’ and mothers’ perspectives on effective communication in the maternity ward.</p> Methods <p>This study is a part of a mixed-methods study. A qualitative inductive content analysis study using in-depth interviews with 10 midwives and 11 mothers was performed in Ahvaz, southwestern Iran, between July and October 2023. The data were analyzed via inductive content analysis techniques.</p> Results <p>The qualitative content analysis identified a core concept: mothers’ self-entrustment to midwives, reflecting their growing confidence and reliance on midwives through effective communication in maternity care. This concept is underpinned by three main categories: (1) Creating a safe space; midwives ensure physical and emotional security through empathy, privacy, and non-judgmental communication; (2) Establishing spiritual oneness; a deep emotional connection fostering unity and holistic support; and (3) Building trust; rooted in midwives’ competence, honesty, and reliability. These main categories, further elaborated through eight categories, outline specific behaviors and interactions that enhance midwife-mother communication.</p> Conclusions <p>This study demonstrated that effective midwife-mother communication, achieved by ensuring a safe environment, fostering emotional connection, and demonstrating reliability, facilitates maternal self-entrustment; a process where mothers progressively develop confidence in and reliance on their midwives. These key components form a practical framework for enhancing maternity care interactions and strengthening therapeutic relationships.</p>