Implementing governance standards for hospitals may have a beneficial influence on the clinical efficacy of preterm deliveries. These standards encourage the provision of high-quality treatment, the protection of patients, and the successful administration of healthcare facilities. This study sought to determine the reality of adopting hospital governance standards in two hospitals in Bethlehem governorate from employees’ perspectives, the extent of effective preterm birth case management in those hospitals, and the impact of those standards on that management. Qualitative, observational-cross-sectional investigation. This design suits the research variables. Beit-Jala and Holy Family hospitals were studied in Bethlehem gouvernante. The study's target population was the 189 employees in the administrative, obstetric, and neonatal intensive care unit (NICU) departments of two Bethlehem's hospitals (Beit-Jala and Holy Family). Beit Jala Governmental Hospital has 101 personnel (66 administration, 24 obstetric, 11 NICU). Holy Family Hospital has 88 staff (10 administration, 46 obstetric, 32 NICU). A non-random sample of 189 employees in both hospitals’ administrative, obstetric, and NICU departments received questionnaires, and 133 (70.4%) were returned. The hospital governance standards impact obstetricians’ preterm birth care that Responsiveness, Participation, Rule of Law, Equality, and Justice affect preterm birth management (0.000, 0.000, 0.036, and 0.004). After conducting this study, which aimed to identify the reality of adopting governance standards in two hospitals and their impact on the clinical effectiveness of preterm birth (PTB) cases at Bethlehem governorate from the employees in the administrative, obstetric, and NICU departments, the results show that administrative and obstetric employees have a high reality according to their perceptions. Obstetrics and NICU staff affected PTB management at both sites.