Simulation-based clinical education plays a pivotal role in assessing and enhancing clinical competence, particularly during the COVID-19 pandemic. This study, in support of the CHED-LAKAS program of the Commission on Higher Education (CHED), evaluated the perceived competence and satisfaction of Level IV nursing students in intrapartal and immediate newborn care during delivery room simulation-based learning (DR-SBL) at a state university. Using a quantitative descriptive correlational design, 143 respondents from the West Visayas State University College of Nursing, La Paz, Iloilo City, were surveyed through researcher-made questionnaires adapted from standardized tools. Results showed that students rated themselves as highly competent in intrapartal and immediate newborn care, with the highest competence observed in managing resources, environment, and equipment. Satisfaction levels were similarly high, with no significant differences based on gender. A positive correlation was found between perceived competence and satisfaction (p < .05), highlighting the interconnectedness of these factors in DR-SBL. The findings affirm the effectiveness of DR-SBL in fostering competence and satisfaction among nursing students, ensuring meaningful learning experiences and readiness for clinical practice.