Background: The choice of care models during childbirth, particularly midwife-led care versus shared obstetrician-led care, has significant implications for maternal and neonatal outcomes. Understanding the comparative benefits of these models is crucial for informing maternity care practices globally. This study aimed to evaluate the impact of midwife-led care compared to shared obstetrician-led care on assisted vaginal birth, caesarean section rates, APGAR scores, stillbirth/neonatal mortality, and postpartum haemorrhage through a systematic review and meta-analysis. Methods: A systematic search of databases (PubMed, ScienceDirect/Scopus, and ProQuest) identified 1,621 records. After duplicate removal, title and abstract screening, and eligibility assessment, 24 studies were included in the meta-analysis. Data were analyzed to determine the relative risk reduction and statistical significance of outcomes between midwife-led and shared models. Results: The midwife-led care model significantly reduced the risk of assisted vaginal birth by approximately 45% (p < 0.010) and caesarean section rates by about 47% (p < 0.010). However, no significant differences were observed between the two models in terms of APGAR scores < 7 at 5 minutes (p = 0.150), stillbirth/neonatal mortality (p = 0.700), and postpartum haemorrhage (p = 0.61). Conclusions: The midwife-led model of care demonstrates clear advantages in reducing the rates of assisted vaginal birth and caesarean sections without compromising neonatal outcomes such as APGAR scores or mortality. Additionally, the model does not increase the risk of postpartum haemorrhage compared to shared obstetrician-led care. Healthcare systems should prioritize implementing and scaling midwife-led care models for low-risk pregnancies, to improve maternal outcomes while maintaining neonatal safety. Further research should explore barriers to adopting this model in various healthcare settings.