Background <p>Care for low-risk childbirths constitutes a large proportion of deliveries and is highly influenced by factors such as region, birthing facilities, and health care providers. Audit and feedback as a quality indicator (QI) intervention alone have limited effectiveness. Multidisciplinary approaches, including QI and organizational development, are reportedly effective; however, the impact on low-risk childbirth care remains unclear. We aimed to assess the impact of multifaceted intervention, including audit and feedback, on improving care for low-risk childbirths using QIs.</p> Methods <p>We conducted a 1-year pre–post comparison targeting healthy pregnant women in four obstetric wards in Japan. The intervention included audit and feedback combined with multifaceted approaches, improvement efforts by a multidisciplinary team, and educational training on health care quality and organizational culture. The outcomes were 12 QIs.</p> <p>The main analysis used interrupted time-series analysis over 6&#xa0;months pre- and post-intervention. We compared the 9&#xa0;months pre-intervention with 3&#xa0;months post-intervention in secondary analysis to assess delayed effects.</p> Results <p>We included 288 women pre-intervention and 167 women post-intervention. “The spontaneous vaginal delivery indicator showed a significant increase in slope (risk ratio [RR] 1∙08, 95% confidence interval [CI]: 1∙00–1∙16, <i>p</i> &lt; 0∙05), indicating a trend-based improvement rather than an immediate change per month in the main analysis. Secondary analysis showed a significant increase in the administration of uterotonic agents during the third stage of labour (RR 1∙19, 95% CI: 1∙01–1∙41, <i>p</i> &lt; 0∙05).</p> Conclusion <p>The improvement effects of multifaceted interventions, including audit and feedback, using QIs for low-risk childbirths were limited. However, some indicators may improve over time, suggesting a potential delayed effect.</p> Trial registration <p>Not applicable.</p>