Objective: To investigate the impact of individualized midwifery care on delivery outcomes among older women. Methods: A total of 72 cases involving elderly puerpera, admitted to the hospital from June 2022 to June 2023, were randomly assigned to two groups. Group A received individual midwifery intervention, while Group B received routine obstetric intervention. The mode of delivery, maternal emotional score, and maternal vital signs were compared. Indices such as total labor duration, postpartum hemorrhage, and nursing satisfaction were also assessed. Results: The cesarean section rate in Group A was significantly lower than that in Group B (P < 0.05). Following nursing, the SAS and SDS scores in Group A were lower than those in Group B, and indicators such as SBP, DBP, and HR were also lower in Group A (P < 0.05). The total labor duration was shorter in Group A, and the amount of postpartum bleeding at 24 hours was lesser compared to Group B (P < 0.05). Furthermore, parturients in Group A expressed higher satisfaction than those in Group B (P < 0.05). Conclusions: Individualized midwifery care for older women proves effective in reducing the cesarean section rate, shortening the labor process, and minimizing bleeding. These findings underscore the practicality and feasibility of implementing individualized midwifery care for this demographic.