Background: Socially disadvantaged women have less choice and control over their maternity care and experience poorer birth outcomes than more advantaged women. Midwifery literature suggests that woman-centred care improves birthing experiences for women. However, challenges in providing socially disadvantaged women woman-centred care have been identified. Method: This paper reports on literature relating to social disadvantage, health inequalities and birth outcomes within the Australian context as well as international literature regarding interpersonal challenges identified by women and midwives during interactions. Findings: The establishment of positive, mutually respectful relationships between midwives and women has the potential to improve women's emotional wellbeing, birthing experiences and reduce birthing inequalities. Midwives' ability however, to preserve woman-centred care and develop relationships with women have been identified as challenges when working with socially disadvantaged women. Conclusion: Midwives, as the primary health professional group working with birthing women, are in the best position to enhance maternity experiences and improve birth outcomes. The midwifery profession can strengthen its sociological underpinnings to ensure socially disadvantaged women are supported emotionally as well as physically during pregnancy, birth and their transition to motherhood. Midwifery education that endorses woman-centred care from both a theoretical and clinical perspective can generate stronger midwife-woman relationships and assist in the alignment of ideological stances and practice.