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Introduction: The 400 000 residents of the Illawarra Shoalhaven Local Health District (ISLHD) experienced two distinct lockdowns aimed at mitigating the transmission of severe acute respiratory syndrome coronavirus 2 infection. Analysing effects of these lockdowns on maternal and neonatal outcomes presents a valuable opportunity to assess the impact of pandemic-level restrictions on maternal and neonatal outcomes. Aim: Evaluate the impacts of restrictions from two lockdown periods on maternal, birthing, and neonatal outcomes within a regional local health district. Materials and Methods: The study included 22 166 women who gave birth within ISLHD between 2017 and 2022. Groups included for analysis: Control Group – mothers pregnant before the pandemic (conception before 3 April 2019); Exposure Group 1 – mothers pregnant during the first lockdown (conception date 22 January 2020 to 5 May 2020); and Exposure Group 2 – mothers pregnant during the second lockdown (conception date 30 A

Illawarra shoalhaven local health districtExposure groupControl groupExposure groupsArs cov 2