Background: Midwife communication is one of the important competencies in midwifery services that plays a role in improving patient satisfaction and service quality. Although there have been many studies on midwife communication, the results are still scattered in various service facilities so that a synthesis of scientific evidence is needed. Objective: Identify, evaluate, and synthesize scientific evidence regarding the role of midwife communication in building therapeutic relationships and improving patient satisfaction with midwifery services through a Systematic Literature Review. Methods: This study uses the Systematic Literature Review method referring to the PRISMA 2020 guidelines. Article searches were conducted through Google Scholar and PubMed databases using keywords related to midwife communication, therapeutic communication, patient satisfaction, and midwifery services. Articles published in 2020–2025 were selected based on inclusion and exclusion criteria so that six articles were eligible to be analyzed using narrative synthesis. Results: The six articles reviewed consisted of five cross-sectional studies and one quasi-experimental study. All studies show that midwifery communication has a positive effect on patient satisfaction, while therapeutic communication contributes to a decrease in maternal anxiety during pregnancy and childbirth. Communication that is empathetic, clear, responsive, and involves patients in decision-making can improve therapeutic relationships, patient satisfaction, and a positive service experience. Conclusion: Midwife's communication is a core competency that plays a role in building therapeutic relationships, increasing patient satisfaction, and supporting the psychological well-being of the mother. Strengthening communication competence needs to be integrated in midwifery education, continuous professional training, and service practices to support quality, safe, and women-centered midwifery services.