Purpose - This chapter briefly outlines the history of childbirth in the United States and describes the influence of the natural birth movement and consumer demand in shaping the contemporary advertising of mainstream maternity services. Design/methodology/approach - Qualitative content analysis of 59 hospital websites was undertaken in order to understand how hospitals depict childbirth in their online advertising. Findings - Our findings illustrate how contemporary medical institutions idealize childbirth through their depictions of its physical and social dimensions. Although hospital advertising has adopted some of the rhetoric of the natural birth movement in describing the social and symbolic dimensions of the childbirth experience, this rhetoric is shown to stand in tension to the highly rationalized and bureaucratic institutional nature of hospitals. These tensions are most apparent in advertised descriptions of the physical environment of maternity centers and in the attempt to depict hospitalized birth as an opportunity for the individual empowerment of women. Research limitations/implications - This research is limited to an analysis of how providers advertise their services and does not provide data on whether practices actually reflect the rhetoric of the ideal birth. Future research should consider the fit between rhetoric and reality in hospital maternity practices in order to better understand the social structural constraints of delivering these services in a hospital maternity center. Originality/value - This chapter highlights the importance of consumer demand for how maternity services are portrayed and identifies key tensions between an idealized image of birth and the rational, bureaucratic demands of modern medical institutions.