Eighty-eight women from diverse educational backgrounds were interviewed as they made several important and related life decisions during their pregnancies. In this article, the focus is on the choice of birth attendant. There were few differences between those women who did and did not consider a midwife. Women who selected a midwife reported feeling more knowledgeable about birth attendants, more in control over the birth attendant decision, more satisfied about their delivery decisions, more in control of and satisfied with pain medication decisions, more autonomous in their pregnancy decision making, and more in agreement with “alternative birth” philosophies and less in agreement with “conventional birth” philosophies. The participants also reported receiving more approval from spouse/significant other and friends, were more likely to use “gut instinct” and previous experience or habit to make pregnancy decisions, and were more ready to make these decisions than were women who had not selected a midwife as their primary birth attendant.