Although many women in the United States speak about childbirth as a natural process, to differing degrees they accept and often prefer a medicalized birth. This article analyzes issues of choice and control related to women's desire for and access to knowledge about childbirth in light of advanced technology and with constraints imposed by medical institutions, medical ideology, and social class. In a comparison among three groups, lay middle-class women, health professionals who are also middle-class, and poor women, research findings showed that lay middle-class women held a wide range of views about technological birth. Most of these women were concerned with making choices that would allow them to have some control over the course of their pregnancies and over childbirth. To facilitate control, they often chose a physician, in part, to serve as their advocate within the medical system. Middle-class health professionals, also concerned with control, used their knowledge of the system as a way of maintaining that control. On the other hand, poor women neither expected nor desired control but were more concerned with continuity of care.