When and why did the overwhelming majority of Western women come to deliver their babies in hospitals? Though lying-in institutions had been established in the eighteenth century, only after World War II did hospital birth become the norm. This shift, which went hand in hand with population-wide surveillance and extensive monitoring, gained wide acceptance but was challenged by activists in the context of consumer and feminist critiques of paternalistic and patriarchal healthcare services. The chapter reviews historical writing on this hugely consequential transformation, and reflects on the state of play after the ‘birth wars’ of the 1970s and ’80s. Situating shifts in the management and experience of childbirth within wider developments in hospitals as institutions, it argues that the move to the hospital resulted from the interplay between the attitudes and expectations of women and their families, medical innovation, state policies, and broader social and economic change.