The notion of choice, especially of informed choice, is a central tenet of maternity services in most western countries; it also underpins debate about rising rates of intervention that are now a feature of childbirth in many of these countries. Our study investigated the shaping of understanding and practice in relation to these rising rates of intervention in childbirth in the New Zealand context. Critical hermeneutics was used to analyse the data from interviews with nine midwives and obstetricians, and six focus groups with 33 women. This article reports on the notion of choice, which featured prominently in all the interviews. It became clear that women’s choices were strongly influenced and determined by social change, by the gendering of women, and by values such as control, predictability, convenience, the ‘quick fix’ and the normalization of surgery. We argue that the prevailing notion of ‘informed’ choice obscures the structural and social influences on ‘choice’.