The purpose of this study was to determine the level of satisfaction with maternity care and whether satisfaction was related to the patterns of communication between caretakers and patient and to specific clinical procedures used during labor and delivery. Data, gathered in a statewide survey, indicated widespread satisfaction with prenatal labor and delivery care. Level of satisfaction was related to both the quality of communication and the fulfillment of preferences about the management of labor and delivery. There was a general consensus among respondents about the desirability of childbirth coaches, controlled breathing and relaxation techniques, and freedom to move around and the undesirability of medication rendering one unconscious for delivery. There was considerable variation in desire concerning medication during labor, use of a fetal monitor, presence of family members and choice atmosphere. The implications for alternatives in maternity care are discussed.