Cesarean deliveries on maternal request (CDMR) have become increasingly common in China within the past 20 years, coinciding with the dramatic rise in cesarean section rates. In recent years, the state has tried to control the escalation of cesarean section rates by restricting those that are considered medically “unnecessary” and particularly those requested by mothers. Drawing upon eight weeks of ethnographic fieldwork and 34 interviews with women, providers and family members at a district hospital in Shanghai, this thesis looks at the sociocultural context that influences mothers in China to request cesarean deliveries, as well as the ongoing negotiations among the state, doctor and woman over control of the childbirth process. Examining the politics of delivery decision-making, in turn, provides a platform for understanding reproductive governance, childbirth and the underlying system of health care in China.