This chapter evaluates the provision of perinatal care within the British National Health Service (NHS). It explores the institutional dynamics inherent to the natal experience and examines the degree to which well-being (of newborn, family, and the wider community) is realised, not just through clinical expertise, midwifery and care-giving but via the officiating organizational mechanics – or bureaucracy – associated with the NHS. To this end the NHS can be represented as (1) existentially secure environment; (2) resource maximiser; (3) broker of community relations; (4) mediator between clinical orthodoxy and cultural contingency; (5) fractional matriarchy; and (6) validating institution. The chapter also reflects on the epistemological challenges and ethical tensions associated with the opportunistic auto/ethnographic method employed.