This article focuses attention on how care is carried out in the modern Russian obstetrics system in the case of a maternity clinic. In research done on this question, care and the application of technological methods of treatment appear as two opposing approaches to childbirth. Researchers have identified emotional labour, attention to the specifics of the individual giving birth and the creation of a comfortable atmosphere as the key professional qualities of nurses and midwifes. The utilisation of analgesic technologies in childbirth raises the question of the doctor’s role in providing care, as well as issues over the separation of job duties between the doctor and the midwife. An analysis of the use of epidural anaesthesia in Russian birth clinics allows us to draw fresh conclusions on a variety of issues. These include the meaning of anaesthesia for doctors, the value of care for the patient as a marker within the medical hierarchy, professional differentiation in medical care and the alternatives on offer in care and anaesthesia at Russian birth clinics.