Scientific and technical progress in maternal care has improved birth outcomes significantly in the last 150 years, but as several recent reviews of services have reported, cultural challenges remain problematic in many institutions of maternal care. This chapter examines ways in which changing patterns of health and practice have placed new demands on maternity services, driving up costs. Efficiency savings are not a long-term sustainable solution and end up placing more stress on the workforce and reducing the quality of care. Restoring a humane culture which prioritises relationships and care is needed alongside appropriate use of technical interventions. Privileging the voice of women, creating ways for them to share their experiences as citizens and as participants in their care plays an essential role in humanising maternity care. This is achieved through culturally sensitive, community-based care. In short, a human response across the whole maternity system, to enable compassion, deep listening and responsiveness to women’s needs offers a resilient and lasting response to these challenges.