This article reports on a study of 551 women's birth stories that were posted on a birth stories Web site. These online stories were analyzed for the communication and decision making that takes place between patients and clinicians during the birthing process. In more than half of the stories, the women wrote about at least 1 decision that was made. Further analyses were performed on the 285 stories in which decisions were made. According to this analysis, overall, women were involved in decision making about 57% of the time. The most frequent decision was about painkillers. Making decisions about painkillers and having a midwife as a primary clinician predicted a woman's increased involvement in decision making. Women's involvement in decision making correlated positively with the use of positive emotion words and negatively with the use of negative emotion words in the online birth stories.