The midwife has a time-honoured, powerful and privileged role in creating a facilitative environment for birth. The midwife’s capacity-building role extends to supporting each woman to discover who she is and what she is capable of. The mother/fetus dyad is an ecosystem and physiological birth is eco-friendly. Physiological labour and birth do not require a great deal in terms of material resources; they do, however, require the loving attention of skilled and caring midwives. Physiological birth needs to be protected, promoted and supported because it is the epitome of a human activity with an extremely low carbon footprint. In this chapter, Carolyn Hastie explains midwifery’s vital and influential part in ensuring the sustainability of the childbearing process and maternity care and offers a series of support strategies in order to achieve this.