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The article analyses the contexts and practices of head doctors regarding childbirth, whether reproducing or challenging the gender regimes. The research sheds light on men’s practices and representations of masculini- ties in hospital maternity wards and links the personal practices and structural mechanisms reproducing men’s positions of power in the Czech organization of childbirth. It is based on data from research interviews and the public speeches of senior Czech obstetricians and head doctors of maternity wards (15 in-depth interviews and 3 panel discussions). Two basic topics are taken into detailed consideration when discussing the patterns of men’s practices and their discursive representations: (1) defence of the status quo (compliance with the lege artis approach) in contrast to alternative approaches to childbirth by some head doctors and (2) the living paradox of the hospital setting presented as being a formal institution par excellence, while at the same time being an environment for the very informal, individual authority of head doctors. 
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