The purpose of this critical ethnographic study was to explicate the ways that employed mothers' personal and family health decision making were socially organized through the institutions of motherhood, the family, the workplace, and the health care, education, and social systems in Canada. Data were analyzed from individual interviews, a focus group, workplace policy documents, and popular media articles. Twenty women participated over 2 years. Family, workplace, and social contexts were external influences on women's choices and were embodied through internal influences such as personal expectations that framed decision making. Strategies are suggested to promote the health and well-being of employed mothers and their families.