Problem: geography and difficulty of access to health care contribute to maternal and neonatal mortality in the North and Northeast of Brazil. Aim: to identify the care arrangements used during labor and birth by midwives from the Amazon. Method: 15 midwives from the cities of Manaus and of Vila de Lindoia/Itacoatiara region took part in two focus groups held between December 2015 and March 2016. Data analysis focused on three cores of meaning and the use of narratives. Results: most of the arrangements designed to assist women occurred in cities in the inner regions of the state of A mazonas, B razil. The midwives’ narratives were based around three core sets of meanings: Complicity and Recognition; Midwife Memories, and Labor and Birth. Conclusion: midwives build a logic for care centered around women. It is an extensive and creative practice, available to sustain life during and after the birth.