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Institutional births increased in India from 39% to 79% between 2005 and 2015. Drawing from 17 months of fieldwork, this article traces the shift from home to hospital births across three generations in a hamlet in Assam in Northeast India. Here, too, one finds that most births have shifted from home to hospital in less than a decade, aided by multiple factors. These include ‘free’ birthing facilities and financial incentives offered by government schemes, idiosyncratic changes within the hamlet, such as the introduction of biomedical practices through home births where oxytocin was used, and changes in cultural belief systems among local people. The exploration reveals significant transitions between (and fluidities of) categories such as local/global, tradition/modernity, past/present and nature/technology, creating a complex and ambivalent narrative of change, in which the voices of mothers should not be ignored.