The purpose of this paper is to discuss the potential role of Thai women during pregnancy and childbirth as active co-participants in their own care, with particular emphasis on the role of Thai culture. This paper is a review of the published literature in this field and what is available in Thailand. In addition the writer's experience has been used to provide further insights into the Thai context and practice. Patient participation is widely regarded, within the health profession literature, as valuable in improving patient health outcomes and the quality of care. It increases the patients' self esteem, sense of control, and also their responsibility for their own health, self care, and satisfaction with health care services. Several factors are related to patients’ participation in their care including; the patients' demographic characteristics, their physicians' characteristics or behavior, the patient-physician relationship, the severity and type of illness that the patient might be experiencing, knowledge of and information about diseases and their interventions, and the health care system. However, in Thailand, patient participation is still rare. To improve the quality of services, health care providers should encourage patients to be actively involved in the health care process.