This dissertation is concerned with utopian/dystopian projects of future-making, which I examine via the embodied experiences and theoretical implications of caregiving relationships surrounding birth. I’m particularly attentive to those who see such relationships as having transformative social potential, and I argue that the childbearing body is iconic of society in the visions of birth workers, caregivers, medical institutions, parents, and activists. By advocating for particular practices during pregnancy, birth, and infant rearing, these actors work to shape social values and institutional structures. Childbearing is not merely a site for social control, consumer choice, or aspirations to justice, as many popular, professional, academic, and activist works argue. What happens “near birth” is really grappling with assumptions about personhood, the social contract, and foundational American cultural categories. Near Birth builds out from three years of ethnographic fieldwork based in the California Bay Area. The Bay Area is not a paradigmatic site, but a vibrant one that generates opinions, imaginaries, and potentials. With its boom-and-bust industries, high immigrant concentration, massive wealth disparities, and reputation as a haven for free-thinking, it is a bellwether and a place in which tensions over American futures are highlighted. During fieldwork I trained and served as a doula, attended childbirth classes and activist gatherings, participated in professional conferences and salons, and volunteered serving vulnerable childbearing populations. I also followed national and local media, wrote for a medical blog, and interviewed new parents and birth practitioners. In my theoretical framing, I avoid re-inscribing the dichotomies that characterize much scholarly and popular work on the subject. While recent anthropologists of childbirth have produced important topical studies, they have overlooked the illuminating connections and tensions that become visible when the terrain of American childbearing is viewed broadly. There are enormous disjunctures between aspirations, fears, and realities near birth. Utopian and dystopian fantasies of what birth might be are at work in these disjunctures, building upon and referencing each other. The questions raised near birth are nothing less than what is the future of society, and what kind of human is being built for it? Reactionary nostalgia, dystopian panic, and utopian vision motivate the birth worlds of California's Bay Area. Gendered politics, embodied ecologies, and ethical futures are imagined and contested, near birth.