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Aim: To determine the relationship between perceived satisfaction with childbirth and perceived autonomy in decision making during the childbirth process. Design: Cross-sectional study. Methods: The study took place within the international INTERSECT project. Data were collected in four hospitals in Slovakia. The research group consisted of 437 female respondents (average age 30.5 ± 4.8). Birth Satisfaction was measured by the Birth Satisfaction Scale - Revised (BSS-R). Level of autonomy in decision making during childbirth was measured by the Mothers' Autonomy in Decision Making Scale (MADM). Results: Respondents who perceived a higher level of autonomy in decision making during childbirth perceived higher overall satisfaction with childbirth (p = 0.001, r = 0.416). Higher age of mothers was also associated with higher birth satisfaction (p = 0.004, r = 0.139). Almost 17% of respondents perceived their childbirth to be a traumatic event. Respondents described lower levels of satisfaction with childbirth (p = 0.001) and lower levels of autonomy in decision making during childbirth (p = 0.002) if they subjectively perceived their childbirth as traumatic. Significant associations for the BSS-R score were also demonstrated regarding parity (p = 0.001), mode of delivery (p = 0.001), and type of delivery (p = 0.001). Conclusion: The involvement of the mother in the decision-making process of her own birth is a fundamental aspect of healthcare during childbirth and overall satisfaction with the birth.