This article explores emotional styles of Russian maternity hospitals and their recent changes. We focus on two emotional practices that characterise different emotional styles: the Soviet-associated emotional practice of khamstvo (rudeness) and the post-Soviet neoliberal practice of smiling. Emotional styles in healthcare in Russia have been transformed under childbearing women’s consumer demands and new professional standards. However, maternity care in Russia has not been changed entirely into a neoliberal capitalist one. It is ruled by both bureaucratic paternalist (including direct state control) and consumerist logics simultaneously. The hybridisation of these logics has led to numerous problems in the coordination of institutional inconsistencies, which in turn cause emotional dissatisfaction of healthcare recipients. Doctors and midwives are expected to cope with these interactional and institutional challenges and consequences. They juggle emotional practices that refer to repertoires of different emotional styles, performing one or another according to their reading of the situation and type of patient (‘extra demanding and aggressive’, ‘miserable’, ‘ignorant and noncompliant’, ‘service-oriented’). We argue that the shift from one emotional style to another is nonlinear and leads to the appearance of a hybrid form that makes both emotional practices of khamstvo and smiling coexist in maternity care.