Maternal request for caesarean section: is it obstetrician driven?

To assess whether maternal request for elective caesarean section was in fact obstetrician driven a postal questionnaire was undertaken in the North Thames Region. One hundred and thirtyfour consultants who undertook NHS obstetrics replied to the questionnaire. Only one (0.8%) offered elective caesarean section to all women, and all suggested trial of scar in selected cases. Eighty-three (61.9%) of respondents felt that maternal request had significantly increased their caesarean section rate. It is concluded that maternal request for caesarean section is not obstetrician led, but patient driven.