Is elective cesarean birth an issue of a woman's autonomy to choose her mode of birth or fear of labor by both the patient and the providers? Are women consenting to this procedure truly informed about the short-term and long-term risks associated with cesarean birth versus vaginal birth? This article examines the issues associated with elective cesarean birth and the factors that have led to recent consideration of this option. It is essential that we evaluate how risks, benefits, and liability issues impact the recommendations for the mode of birth. The ethics of making an informed choice as well as ethical professional responsibilities are explored.