A survey of the influence of patients' choice on the increase in the caesarean section rate.

The caesarean section rate in the Royal Gwent Hospital has, as in the rest of the UK, risen significantly over the last 10 years. A commonly proposed reason for this increase is that women themselves are now more likely to request an elective caesarean section, when there is little or no medical indication. The aim of this survey, carried out prospectively, was to find out whether patients' requests for caesarean section are contributing significantly to the rise in the section rate, by attempting to actually quantify the influence of patients' choice on the decision to perform a caesarean section. The results showed that it is possible to quantify this influence, and that maternal request does play a major role in the decision-making process.