The national C-section rate has sky rocketed to nearly 25% of all births, although its widespread use has not improved birth outcomes. Elective cesarean surgery for non-medical reasons is now available to women. The ethical dilemma of elective cesarean involves confusion about what constitutes informed consent. Issues related to autonomy and informed consent requires examination within the context of women's actual health care experiences. The midwifery model of care should be utilized to foster health promotion and active family participation in prenatal care decision making.