As the rate of primary and repeat Caesareans around the world increases, obstetricians, midwives and primary care providers are being expected to provide counsel to women seeking information regarding birth choices for delivery after a prior emergency Caesarean. This article seeks to contribute to the knowledge on this topic by presenting research findings from a qualitative study designed to explore, from the mothers' perspective, the decision-making experience with regards to subsequent birth choice for women who have previously delivered by Caesarean section. Specifically, the findings in this article present the perspective of the mothers who opted for elective Caesarean. Eighty per cent of mothers in this study chose elective Caesarean for reasons of fear and the desire to retain some control over the birthing process. For many, this decision is made prior to or early in pregnancy without any openness to consider other possibilities. Thus, the findings strongly emphasize the importance of understanding and taking into consideration the mothers' psychosocial perspective on birth choices as a key to providing counsel and support.