Background: Numerous clinicians and researchers have expressed concern about the necessity and potential adverse consequences of many cesarean births in the United States. The purpose of this study was to explore college students' attitudes and beliefs about cesarean section. Methods: One hundred two college students (66% women) completed a 20-item questionnaire that asked i f they viewed cesarean delivery as a potentially negative experience, as a normal or acceptable method of childbirth, and as medically necessary, and asked about their beliefs concerning risk and prevention of cesarean birth. Results: The number of "undecided" responses in the study was striking (7.8% to 69.6% across the 20 items). In general, women and men responded similarly, although women were signijicantly more likely than men to say they would be profoundly disappointed if their babies had to be delivered by cesarean section. Despite expressing cynicism about the cesarean birth rate (40% agreed that many unnecessary cesarean births occurred) and not viewing the procedure as a normal way of giving birth (47%), most respondents (over 70%) disagreed that giving birth by cesarean would be a negative experience or would make a woman feel like a failure. Conclusion: A high level of uncertainty exists about certain aspects of cesarean birth among young women and men, highlighting the need for information for prospective parents. Most college students did not view the cesarean birth experience as either potentially negative or normal. Future research should explore coverage of cesarean birth in childbirth education classes and the roles physicians, nurses, and midwives play in preparing expectant parents for the possibility of cesarean delivety. (BIRTH 24:3, September 1997) Over the past 25 years, the number of women in the United States giving birth by cesarean section has increased dramatically. In 1970 approximately one in 20 births was by cesarean section; in 1988 the rate was nearly one in four (1,2). Since 1988, however, the rate has declined. In 1994, 22 percent of women delivered by cesarean section (I), and in 1995 the rate declined to 20.8 percent (3). Despite the recent reduction, the striking rise in the cesarean birth rate during the latter part of this century reflects the "medicalization" of Claudia Lampman