The authors have trawled the literature on self-inflicted Caesarean section, assessing circumstances and probable motivation; 19/22 cases had sufficient information. In seven cases, the apparent intention was to kill the child. In four, the action resulted from some form of mental illness. In eight, the woman, in the agony of obstructed labour, took matters into her own hands. We think the third group would be more numerous if there were more publications from Africa and South Asia, where many women give birth without the aid of modern obstetrics. The survival rate among the mothers was surprisingly high.