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Objective – To fully understand and address the phenomenon of caesarean section on maternal request, it is import to understand exactly how the decision is made. This study attempts to unravel determinants of the decision-making process from women’s point of view. Design – A descriptive phenomenological study was conducted using semi-structured face-to-face interviews. Setting – The study population consists of women with a preference for caesarean section on maternal request from Flanders, Belgium. Women were recruited through an online advertisement, both on social media network Facebook as well as on Belgian/Dutch online pregnancy forums. Participants – Purposive sample of ten women with a distinct preference for caesarean section on maternal request who are currently pregnant or gave birth in the last five years, were interviewed. Findings – A total of seven determinants were discovered, which can be divided into intrinsic and extrinsic determinants. Intrinsic determinants were beliefs, emotions, experiences and needs. Extrinsic determinants were supportive relationships, birth stories and social judgement. Intrinsic determinants dominated the women’s stories. Key conclusions – Decision making for caesarean section without medical indications as preferred mode of delivery contains both affective and cognitive elements. In particular fear, traumatic experiences and deviant risk perceptions are decisive for women’s decision-making process. Overall, the request for a caesarean section can be understood as wish for a positive birth experience. Implications for practice – There is a need for more adequate patient-physician communication and prenatal provision of information to all women and women with negative previous experiences in particular.