Elective cesarean delivery, or cesarean delivery on maternal request, was the focus of a recent State-of-the-Science Conference sponsored by the National Institutes of Health. On the basis of the information from comprehensive literature review and expert speakers, the panelists determined that weak-quality evidence supported elective cesarean delivery over planned vaginal delivery for urinary incontinence, although the duration of effect is not clear. For other maternal outcomes related to pelvic floor function, including pelvic organ prolapse, fecal incontinence and other anorectal symptoms, and sexual function, weak-quality evidence did not favor either route of delivery.