This research aimed to address the following research questions. (1) Is generalized maternal optimism or pessimism (assessed during pregnancy) associated with unplanned cesarean section among women giving birth in a tertiary care hospital in Beijing? (2) If optimism or pessimism is associated with unplanned cesarean section, which is more strongly associated, optimism or pessimism? And (3) if there is a significant relationship between optimism, pessimism, and unplanned cesarean section delivery, is that relationship robust enough to remain significant when clinical factors are included in the model?