Individual obstetricians have the right to decline to conduct a c-section under the guidelines, but they must refer you to another obstetrician who is willing to do the procedure. The NICE advice is applicable throughout the United Kingdom. It is different in other countries. For example, in some American hospitals, it is common practice for doctors to offer elective c-sections on all women without first asking whether a vaginal delivery would be safer for the mother or baby. The reason why some physicians may refuse to perform a c-section is because of fear of making a mistake that could cause serious injury to the mother or child. However many experts believe that this is not a valid reason for refusing to perform these procedures when necessary. You should ask your doctor their opinion about c-sections before going into labor so there will be no misunderstanding later. Some physicians may also refuse to perform a c-section because they do not want to risk their reputation by being known as a surgeon who often fails at performing this simple yet important operation. Finally, some physicians may refuse to perform a c-section because they feel it is not medically necessary and they can manage any complication that might arise during the process. However, others may feel that a c-section is too risky and choose to avoid them altogether rather than take the chance of something going wrong.