There can be no doubt that far too many caesareans are being performed all over the world without any real benefit to either mothers or babies. Even if a surgical delivery is unavoidable there is evidence to show that both mother and baby benefit from a period of spontaneous labour.

There are many areas of concern regarding the rising caesarean rates, particularly the growing number of non medical reasons for performing this form of major abdominal surgery. Chief among these is doctors' fear of litigation, should they not intervene soon enough in a difficult labour (though considering the number and severity of side effects of caesarean delivery, it is only a matter of time before a case is brought against a doctor for intervening when it was unnecessary). Physician's impatience and convenience also play a disproportionate part.Where caesarean is necessary, it can sometimes be because of interventions earlier in labour. For instance, artificial rupture of the membranes to induce or augment labour can lead to cord prolapse, where the umbilicus comes out before the baby does and is crushed by the baby descending into the birth canal. This in turn can cause brain damage and death unless a caesarean is performed quickly (usually under a general anaesthetic, which carries its own specific risks). Reducing the caesarean rate is likely to be the result of multi dimensional pressure brought to bear on our practitioners.