Caesarean section (CS) is a routine part of modern obstetric practice, with the aim of reducing maternal and perinatal morbidity and mortality. There is significant geographical variation in CS rates throughout the world, ranging from 0.4 percent in Chad to 45.9 percent in Brazil, with significantly higher rates seen in developed countries. Caesarean section is an integral part of obstetric practice, with around a quarter of babies in the UK being born by this method. There are many drivers to reduce the number of ‘unnecessary’ caesarean sections. In some cases of planned CS, maternal choice should be considered in the decision-making process, including cases with no previous CS and no medical indication. Elective CS rates showed little variation across England, but there are significant differences in emergency CS rates between organisations. CS before the onset of labour is associated with increased respiratory morbidity in the neonate, the risk of which decreases after 39 weeks’ gestation.