Approximately one-third of all babies born in the UK at the time of writing will be delivered by Caesarean section (CS). For some, this will be a medical necessity but may be viewed by the woman as a trauma in itself, regardless of how competently the surgery was performed. For other women it will come as a relief to have their baby born in this way, especially if a previous vaginal birth had been traumatic. All surgery has risks and those related to obstetrics can be extremely serious, including major haemorrhage and damage to other organs. Risks will be increased by repeated operations, a point that becomes relevant when women have four or more CSs, but which may be an issue after only one previous CS. The potential risks of surgery must be explained carefully prior to the procedure. Particular attention is needed when having these discussions with those who may lack capacity to give consent and those who decline blood and blood products.