During the last few decades the cesarean delivery rate has been around 15% in Finland. It has remained moderate compared with USA where 30% of women deliver by cesarean section. Compared with vaginal delivery, cesarean section is associated with a three- to sixfold risk of severe complications. Furthermore, it increases also long term gynecological morbidity, including intermenstrual bleeding, chronic pelvic pain and risk of secondary infertility. Scar pregnancy, uterine rupture, placenta previa and accrete are known risks after cesarean section. Because cesarean delivery is associated with increased long-term morbidity, the decision of performing cesarean section should always be carefully considered.