Will there ever be an end to the Caesarean section rate debate?

Caesarean section rates continue to rise. To date, no serious attempt has been made to address this issue. There are no scientific grounds for identifying an 'appropriate' level for Caesarean section rates. A 'Term Cephalic Trial' may provide such information, but poses major logistic and ethical challenges. The authors propose that a combination of known and newly developed predictors of emergency operative delivery may allow an antenatal risk assessment that could make intervention trials both ethically sound and logistically feasible.