The increase in incidence of Caesarean sections in the Netherlands has resulted in improved infant outcomes in breech infants. About two hundred extra caesarean sections are needed to 'save' one baby. However, maternal outcome is impaired, with increased risks of uterine rupture, placenta praevia and placenta increta in subsequent pregnancies. Data from the Netherlands indicate that for every infant saved by a caesarean section, one woman will experience a uterine rupture during a subsequent pregnancy. These factors have to be taken into account when counselling women. Future reproductive considerations and the motivation of the woman and the gynaecologist for a vaginal breech delivery should be discussed during counselling.