Prolonged labour is associated with poor pregnancy outcomes with high levels of both maternal and fetal morbidity and mortality. Obstructed labour can lead to uterine rupture, postpartum haemorrhage, sepsis and obstetric fistulae, complications which tend to be seen more commonly in the developing world where reliable healthcare provision is less available. In the developed world catastrophic results from these complications are rare but the caesarean section (CS) rate has been steadily increasing over the last few decades and CS itself is not without risk of maternal morbidity and mortality especially when performed as an emergency. At least one third of all CS are performed for dystocia and over two thirds of women who have a CS in their first labour request an elective CS in a subsequent pregnancy. Caesarean delivery can also lead to problems in future pregnancies including Caesarean scar pregnancy, uterine rupture and placenta accreta spectrum disorder (PASD), complications which are now included in the pre-operative consent taking.