Caesarean section rates (CSR) have climbed over the last three decades but some authors have argued that there is no reason to count them, claiming that this practice may lead to inappropriate attempts to lower CSR. However, there are many adverse effects of CS and these are short, medium and long‐term for both mother and baby. There is likely to be an optimal CSR which gives the best perinatal outcomes and unless each caesarean counts, and is counted, CSR will be higher than they need to be for best perinatal outcomes.