SummarySummaryThere were 9387 deliveries within the study period, of which 104 (1·1 per cent) were caesarean sections for fetal distress in labour, with a singleton cephalic presentation at 37 or more weeks gestational age. Caesarean section for fetal distress was associated with a significant increase in the incidence of poor neonatal condition as defined by low Apgar scores (P<0·-001) or special care baby unit admission for asphyxia (P<0·001): but not with any increased incidence of fetal scalp blood or umbilical arterial or venous acidaemia.There was an association (P<0·05) between the interval between decision to deliver and operative delivery, and admission to the special care unit. The relative risk doubled between a 10 and a 35 minute interval. No correlation was found between the decision delivery interval and 1 or 5 minute Apgar scores, or cord arterial and venous acid-base results.A short interval from decision to delivery may be important if optimal neonatal condition is to be achieved.