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Objective: To compare maternal medical outcome after planned vaginal delivery and planned Caesarean section. Methods: We conducted a prospective cohort study of healthy primiparous women in Stockholm, Sweden, who were either scheduled for a planned Caesarean section (for breech presentation or at maternal request) or admitted for a vaginal delivery. Data were analyzed according to intended mode of delivery. Results: A total of 541 women were included in the study; of these, 247 had a Caesarean section and 294 a vaginal delivery. There were sociodemographic differences between the groups. No difference in mean estimated blood loss or rate of infection was found Complications in the planned Caesarean section group were lower than previously reported. The difference in estimated blood loss between women undergoing planned Caesarean section and women who had a vaginal delivery was not more than 7%. Morbidity in the planned vaginal delivery group was mostly due to operative interventions The Caesarean section group had a longer hospital stay than women who delivered vaginally. Conclusion: We found no difference in short-term medical outcomes between primiparous women undergoing planned Caesarean section and those undergoing planned vaginal delivery after analysis according to the intended mode of delivery. © 2011 Society of Obstetricians and Gynaecologists of Canada.