In recent years, there has been an upsurge of interest in therapeutic intervention for fetal benefit prior to delivery. The main drivers of the increasing tendency towards intrauterine intervention are improving imaging techniques, increasing confidence and experience of global centres with fetal therapies and wider developments in the field of minimally invasive surgery. The accelerating trend for trialling new fetal therapies means that careful consideration of the overall benefit of intrauterine intervention is required. Any therapy performed for fetal benefit during pregnancy inherently requires consideration of maternal risks, whereas delaying intervention until after delivery avoids maternal complications. Therapies performed after birth are also technically easier; the baby is larger, surgical access is easier and appropriate anaesthesia can be assured. An additional risk of fetal therapy is of provoking preterm delivery, and hence complicating a precarious clinical condition with the additional burden of prematurity. Even if preterm delivery does not occur, there is still the hurdle of delivery itself to be overcome after definitive therapy has been performed. In view of these significant advantages associated with post-delivery interventions, it is vital to ensure that the benefits of intervening for fetal benefit during pregnancy truly outweigh the risks.