More and more Australian women are having elective caesarean sections for “lifestyle” reasons, according to a major survey. A study of more than 430,000 births over 20 years found that the rate of caesareans had doubled between 1984 and 2003, even when other factors were taken into account. Study co-author Fiona Stanley, from the Telethon Institute for Child Health Research in Perth, said that these figures “suggest there’s some social or lifestyle factors that may be influencing women”.

First-time mothers were 4.5 times more likely to have an elective caesarean than in the 80s.

“If women are following this as a lifestyle choice, because they don’t want to damage their perineum or because some celebrity has had one, and pressure is being put on obstetricians for these lifestyle reasons, then women need better advice,” said Dr Stanley.

The trend is often blamed on women who are “too posh to push”, in the memorable coinage of some British sub-editor, and significantly, the rate is highest amongst women who need them least, including women with private health cover. However, it is more than a matter of character. Doctors are also concerned about rising costs and small but significant health risks.

A Brisbane GP, Sarah Buckley, commented in an op-ed in The Australian that rates of caesareans were rising because of “our cultural over-confidence in medicine”. She also referred to research showing that women have fewer subsequent children after caesarean births.