The caesarean rate is still rising in Britain, even though it has levelled off in other parts of the world, including the US.

According to Caesarean Birth in Britain (Middlesex University Press, 1993), written by outspoken obstetrician Wendy Savage, among others, Britain's caesarean section rate, which reached a plateau at 12 per cent in the late Eighties, increased to over 13 per cent in 1992, with considerable variation among the regions.

This is still modest compared to a 24.7 per cent rate in the US in 1988, which represents a near doubling of the rate in 10 years, although there is some evidence that this rate has fallen marginally in the Nineties as the rate of vaginal birth after a previous caesearean section rose sharply.

Fear of litigation was the reason most commonly cited for this increase, by half the British obstetricians interviewed.

According to Pieter Treffers and Maria Pel, two obstetricians from the Academic Medical Centre in Amsterdam, who reviewed the book in the British Medical Journal (23 October 1993), the increase is also due to the attitude among British obstetricians over whether elective caesarean delivery should be given in cases of babies in breech presentation or women who'd had a previous caesarean.