WHY are more women giving birth by Caesarean section? Astonishingly in our age of endless health research and statistics, no one seems to know.

The facts are these. The World Health Organisation (WHO) states that no more than 15 per cent of births should be by C-section in Western countries. Yet in Britain, the figure is 21 per cent - and in York it is higher still at 27 per cent.

We should be worried that more than a quarter of local mothers undergo this procedure. It is a major abdominal operation. As such, it carries real risks, including infection and thrombosis. Mums need weeks to recover.

A lesser but important consideration is the expense. Every Caesarean delivery costs the NHS twice as much as natural childbirth.

It is clear that most of the operations are medically necessary. But not all.

There may be an element of the celebrity culture contributing to the rise in C-sections. The number of female icons opting for the op, including Victoria Beckham, Madonna and Elizabeth Hurley, inevitably affects the perceptions of some mums-to-be. Childbirth is a scary prospect, and the suggestion that surgery could take away the pain and exhaustion is enticing.

But this does not account for the regional variations. The National Childbirth Trust argues that the best way to reduce C-section rates is to ensure all women in labour have one-to-one support from a midwife they know, and that the "hospital culture values straightforward birth and sees birth as a normal - rather than medicalised - process".

With the appointment of a specialised consultant, and increased support for other maternity staff, York Hospital has already taken this message on board.

Updated: 10:20 Tuesday, April 04, 2006