A soon-to-be-released inquiry into obstetric care in the UK will show that hospitals are battling to cope with rising numbers of older mothers, obese women and IVF patients requiring extra medical attention. Not enough staff are available to care for ordinary deliveries. Experts say that caesarean rates have doubled over the past 15 years to one in four births. In some hospitals 35% of births come via caesareans, despite advice from the World Health Organisation that the figure should not rise above 15%. The report, by the medical thinktank, The King’s Fund, cites "wide professional unease" over the increasing use of surgery in childbirth.

More older mothers, who require special care, have increased the pressure on maternity wards. The latest annual figures show that more than 90,000 children were born to mothers in their late 30s, compared with 54,000 10 years ago. The number of births among women over 40 has gone from 8,000 to 16,000. More obese women are also a problem. Half of all maternal deaths in childbirth involve women who are overweight or obese.

Experts warn that the increased "medicalisation" of birth causes staff to concentrate on "high risk" cases. Belinda Phipps, of the National Childbirth Trust, told the London Telegraph: "This medicalisation of childbirth is bad for the women who fall victim to it, but it also means there are fewer midwives on the wards, leaving them running from one mother to the rest."

Katherine Murphy, of the Patients' Association, says too many women are "being treated like they are on a conveyer belt". She said: "At a time when mothers are frightened and vulnerable, the midwives are so stretched that there is no time for them to offer reassurance and advice, and instead women get pushed into caesareans. We think that is appalling."

Professor Sabaratnam Arulkumaran, of the Royal College of Obstetricians and Gynaecologists, says much of the rise in caesareans can be explained by greater health risks among older and obese women, although consultants can be too quick to act because they fear litigation. But he also feels that some pregnant women value their lifestyles over their health. "For some it comes down to convenience; their husband is flying off next week, and they want to fit the birth in first." ~ Daily Telegraph (London), Feb 27