Just under a third of all births between January 2017 and October 2017 – 32.3% – were by Caesarean section, according to Health Minister Chris Fearne.

Although this was slightly below the 34% reported at a conference in 2017 for the previous year’s figures, it is still one of the highest in Europe.

Dr Fearne said in reply to MP Maria Deguara’s parliamentary question that 2,272 births out of the 3,590 during that period were normal delivery, four were forceps, and 155 were ventouse. There was only one breech birth. The rest were by Caesarean section.

A European survey based on 2010 data, the European Perinatal Report, showed Cyprus had the highest overall caesarean rate, at 52.2%, followed by Italy with 38.0%, Romania with 36.9%, and Portugal with 36.3%.

Germany, Luxembourg, Malta, Poland, and Switzerland also had rates of 30% or higher. Everywhere else, rates were below 30%. The Netherlands, Slovenia, Finland, Sweden, Iceland, and Norway had rates below 20%.

Since 1985, the international healthcare community has considered the ideal rate for Caesarean sections to be between 10-15%. The World Health Organisation said that since then Caesarean sections have become increasingly common in both developed and developing countries. Studies show that when Caesarean section rates rise towards 10% across a population, the number of maternal and newborn deaths decreases. However, when the rate goes above 10%, there is no evidence that mortality rates improve.

The Malta Midwives Association argued last year that unnecessary Caesarean sections had cost the national coffers €3.7 million in 2011.