Nearly one in two Chinese mothers chose to give birth by caesarean

Wu Xi recalled her college friend's horrifying tale of how she spent a whole day in labour in a hospital maternity ward, moaning in pain, with no family by her side and just occasional checks by nurses, only in the end to have her son delivered by caesarean section.

"I can't imagine enduring that much pain, so I just told my doctor during my pregnancy that I wanted a C-section, period," Wu said. Although she spent three days in bed after the procedure and needed painkillers while the wound healed, she said it was worth it.

"Besides, my daughter might be cleverer because her head was not squeezed in labour," Wu said.

The number of mainland women like Wu who opt for a caesarean section instead of natural delivery has risen from about 5 per cent three decades ago to 46 per cent in 2010 - the highest rate globally. The World Health Organisation recommends the rate should not be higher than 10 per cent to 15 per cent.

A 2011 report in the WHO Bulletin found the proportion of caesarean births on the mainland rose dramatically within a decade, becoming common not only among the wealthy and well-educated, but across the socio-economic spectrum, including the poor, the uneducated and the rural population.

Many factors have contributed to the rise, said Zhang Xiaohong, a professor of obstetrics at Peking University People's Hospital. Natural delivery is believed by some to be extremely painful and presents an avoidable health risk.