Canterbury's caesarean rate is too high with nearly a third of babies delivered by C-section, the College of Midwives says.
Canterbury has the highest caesarean rate in New Zealand at 30 per cent.
Less than 20 per cent of mothers in Counties-Manukau and Waikato have the operation.
The national caesarean rate has risen from 14 per cent of births in 1993 to 23 per cent in 2008.
The college believes every decision to deliver by caesarean should be clinically reviewed to ensure it is for the right reason.
A World Health Organisation report in The Lancet in January said caesareans had reached "epidemic" proportions in many countries.
Women having caesareans that were not medically necessary were more likely to die or be admitted to intensive care units, require blood transfusions or have complications that led to hysterectomies, it said.
College of Midwives midwifery adviser Norma Campbell said a 30 per cent caesarean rate seemed "too high" for a population of healthy women.
The college wanted surgeons to review each caesarean decision to ensure all options were explored.
Campbell said surgeons should discuss the reasons for the operation with the women, and their chances of a future normal birth.
Delivering more babies in rural hospital units would also reduce the caesarean rate, she said.
In the 2008-2009 financial year, 14 per cent of Canterbury babies were born in rural birthing units and 2 per cent at home.
Canterbury District Health Board (CDHB) team leader planning and funding Greg Hamilton said encouraging women to give birth in rural units fitted with a move to deliver more community care.
"Birthing at home or in a birthing unit is a safe and reasonable option for most healthy women, without complications for the mother or baby," he said.
Hamilton said the older average age of women giving birth in Canterbury had a "strong impact" on caesarean rates.
"Theoretically", there were no elective caesareans as they were not available privately and the decision was made by clinicians in the public system, he said.
Home Birth Canterbury coordinator Gary Dodd said Christchurch Women's Hospital should be kept for high-risk women.
The association was putting together a funding proposal for the CDHB to support people choosing home births.
Marie Wood, 40, has given birth to two children at her home in Christchurch.
"It doesn't have to be a medical process, it's just a natural process," she said.
- The Press