A Perth obstetrician has sparked outrage from midwives around the country by claiming elective caesareans are safer for babies than normal births.
Mark Sillender from Pearl Obstetrics Gynaecology in Attadale says on his practice's website that generally elective caesareans are the safest option for babies, and no riskier for women, who mostly enjoy the experience.
For many of the women likely to have only one or two children, the safest way to deliver was to have an elective caesarean, while those planning to have more children might be better off having normal births because repeated caesareans could become difficult.
His website says more Perth women are choosing to have caesareans for reasons including reducing the risk of tearing or painful sex after birth.
Many feel well a week after surgery and are back driving.
But dozens of posts on the Australian College of Midwives Facebook page claim the comments portray normal labour as riskier than surgical birth.
Vice-president of the college's WA branch Pauline Costins said women needed to make good choices, but the website had upset a lot of people.
"There is growing evidence about the health implications to the baby and mother after caesarean section, including the long-term effects," she said.
"It's major surgery, and from a college perspective this information goes against all the latest best practice and government policies."
The Royal Australian and New Zealand College of Obstetricians and Gynaecologist says no good quality trials on caesareans for non-medical reasons have been done, as most studies include statistics from both emergency and elective caesareans. It says doctors should discuss the benefits and risks with patients.
But Dr Sillender defended his comments, saying his practice provided non-judgmental maternity care.
"We trust women to freely make their own informed decisions," he said.
"Many women aim to achieve a natural birth, and some women choose an induction of labour, an elective caesarean or a vaginal birth after caesarean because it's right for them. All have different benefits and risks, both immediate and long-term."
Dr Sillender said doctors dealt with women throughout their lives, not just at childbirth, and were in the best position to provide accurate information.