There has been a considerable jump in Caesarean section rates from the 1990’s from 10% to more than 50% of women now delivering by Caesarean section. This is an observation by Assistant Professor Susan Hellerstein of Harvard Medical School. While patient preference may play a role here, Caesarean delivery appears to be encouraged as a matter of policy. The Midwife to patient ratio is ⅛ of the ratio we have in the first and second world. Having a Midwife with a labouring patient requires more man hours. This economic imperative seems to be part of the reason for the very high Caesarean section rate. Women in labour do not have access to pain control or epidurals and the absence of good nursing support during labour seems to encourage patients towards Caesarean section.