The report by the International Journal of Obstetrics and Gynaecologists (BJOG) found that 38 percent of births in Italy are carried out through caesarean section.
Cyprus has the highest rate (52 percent) while Switzerland and Germany come third and fourth with 33.1 percent and 31.3 percent, respectively.
Iceland has the lowest rate (14.8 percent), followed by Finland (16.8 percent) and The Netherlands (17 percent).
Marina Cuttini, a co-author of the report and researcher at Rome’s Bambino Gesù Children's Hospital, said most caesareans are suggested by doctors towards the end of a pregnancy in order to avoid complications and the risk of being sued if anything goes wrong.
Doctors also prefer this option as they are able to better plan the delivery date and care around the birth.
Women who gave birth to their first child through caeserean section are also more likely to be advised to repeat the procedure for the second and subsequent births.
Meanwhile, women also ask for a caesarean in order to be able to schedule when their child will be born as well as to avoid the pain of a natural birth.
“But the abdominal surgery involved with a caeserean is also painful," Cuttini told The Local, adding that demand from women depends on how information on the options for childbirth is transmitted.
Italy also has the highest number in Europe of mothers giving birth to their first child over the age of 35, which plays a role in doctors’ recommending caesereans as it is deemed safer than a natural birth for older women.
Private clinics tend to perform more caesereans than public hospitals, with the financial reward being an incentive, Cuttini added.
But although the rate of caesarean deliveries grew steadily since the 1980s, it has stabilized in recent years thanks to government intervention, she added.
“There was action at government-level, such as issuing guidelines, in response to our last report in 2008. We are happy now that the rate is stable.”
The rate of caesarean deliveries has been rising around the world for years, Cuttini said, adding that many are done unnecessarily, putting women and babies through the risks of a major operation.