The Safer Births report said that just under 30% of all babies born in the region were delivered by caesarean section.In Northern Ireland, 28.4% of the 25,703 births were by caesarean in 2011-2012, which was higher than in England at 25%, Scotland which was 27.8% and the rate of 28% in the Republic of Ireland.Although NI is the region with the highest rate, the level is in line with the rest of the UK.The method is the most common surgical intervention carried out in maternity care and costs twice that of a normal delivery, around £3,724 compared to £1,933.The NIAO's report found that there is wide variation in the rate of caesarean sections performed at different maternity units; for example, while the Mater Hospital in north Belfast has a rate of 23%, almost 36% of births are by caesarean at Daisy Hill Hospital in Newry.The NIAO said that although some variation would reasonably be expected, given differences in patient populations, the scale of the variation may be indicative of variations in clinical practice.Commenting, Comptroller and Auditor General Kieran Donnelly, said: "In the current financial climate it seems particularly important that clinical managers in the health and social care trusts understand and manage the cost implications of different modes of childbirth."The use of a classification system such as that demonstrated in this report will be an essential aid in assisting health and social care trusts to verify that resource allocation is determined on the basis of clinical decisions."NI Chief Medical Officer, Dr Michael McBride said the Department of Health would consider the report's findings.He said: "The underlying objective for me, and all the people who work in our health and social care services, is to protect and improve the quality of those services."This means that services must be safe, effective and focussed on the mother and baby who must rightly be at the heart of everything we do.""I welcome the Audit Office acknowledgement of the efforts being made within Trusts to examine and reduce caesarean section rates and the ongoing work on normalising births."