In the "Child and Youth Health - Portugal 2018" report, the DGS points to a slight drop in the overall proportion of deliveries by caesarean section, but still put the country above the rate recommended by the World Health Organization (WHO).

Portugal went from a 35.6% caesarean rate in 2013 to 33% in 2016. However, in the hospitals of the National Health Service (SNS) the rate of caesarean section is below 30%, standing in 2016 at 27.6%.

In fact, the rate of caesarean sections in SNS hospitals has fallen slightly, but remained steady from 2013 to 2016.

In private hospitals, the caesarean rate was 65.5% in 2016, a year in which private units accounted for almost 12,500 of the more than 85,000 deliveries in Portugal.

"Although caesarean deliveries showed a downward trend, the percentage of acesareans is still high and it is important to mention that it is significantly higher in private maternity hospitals, and there is room for improvement and a need to reflect on this imbalance," concluded the report from the Directorate-General for Health.

The document, published on the DGS website, noted that "clinically unnecessary caesarean sections are of medical and economic concern."

The report on child and youth health also focuses on breastfeeding, with a trend towards improvements in exclusive breastfeeding for the first six months of a baby's life.

However, the DGS recognises that "special attention" is needed to ensure "sustainability of this improvement trend."