The panel convened by the National Institutes of Health did not endorse delivering babies by the surgical procedure, but the experts found no clear reason to routinely discourage women from choosing that option, which continues to grow in popularity. The findings contrast with decades of medical advice aimed at trying to reduce the number of Caesareans, which for years were seen as unnecessary, costly and potentially risky.

Overall, the panel found current scientific evidence is insufficient to recommend for or against doing Caesareans on demand, saying the available studies suggest both risks and benefits. Caesareans should not be done until the baby's lungs have developed sufficiently or on women planning to have more than two or three children, the panel concluded. But the experts said the procedure is an acceptable option for women planning one or two children, especially those in their 40s.

The report was praised by advocates of giving women more of a choice in how they deliver their babies and denounced by opponents who argue Caesareans are dangerous and overused. Both sides said they expected the report would prompt more women to request the procedures, more doctors to honor those requests and more insurance companies to pay for them.

More than 1 million of the 4 million babies born each year in the United States are delivered by Caesarean, which involves removing the baby from the womb through an incision in the mother's abdomen. The procedure was developed primarily to deliver babies in situations where the mother or child is experiencing complications that put one or both at risk.

The Centers for Disease Control and Prevention has not yet released the state C-section rates for 2004.

In Utah in 2003, the C-section rate for women who were delivering their first child was 15 percent. That was up slightly from 14 percent in 2002.

Steven Clark, a perinatologist at St. Mark's Hospital in Salt Lake City, said the medical center has no written policy. Doctors talk about the risk to patients who elect to have the surgery.

"The change is in times past, no reasonable doctor would have considered an elective C-section," he said. "Requesting a C-section has become medically accepted in the medical community. The C-section has become so safe that the risk of a mother dying with a planned C-section is less than that of vaginal delivery."

Intermountain Healthcare hospitals also have no policy but leave the consultation up to individual physicians.

"Overall, it's still a minority of patients that are choosing elective C-sections," said spokesman Jess Gomez. "But we are seeing a trend of more patients choosing to have C-sections. Certainly, the cost and length of stay with C-sections are more than vaginal deliveries."

University Hospital also has no policy.

"There are a lot of potential benefits and drawbacks to Caesareans," said Bob Silver, a doctor who works in high-risk obstetrics. "I discuss all the pros and cons with my patients. I think the risks are low enough I would do the surgery if the woman felt strongly about it."