More than a quarter of babies delivered at Ontario hospitals were born by caesarean section, according to a new report that found that while c-sections were riskier, the overall rate of birthing complications were low.

Specifically, 28 per cent of babies were born by C-section, researchers from the Institute for Clinical Evaluative Sciences said Tuesday.

Overall, the evidence suggests Ontario "is a very safe place for women to give birth and for babies to be born," the study's authors concluded in a report that focused mainly on deliveries such as C-sections.

But there was also "substantial variation" in the type of obstetrical and gynecological care provided, such as abortion, depending on where women live in the province.

"There are large differences in teenage pregnancy and abortion rates between the rich and poor. Caesarian section rates are high and vary by region," Dr. Arlene Bierman, the study's principal investigator, and her co-authors wrote in Tuesday's the POWER (Project for an Ontario Women's Health Evidence-Based Report) study on reproductive and gynecological health.

Women aged 15 to 49 in the lowest-income neighbourhoods were more than twice as likely to have an abortion as women living in the wealthiest neighbourhoods — 2.1 abortions per 100 women versus 1.0 abortions per 100, the researchers found.

The researchers called for reproductive health programs that reach out to low-income women, particularly low-income teens, noting there's evidence that programs based in schools and the community can help reduce teen pregnancy rates.

C-section rates varied from 24 per cent of deliveries in the southwest of the province to 31 per cent in North Simcoe Muskoka, researchers found.

The number of women who deliver their babies by C-section is high nationally and varies across the province, Bierman said.

It's important for women to make informed choices about their delivery and actively participate in deciding on treatment since once a women has had a C-section it is likely she will have one for later pregnancies, Bierman added.

Other findings included:

• Among women gave birth to a full-term baby presenting head first, or vertex presentation, 23 per cent of deliveries were done by C-section.
• Among women who had a previous C-section, 84 per cent of deliveries were done by caesarean section.
• Nearly three-quarters of women aged 21 and older who had a vaginal delivery were discharged home within 48 hours of delivery and almost 90 per cent of women who had a C-section were discharged within 96 hours of delivery.

The report also looked at prenatal care, hysterectomy, and sexually transmitted infections.