One of the country's top maternity units carries out double the average number of Caesareans, a report has found.
Both the Beckhams children were born by Caesarean at the Portland
The Portland Hospital for Women in Children in central London is a favourite with celebrity mothers such as Victoria Beckham and Claudia Schiffer.
But inspectors from the National Care Standards Commission (NCSC) said there should be an audit to look at why so many Caesareans are carried out there.
The NCSC, which monitored the hospital for three months, found the Portland's Caesarean rate was 43%, twice the UK average and four times the maximum rate recommended by the World Health Organization.
The inspectors were told this was because the hospital had more older and
overseas patients and a higher request rate for Caesarians from mothers-to-be.
We have one of the highest levels of specialist nursing and consultant care to the women and children who are our patients
Judy van den Broek,Portland Hospital
The NCSC, an independent public body set up to regulate social care and private and voluntary health care services in England, said the Portland had failed to comply with minimum standards set by the government.
It said there was a lack of clear policies for referring women in labour to a consultant in an emergencies.
And it added it typically took on-call midwives 20 minutes to reach the unit as
opposed to the minimum standard of 15 minutes.
The NCSC recommended the hospital needed to confirm doctors' qualifications with the
General Medical Council and update its protocols for emergency referral of women
It also said training should be developed to include risk management and there
should be a review of policies for reporting adverse incidents.
A spokeswoman for the Portland Hospital said it disagreed with many of the report
Judy van den Broek, the hospital's
chief executive said: "We have one of the highest levels of specialist nursing and consultant care to the women and children who are our patients, 24 hours a day.
"Uniquely, we have a resident consultant anaesthetist at the hospital at all times as well as a senior registrar or research fellow in obstetrics and in paediatrics, all on site 24 hours a day to meet patients' care needs."
She called the NCSC's call for a report "surprising" because the hospital undertook ongoing audits of all clinical practic, including various delivery options.
The hospital came under the spotlight after two mothers died there.
Last December an inquest jury returned an open verdict on Tracey Sampson, 36,
who died of heart failure after having a general anaesthetic during a Caesarean
at the Portland Hospital.
In 1999, 31-year-old Laura Touche died after giving birth to twins at the hospital. A jury found she died from natural causes contributed to by neglect.