C section rates are always higher in the private sector than in the state sector, for the reasons Criss mentions. In the state sector women only have c-sections if they are absolutely necessary.
The World Health Organisation recommended percentage is 15% of all births. In the UK the trend for elective c-sections is on the up, but it is still not that much higher than the 15% level. I have read that in Latin American countries it is 70% or more.
Factor in the difference between private and public health sectors and you get almost universal c-section rates in the private sectors.
It definitely seems that way anecdotally: people in the DR don't ask you when is your baby due, they ask, 'when is the Caesarian?' They don't ask you how the birth went, they ask you 'how is the Caesarian scar healing?'
The reasons therefore are cultural as well as medical/financial: I find that pregnant women here are told to rest rather than exercise, and pregnancy is treated almost like an illness, with the pregnant woman as a fragile creature who cannot stand in line at the bank and should not be expected to cross a supermarket car park. I am not saying I didn't appreciate the privileges when I was pregnant, but I think it goes too much the other way. For this reason many women are not physically or mentally equipped for 'normal' deliveries.
Childbirth preparation classes are not the norm, partly because women tend to be in closer knit families with female relatives at hand to give advice, compared to Europe and north America. there is also the perception that c-sections are the modern way to go about things, in contrast to the 'primitive' ordeal of childbirth. The same goes with breast and bottle feeding. See also previous threads on this.
Chiri