Pregnant women in south Staffordshire have been banned from having Caesarean sections unless their health is at risk.
But mothers-to-be in the Black Country can continue to make their own choice of delivery.
Health chiefs at South Staffordshire Primary Care Trust have made their decision after an increase in requests from expectant mothers.
The PCT pays for the health services of people living in Stafford, Lichfield, Cannock, and Rugeley. Planned Caesareans are £800 more expensive than a natural birth.
They are also more high-risk, and unless the mother or baby's health is in danger the NHS guidance is they should be avoided.
The Staffordshire PCT is one of the first to impose the restrictions with more expected to follow as more and more women are choosing to have the procedure.
In the Black Country the number of Caesareans will be reviewed regularly but Laura Broster, spokesman for the region's PCTs, said: "Across the Black Country there are no commissioning policies that limit or restrict Caesareans."