Caesareans overtake natural vaginal births in England for first time, NHS data finds | Caesareans

Caesarean section deliveries have for the first time overtaken natural vaginal births in England, NHS data has revealed.

Last year, 45% of births in England took place by caesarean section, 44% by natural vaginal birth and 11% were assisted by instruments such as forceps or suction cups, according to data released on Tuesday.

More than four in ten caesarean sections, also known as C-sections, carried out by NHS England were elective and planned operations.

For women younger than 30, the most common method of delivery was natural vaginal birth, and for women 30 and older, cesarean section was most common.

Fifty-nine percent of births to women aged 40 and over occurred by cesarean section. In total, 20% of births in 2024-25 were planned C-sections and 25.1% were emergency births, with both figures reaching the highest levels on record.

The data covers the period from the beginning of April 2024 to the end of March this year.

A total of 542,235 births took place in NHS England hospitals during this period, compared to 636,643 in 2014-15, and one in four births (23.9%) were to mothers aged over 35.

In 2023-2024, there were 225,762 cesarean deliveries, or 42% of births, according to figures released last year. In 2014-2015, cesarean deliveries represented 26.5% of births.

The increase in cesarean births over the past decade has been attributed to the growing number of complex pregnancies and deliveries, driven by factors such as rising obesity rates and women waiting until they are older to have children. The proportion of spontaneous births without medication or other medical interventions has steadily declined over the past decade.

An audit of NHS maternity care, published in September, found that half of women having babies in Britain now do so through medical intervention. The proportion of babies born by caesarean section in England, Scotland and Wales was found to have increased from 25% in 2015-16 to 38.9% in 2023.

Donna Ockenden, one of the UK’s most experienced midwives who is leading the largest investigation into maternity failures in Nottingham in NHS history, told BBC Radio 4’s Today program that the rise in caesarean sections was a “complex” and “changing picture over time”.

She said: “The thousands of women I have spoken to want a safe birth above all, so we should not vilify or criticize the women who make these decisions.

“In the reality of today’s maternity services – where women live in poverty, destitution and have pre-existing conditions – there is only so much obstetricians, midwives and nurses can do, and we are not always doing enough in all cases to optimize women’s pre-pregnancy health.

Soo Downe, professor of midwifery at the University of Lancashire, added: “In some cases, women opt for caesarean section as a sort of worse option because they don’t really believe that they will have the kind of support they need to have a safe, simple and positive labor and delivery in hospital.

“Or because their birth centers are closed… or because they go into labor wanting to give birth at home and the midwife can’t come see them because she’s called elsewhere.

“But for some of them, it becomes the only choice on the table…and for other women, they choose a C-section because they really want one, and that’s completely normal.”