Caesaran sections overtake natural vaginal births for the first time

In England, there are more babies born by caesarean section than babies born naturally – without assistance – for the first time.

The latest NHS data for 2024-25 shows that 45% of births took place by caesarean section, compared to 44% which were spontaneous, the term used to describe a natural vaginal birth. A further 11% needed additional support and interventions such as forceps.

Nearly half of C-sections – when the baby is delivered by surgeons cutting into the mother’s abdomen and uterus – were planned in advance.

NHS England says this increase is influenced by many factors, including women’s choice of this type of birth and an increase in pre-existing conditions such as diabetes and obesity.

Experts say the picture behind these figures is “very complex”.

Dr Donna Ockenden, who is chairing an independent review into maternity wards at Shrewsbury and Telford hospitals, says the picture has “evolved over time”.

“We know that maternal age is increasing, health problems are increasing. I also think that previous experience will play a role.

“Birth trauma and a first C-section may influence their decision to have a C-section the second time.”

For many women, having a cesarean section (also called a C-section) is a matter of choice.

Over the past ten years, the number of cesarean sections has doubled.

Dr Alison Wright, president of the Royal College of Obstetricians and Gynecologists, said this was partly due to improvements in “our ability to detect when a baby’s wellbeing is deteriorating during labour, and therefore respond appropriately”.

Soo Downe, professor of midwifery studies at the University of Lancashire, says many factors are contributing to this increase.

“The average age of motherhood has increased by only one year over the past decade, and women’s BMI [Body Mass Index] increased only very slightly.

“This does not explain this very rapid increase that has occurred over the last ten years.”

She suggests part of the picture is the growing number of women who feel a caesarean section is “the least worst option” because they fear they won’t get the support they need for a “positive, simple and safe labor.”

Maternity services in England have been heavily criticized, with reviews of maternity care underway at 14 NHS trusts.

An NHS spokesperson said: “All women should receive safe and personalized maternity care, in line with best practice and clinical evidence.

“The priority must always be the safety and well-being of mothers and babies, and decisions about how a baby is born are made through informed discussions that take into account the woman’s individual circumstances, clinical advice and preferences, ensuring the safest and most appropriate approach for each birth.”