Caesaran sections overtake natural vaginal births for the first time

For the first time in England, more babies are being born by caesarean section than by natural birth without assistance.

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

Nearly half of C-sections, where surgeons deliver a baby through the abdomen and uterus, were planned in advance.

NHS England says many factors are influencing the rise, including women choosing to have this type of birth, as well as a rise in pre-existing conditions such as diabetes and obesity.

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

Dr Donna Ockenden, who is leading an independent review of maternity services at Shrewsbury and Telford Hospitals, said “the picture has changed over time”.

“We know that the mother’s age is increasing, we know that health is deteriorating. I also think previous experience will play a role.

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

For many women, having a caesarean section (also known as a C-section) is a matter of choice.

Over the past 10 years, the number of caesarean 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 well-being is deteriorating during labour, and therefore respond accordingly”.

Su Down, professor of obstetrics at Lancashire University, says many factors are contributing to the rise.

“Over the past decade, the average mother’s age has increased by just one year, and women’s BMI [Body Mass Index] increased only slightly.

“This does not explain the rapid growth that has occurred over the last 10 years.”

She suggests part of the picture is a growing number of women who consider a caesarean section to be the “least worst option” as there are fears they may not receive the support they need to have a “safe and simple positive birth”.

Maternity services in England have come under fire, with maternity checks continuing in 14 NHS trusts.

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

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