Bold claim: Caesarean births have now surpassed natural vaginal births in England for the first time, according to NHS data.
Last year, 45% of births in England occurred via C-section, while 44% were natural vaginal deliveries, and 11% involved instrumental assistance such as forceps or ventouse. Notably, more than four in 10 of the cesareans performed within the NHS were planned, elective procedures.
Among younger mothers under 30, natural vaginal birth remained most common, whereas among those aged 30 and older, C-sections were more prevalent. The trend is starkest for older age groups: 59% of births to women aged 40 and above came by cesarean. Overall, 2024-25 saw 20% of births designated as planned cesareans and 25.1% as emergency cesareans, both figures reaching record highs.
The period covered runs from 1 April 2024 to 31 March 2025. Across NHS England hospitals, there were 542,235 deliveries in this span, a decline from 636,643 in 2014-15. Women over 35 accounted for roughly one in four births (23.9%).
For context, in 2023-24, C-sections accounted for 42% of births (225,762 deliveries), while in 2014-15 the rate stood at 26.5%.
Experts point to a rise in complex pregnancies and aging populations as key drivers behind the growing cesarean share. Contributing factors include rising obesity and a trend toward delaying childbirth. Meanwhile, the rate of spontaneous, drug-free deliveries has fallen over the past decade.
A September NHS maternity care audit found that half of birthing people in Britain now require some form of medical intervention. Across England, Scotland, and Wales, cesarean births rose from 25% in 2015-16 to 38.9% in 2023.
Donna Ockenden, a leading figure in UK maternity care and head of a major NHS inquiry into Nottingham’s maternity failures, described the shift as a “complex” and evolving landscape. She stressed that most women want a safe birth above all and cautioned against blaming those who choose cesareans, noting the social and health challenges many face before pregnancy. She reminded clinicians that optimizing maternal health before pregnancy and ensuring robust support during pregnancy remain essential.
Soo Downe, a midwifery professor, offered a related perspective: some women consider cesareans the least-worst option when they doubt they will receive adequate support for a straightforward hospital birth, or when birth centers close, or when home-birth plans fail due to staffing limits. Others explicitly prefer cesareans, which is a valid choice for many.
What’s your take on this shift? Do you see cesarean birth as a necessary option in today’s system, or as a sign of broader gaps in maternity care that should be addressed? Share your views below.
