Caesarean births become England's most common birth method, NHS data show

Caesarean deliveries accounted for 45.1% of births in England in 2024/25, surpassing unassisted vaginal births for the first time, according to NHS England. The shift from about 9% in 1980 to nearly half of all births marks a historic change in how babies are born and reflects wider changes in population health and pregnancy care. The number of births delivered by C-section has risen alongside other such interventions, while unassisted vaginal births have declined and assisted vaginal deliveries represent the remaining share.

The rise is linked to rising obesity rates and a growing number of women giving birth at older ages. Some women also opt to schedule an elective C-section on a known date to plan around other life events, a factor doctors say contributes to the trend. The likelihood of a C-section increases with age, and women who have had one are more likely to have another in later pregnancies.

One in four births (23.9%) were to mothers aged over 35, up from 19.9% a decade ago. The rate by age shows a clear rise: 35.6% of births to those aged 20 to 24 were by C-section, 57.9% for those aged 40 to 44, and 71.5% for those aged 45 to 49. An information sheet produced by Barts Health NHS Trust notes that older women are more likely to experience problems in pregnancy and childbirth, but also highlights potential benefits of later motherhood, including greater stability and life experience. The sheet stresses that pregnancy should be approached with a focus on healthy behavior and support, rather than age alone.

Across all births, about 20% were planned C-sections and 25.1% were emergency C-sections, both at or near record highs. Health charities warn that being overweight increases risks for both mother and baby; studies show obese women are up to twice as likely to need a C-section and may experience slower labour and delivering larger babies. More than one in four women aged 18 and over in the UK is now obese, a trend that compounds the probability of requiring surgical intervention. Organizations such as Tommy’s say that BMI before or during pregnancy raises the likelihood of needing a C-section but should not be used as the sole determinant for surgery.

The NHS also reported that the total number of births fell to 542,235 in the last financial year, the lowest in 23 years, down about 3,000 from the year before and roughly 100,000 fewer than a decade earlier. Officials say the overall birth count decline interacts with the rising share of C-sections, alongside demographic shifts and advances in fetal monitoring that can lead to earlier intervention when problems are detected.

Dr Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, said the rise in C-sections mirrors global and national trends. She noted that improvements in detecting fetal wellbeing and responding to concerns during labour contribute to higher intervention rates, and she urged that services be equipped with adequate staffing, theatre capacity and trained personnel to manage increasingly complex births while maintaining high-quality, individualized care.

Costs of childbirth also reflect these shifts. NHS tariffs indicate the average cost of a birth in 2022/23 was about £5,417, covering pregnancy and the immediate postnatal period; planned C-sections are typically around £4,000, higher than natural births, while emergency C-sections can run to about £6,000 per birth.

In parallel to the clinical trends, a Care Quality Commission report released recently highlighted concerns about how some expectant and new mothers experience maternity services. The regulator surveyed 16,750 pregnant women and found that while there were some improvements over the past year, satisfaction levels remained stubbornly static. About one in five women said their concerns were not taken seriously during labour or birth, and one in 10 reported being left alone at critical moments. Women who saw the same midwife throughout pregnancy tended to report more positive experiences, while those from the most deprived neighbourhoods were less likely to feel they were treated with dignity and respect. Fiona Gibb, director of midwifery at the Royal College of Midwives, cautioned that the rising cesarean rate could reflect changing maternal needs and systemic pressures, and emphasized the importance of ensuring that every woman can make informed choices about how to give birth, with no method considered risk-free.

The emergence of C-sections as the most common birth method underscores ongoing pressures and changing dynamics in maternity care. Officials say continued attention to obesity prevention, preconception health, and access to high-quality pregnancy support will be essential as demographic trends and clinical practices evolve in England.