Caesarean births surpass natural births in England for first time, NHS data shows

England's National Health Service data for 2024-25 show caesarean sections have overtaken spontaneous vaginal births for the first time. Overall, 45% of births were by C-section, compared with 44% that occurred without surgical intervention. About 11% involved assisted vaginal deliveries such as forceps. Nearly half of caesarean births were planned in advance.

NHS England said the rise reflects a range of factors, including women choosing this option and a rise in pre-existing conditions such as diabetes and obesity. Dr Donna Ockenden, who is chairing an independent review of maternity services at Shrewsbury and Telford Hospitals, described the picture as an "evolving picture over time." She noted that rising maternal age and ill health, along with previous birth experiences, can influence decisions about mode of birth, including the likelihood of a second C-section.

Dr Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, said part of the rise is due to improvements in detecting when a baby's wellbeing deteriorates during labour and in responding to it. "Part of this was down 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, said multiple factors are at play. She noted that the average age of motherhood has increased only modestly and BMI has risen only slightly, suggesting other factors are driving the surge. Downe added that many women may view a C-section as the "least worst option" because they fear inadequate support for a safe, straightforward labour.

Maternity services in England have faced criticism, with reviews into care ongoing at 14 NHS trusts. An NHS spokesperson said all women should receive safe, personalised maternity care in line with best practice and clinical evidence, and that decisions about birth should be made through informed discussions that consider individual circumstances, clinical advice and a woman's preferences, ensuring the safest and most appropriate approach for each birth.

Over the past decade, the number of caesareans has doubled. Health experts say the figures reflect a complicated mix of medical indications, patient choice and systemic factors. The NHS says the data should be interpreted alongside ongoing reviews.