Caesarean deliveries surpass natural births in England, NHS data show

Caesarean sections have become the most common birth method in England for the first time, according to NHS England data released today. In 2024/25, 45.1% of births were by C-section, up from 9% in 1980. Unassisted vaginal births fell to 43.8% from 76.5% over the same period, while 11% of births were assisted vaginal deliveries using instruments such as forceps or suction.

Health officials say the rise is driven by higher obesity rates and more women giving birth later in life, along with a growing preference among some parents for the predictability of a scheduled procedure. The rate of C-section delivery rises with age, reflecting a population with more older mothers.

NHS England’s figures show that 23.9% of births were to mothers aged over 35, up from 19.9% a decade ago. C-section rates vary by age: 35.6% of births to women aged 20-24 were by C-section, while 57.9% of those aged 40-44 and 71.5% of those aged 45-49 were delivered by C-section.

Older mothers are more likely to experience complications and longer labours, which can lead to elective or emergency C-sections. The NHS has noted that older age is associated with higher risks, but some information materials for women over 40 also outline potential benefits of later motherhood, including stability and healthy lifestyle choices.

The trend toward planned and emergency C-sections continues to rise, with 20% of births in 2024/25 recorded as planned C-sections and 25.1% as emergency C-sections — the highest on record.

Charities warn that being overweight increases risk to both mother and baby. Studies show obese women are up to twice as likely to need a C-section, and obesity can slow labour and contribute to larger babies. More than one in four women aged 18 and over in the UK are now obese. The charity Tommy’s says that a high body mass index before or at the start of pregnancy makes a C-section more likely, but BMI alone is not a determiner; being overweight or obese also raises the risk of complications.

The total number of births fell to 542,235 in the last financial year, 3,000 fewer than the previous year and about 100,000 fewer than a decade ago.

Dr. Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, said the caesarean birth rate has risen globally and in England over the past decade. She urged that services be prepared with adequate staffing, training and theatre resources to manage increasingly complex births and higher levels of intervention, while ensuring safe, high-quality, personalised care.

Cost considerations accompany the clinical trends. The average cost of a birth to the NHS in 2022/23 was £5,417, including care during pregnancy and after delivery, and tends to be higher for older women. A planned C-section costs about £4,000 — roughly £800 more than a natural birth — while an emergency C-section can run up to £6,000 per birth, according to NHS tariffs.

A separate Care Quality Commission report released last week found mixed experiences among new and expectant mothers. The survey of 16,750 pregnant women found that one in five did not feel taken seriously when raising concerns during labour, and about one in ten were left alone during late labour or birth. Women who saw the same midwife throughout pregnancy tended to report more positive experiences, while those from the most deprived areas were less likely to feel respected. Fiona Gibb, director of midwifery at the Royal College of Midwives, said every woman should be supported to make informed choices about birth, noting that no birth is entirely without risk and that access to clear information is essential for good decision-making.

Experts say the rise in C-sections highlights the need for maternity services to adapt, ensuring sufficient staffing, training and facilities to meet growing demand while maintaining safe, patient-centred care.