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Recent analysis by the BBC reveals that emergency caesarean deliveries now account for 25% of all births in England, demonstrating a notable increase over the past five years. Alongside this rise in unplanned C-sections, the incidence of elective caesarean operations has also climbed steadily. Meanwhile, the proportion of vaginal births without the use of instruments has declined from over 50% to 43%, indicating a significant shift in birthing practices.
Professor Marian Knight, head of the National Perinatal Epidemiology Unit, which studies pregnancy and birth care, described this trend as a “total change in how women give birth” within England. She noted that such a sharp increase has not been observed in other European countries. Despite this, the NHS does not provide data detailing the specific causes prompting emergency C-sections, leaving experts without a definitive explanation. Some specialists, however, have expressed concerns that heightened anxiety among maternity staff and expectant mothers may influence the rising number of surgical interventions.
The Royal College of Obstetricians and Gynaecologists has highlighted the pressure maternity units face due to increased demand, stressing that the system is “really struggling” to cope with the volume of procedures required. NHS England maintains that decisions regarding births are made based on individual clinical circumstances to ensure both mother and baby remain safe. It is worth noting that emergency C-sections are categorized by urgency, ranging from immediate life-threatening concerns to situations where labor is not progressing adequately.
From a broader perspective, Professor Knight’s team compared caesarean rates internationally across 42 countries. England’s ranking moved from 14th place in 2020 to 9th in 2025, reflecting a distinct upward trend unmatched by most other nations. Despite these rising rates, statistics show little change in stillbirths or neonatal mortality during the same period. Professor Shakila Thangaratinam, a women’s health expert at the University of Liverpool, underscored that an increase in emergency C-sections without accompanying reductions in adverse outcomes is concerning, especially given the absence of “clear and consistent reporting” on why procedures are performed. She also highlighted notable disparities, with emergency C-section rates reaching about one in three for Black and Asian mothers, compared to the national average of one in four.
Ongoing investigations into factors driving the increase include considerations of maternal age, obesity, and pre-existing health conditions. Additionally, recent high-profile maternity safety scandals, such as those in Morecambe Bay and East Kent, revealed reluctance to perform timely caesareans in the past, which may have contributed to changing clinical approaches. Professor Knight suggests that fear among mothers, families, and healthcare workers might be influencing decisions towards opting for or recommending C-sections more frequently. Supporting this, maternity legal claims against the NHS have risen by 11% over five years, often questioning why caesareans were not performed earlier, whereas clinicians seldom face criticism for operating sooner.
On the ground, maternity services are grappling with these challenges amid resource constraints. Dr Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, warned that many units lack adequate obstetric theatres to handle growing emergency demands. Without investment in staff and facilities, she fears some emergency C-sections may become difficult to perform when needed. The financial aspect is also significant; a routine vaginal birth costs around £4,800, a planned caesarean approximately £6,000, but emergency caesareans surge to nearly £9,000, according to health economist Professor Ed Wilson. The NHS emphasizes that numerous factors influence caesarean rates and maintains that safety of mothers and babies remains the utmost priority, with decisions tailored to each case. Meanwhile, the Department of Health and Social Care reaffirms its commitment to improving maternity and neonatal safety, pointing to ongoing efforts led by the national maternity taskforce
Read the full article from The BBC here: Read More
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