Title: Emergency C-Sections Rise to One in Four Births in England, According to BBC Data

A significant shift in childbirth practices across England has been revealed by BBC analysis, which indicates that emergency caesarean sections now account for one in four deliveries. This figure represents an eight percentage point increase over the past five years, a trend that coincides with a rise in elective caesareans and a notable decline in unassisted vaginal births.

The proportion of vaginal deliveries performed without instrumental assistance, such as forceps, has dropped from over half of all births to 43%. Conversely, planned caesareans now comprise 20% of births, while emergency procedures have climbed from 18% to 26%.

Prof Marian Knight, director of the National Perinatal Epidemiology Unit, which specializes in researching maternal and infant care, describes this upward trajectory as a "total change" in the English maternity landscape. She notes that such a sharp increase has not been mirrored in other European nations. Data from the unit’s comparison of 42 countries highlights this divergence: while England ranked 14th out of 42 nations for caesarean rates in 2020, it had risen to 9th by 2025, a jump not seen elsewhere.

Despite the surge in emergency interventions since 2020, statistics show that stillbirth and neonatal mortality rates have remained largely stable. This discrepancy has raised concerns among experts. Shakila Thangaratinam, a professor of women’s health at the University of Liverpool and consultant obstetrician, stated, "An increase in emergency caesarean sections poses concern if these are not accompanied by a corresponding decrease in stillbirths, newborn and maternal complications."

The reasons behind the rise remain unclear, partly because the NHS does not publish specific data on the clinical indications for emergency C-sections. Prof Thangaratinam emphasized the need for "good quality data" regarding why operations are performed, citing a lack of consistent reporting. She also highlighted racial disparities in these figures; while the national average is one in four, the rate rises to approximately one in three for Black and Asian mothers.

Various factors have been suggested as potential drivers. Some experts and staff have pointed to a "culture of fear" within maternity units and among expectant mothers, potentially fueled by high-profile maternity safety scandals in locations such as Morecambe Bay, East Kent, and Shrewsbury and Telford. These inquiries revealed tragic outcomes where a historical reluctance to perform caesareans contributed to deaths. Additionally, for years, maternity units were pressured to maintain low caesarean rates, a policy target that was officially dropped in 2022.

Prof Knight is currently investigating whether demographic and health factors, such as maternal age, obesity, and pre-existing medical conditions, are contributing to the trend. Meanwhile, the Royal College of Obstetricians and Gynaecologists attributes part of the issue to systemic strain, noting that pressure on staff and operating theatres means the system is "really struggling" to cope with demand.

In response to the findings, NHS England stated that birth decisions are based on individual circumstances and clinical advice to ensure the safest approach for each patient. Data from other UK nations, though less current, show lower emergency caesarean rates: 22% in Scotland, 20% in Wales, and 16% in Northern Ireland.

Source: BBC News Generated at: 2026-06-04 23:41:16 UTC