Caesarean rates are on the rise, with one in four babies born in NHS hospitals in England last year delivered via either emergency or elective caesarean ops – also known as C-sections – new data has revealed.
Of the 398,675 deliveries in England last year, where the method of onset of birth was known, 101,264 (25%) were caesareans – up from 23% in the previous 12 months and 13% a decade ago.
“Over the past decade, there has been a gradual national increase in the number of caesareans,” says Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG).
“A major factor of this is the growing number of complex births. We are seeing national rising rates of obesity and people choosing to have children at a later state in their life, both of which can increase the chance of complications.”
Summary
- One in four babies born in NHS hospitals in England in 2023/24 were delivered via Caesarean section, up from 23% the previous year and 13% a decade prior.
- Experts attribute the rise to increasing obesity rates and women having children later in life, leading to more complex births.
- While elective Caesareans also increased, spontaneous deliveries decreased to 42% from 62% in 2013/14.
- The Royal College of Obstetricians and Gynaecologists emphasizes supporting women’s informed birthing choices.
- The NHS reiterates that Caesareans are major operations, performed when deemed the safest option for mother and baby, although some women opt for them electively.
However, despite this increase in numbers, there are still many misconceptions surrounding caesareans.
1. C-sections are the ‘easy option’
“The phrase ‘too posh to push’ was (and probably still is) used, and there’s this perception that it’s the easy way out – which is absolutely not true,” says Miss Mez Aref-Adib, specialist consultant obstetrician and gynaecologist at London Gynaecology. “It’s definitely not easier – it’s major surgery. However, it can seem more predictable because you know the exact timing of when the baby will be born, which can provide some reassurance. It also reduces the unpredictability of labour and can make delivery quicker.”
And as with any surgery, it comes with its own risks, pain and recovery period too.
“Recovery can take longer than with a straightforward vaginal birth, and there’s the added risk of complications from surgery,” adds Aref-Adib. “So while it might seem like the more controlled option, it’s by no means the ‘easier’ one.”
2. You can’t feel anything during a C-section
“Most women are awake during the procedure and receive either a spinal or epidural anaesthetic, which numbs the lower half of the body,” says Miss Shazia Malik, consultant obstetrician and gynaecologist at The Portland Hospital part of HCA Healthcare UK. “While you won’t feel pain, you may feel pressure, pulling, or tugging sensations as the baby is delivered. These sensations are normal and part of the procedure.
“It’s unusual to feel nothing at all, but your anaesthetist will make absolutely sure that you feel no pain during the procedure, whether it is done as an emergency or a planned procedure.”
3. You can’t have more than one caesarean
“Many women safely have multiple C-sections, but each additional surgery can increase risks, such as scar tissue formation and complications during pregnancy or delivery, such as damage to the bladder or womb,” explains Malik. “This is why generally we do not recommend more than three caesarean births – but it might even be less based on individual risk factors and surgical history.
“Close monitoring and planning are crucial before you get pregnant. Preconception advice from an obstetrician is important if you have any medical or surgical risk factors affecting pregnancy or birth. Your GP can refer you for this.”
4. You cannot have a vaginal birth after previously having a caesarean
“A mother can have a vaginal birth after a previous caesarean,” clarifies Aref-Adib. “And this is often encouraged if the mother wants it and there are no medical reasons to avoid it.
“This is called a ‘VBAC’ (vaginal birth after caesarean). It can be a safe option, but it’s important to discuss it with your doctor or midwife to make sure it’s suitable for you, as it depends on factors like the type of scar from the previous C-section and the current pregnancy.”
5. There are no risks
“Like any surgery, C-sections carry risks. These include infection, blood loss, blood clots (thrombosis), and complications in future pregnancies, such as placenta previa or uterine rupture, implantation of a pregnancy in the scar or even subfertility,” says Malik. “It’s important for women to discuss these risks with their healthcare provider to make an informed decision before each and every birth they might have.”
