One in four babies are born in NHS hospitals of England last year they were delivered by caesarean section, official figures show.
The gradual increase in the number of caesarean births over the past decade is due to the increasing number of multiple pregnancies and births, which are due to factors including rising obesity and women waiting until they are older to have children. The proportion of spontaneous deliveries that do not involve drugs or other medical intervention has steadily declined over the last 10 years.
“Over the past decade, the national number of caesareans has gradually increased,” said Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynecologists (RCOG).
“A major factor in this is the growing number of complex births. We see national obesity rates rising and people choosing to have children later in life, both of which can increase the risk of complications.”
Of the 398,675 births in England, where the mode of birth was known, 101, 264, or 25%, were C-sections. This is from 23% in the previous 12 months and 13% a decade.
A total of 67, 100 elective surgeries were recorded last year, which is a planned surgery usually done around the 39th week of pregnancy. This is a reported increase of 61,030 elective caesareans in 2022-23.
The proportion of emergency caesarean sections – when a pessary birth can be considered too dangerous for either mother or child – also increases year on year from 29,315 to 32,463.
Reasons for a designated section include when the mother has a low-lying placenta that prevents the baby from exiting, due to multiple uteruses, if the mother has health problems that can make a vaginal birth difficult, or if the baby is in the womb. placed Emergency C-sections typically occur if labor is not progressing or if fetal monitoring shows signs that the baby is in distress.
Most women seek a C-section for medical reasons, but they also have the right to choose one out of personal preference. according to the guidelines published by the National Institute for Health and Care Excellence. That states, if the mother does not want a vaginal birth, after discussing the benefits and risks, the doctor should “offer a planned cesarean delivery for women who request a cesarean birth.”
A third of the total deliveries for 2023-24 have been induced, meaning labor has started using artificial methods, such as ablation of the membrane, a pessary or a hormone drip. This ratio has been largely unchanged in recent years. Spontaneous delivery has steadily declined year on year from 62% in 2013-14 to 42% in 2023-24.
Attitudes toward C-sections have shifted over the last decade, as they move away from goals to focus on individual patient-centered decision-making.
In 2022, hospitals in England He was told to leave the targets They aimed to limit the number of caesarean sections performed below 20%, over fears for the safety of mothers and babies. Then the chief midwife described the potentially safe targets. This was followed by the Royal College of Midwives having given up the common nativity, the war in 2017, after years of promoting vaginal births as a priority.
The world Health The organization also moved from its position that the “optimal” rate of C-section should be no more than 15%, based on observations that suggested that beyond this there was less evidence of benefits in terms of infant and maternal mortality. However, there are other medical reasons for a C-section, such as reducing the risk of pelvic organ prolapse or urinary incontinence, which may require surgical treatment later in life.
Dr Thakar said: “The RCOG does not promote one form of birth over another. Women should be supported to make an informed decision about how they want to give birth, including discussion of the risks and benefits of caesarean and caesarean births. The health and care of the woman and baby during pregnancy, labor and delivery should always be the main focus.”