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The rate of cesarean births in the UK has skyrocketed in recent years, with England now recording 42% of all births by cesarean section—up from 29% just five years ago. This sharp increase outpaces most European countries, where rates have remained relatively stable. While cesarean deliveries can save lives in critical cases, the surge has not led to notable improvements in key maternal and neonatal outcomes, sparking concerns among health experts.
Rising Cesareans, But At What Cost?
The UK has seen a steep rise in cesarean births since late 2021, jumping from 35% to the current 42%. International research indicates that cesarean rates above 10–15% yield diminishing returns, with potential risks for healthy mothers and babies. Although stillbirth rates have declined slightly in the UK, maternal and neonatal death rates have risen, and more women report traumatic birth experiences.
The National Institute for Health and Care Excellence (NICE) highlights mixed outcomes for mothers who undergo planned cesarean sections. While they experience fewer vaginal tears and lower incontinence rates, they face higher risks of rare but serious complications, such as hysterectomy and maternal death. Babies born via planned cesarean are also at higher risk for neonatal death and childhood asthma.
Why the Surge?
The rapid rise in cesarean births does not appear to correlate with significant changes in factors like maternal age, obesity, or diabetes rates. The average age of first-time mothers has only increased slightly, from 28 to 29 over the past decade, while obesity rates have risen modestly, and diabetes diagnoses remain stable.
Interestingly, countries like Norway, with far lower cesarean rates, report better outcomes, suggesting that the UK’s increasing reliance on surgical births is not inevitable. A Lancet study calls for a “global call to action” to address excessive cesarean rates, urging countries to adopt strategies that balance surgical interventions with natural and home birth options.
Mothers’ Preferences and Trends
Surveys indicate that most women prefer vaginal or home births, with only about 15% expressing a desire for cesareans in uncomplicated pregnancies. Yet, in practice, fewer than half of women in England now experience spontaneous vaginal births—a trend that continues to decline.
For women aged 30–39, cesareans account for half of all births, and for those over 40, it has become the most common delivery method. These statistics highlight a shift in how babies are born, with potentially significant public health implications if cesarean delivery becomes the default option.
What’s Next?
Efforts to align the UK with European countries boasting better maternal and neonatal outcomes could improve long-term care for mothers and babies. Policies that emphasize safe, evidence-based childbirth practices—while ensuring access to cesareans for those who need or want them—are essential.
As cesarean rates climb, the challenge lies in balancing medical necessity with personal preference, minimizing risks, and preserving alternative birthing options. With the public health consequences mounting, experts stress the importance of addressing these trends before surgical birth becomes the norm in the UK.
Journal Source: The Lancet
