42% of UK births are c-sections

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Is anyone else surprised at this statistic? I’m sure it was only something like 20% when my now-teen was born.

Although I had noticed how so many of my friends/family members/colleagues having babies recently all seem to have had cesareans.

It looks as though the shift will only continue so potentially c-section will exceed 50% of births and be the more common mode of birth in a few years.

I think it’s really interesting! Will there be drive to try and push numbers down and increase vaginal births again? Or will it eventually become standard for most women to just book in for an elective section as standard and ‘attempting natural’ will be seen as a more unusual choice like home birth is currently.

People definitely have CS for social reasons, my friend and her DH are deputy headteachers and had hers agreed for half term and she was surrounded by others in the ward in the same situation.

Poor maternal care will be a factor too. I know many women who have experienced poor maternal care both antenatal and during birth and post natal. I for one am having an elective section after 1 emergency section. Went into labour "early -39+1" with first child , rang triage to be told oh no, you can't possibly be in labour it's your first baby and they are always late. 4 hours after the phone call was 8cm dilated. Labour ward busy so having to labour with other women in corridors. Finally getting a room, denied water birth because of staffing. Left for ages, women pressing buttons left right and centre and ignored. 1st child coming out shoulder first, laboured for hours with no pain relief as the anesthetist wasn't available and busy, told to push despite baby in wrong position. Monitoring clip not working correctly -because it was screwed into DDs shoulder. Midwives coming in and just doing examinations with no consent. Luckily DH was VERY assertive and insisted on a second opinion from the consultant who came in, examined and straight away declared emergency c-section needed as baby was stuck, in distress and shoulder first). Due to the tilt in my uterus, it's likely that DD2 will be the same. Went for my scan yesterday as my section is next week, DD2 is laid in the exact same position as DD1 was. No way am I putting us through all that again.

Our hospital trust is one under the maternity investigation. Women denied pain relief, long waits for pain relief (due to staffing issues), a huge push for inductions if baby is "measuring big" or going over 40 weeks. Lots of instrumental deliveries and poor outcomes for women. I know a woman who had a 3rd degree tear repaired with no pain relief and was told to suck it up. I know a woman who after 23 hours of labour, ventonuse and forceps was unable to sit down on a sofa without pillows under her for 6 months and 4 years later still suffering from incontinence and painful sex - the NHS does not give a toss. I know countless women who have suffered "mild incontinence" due to birth injuries and have had to pay for private treatment. I know a woman who was threatened with reports to SS for endangering her baby as she refused an induction at 40+4 days, baby came naturally the next day.

At least with a planned C-section you know you will be given pain relief for the section. There is a plan, you will not be labouring in pain in a corridor with 6 other women for 3 hours. You won't be intimately examined without consent in a corridor in front of other women and their birth partners. Someone won't screw a "clip" into a babys shoulder and then blame the machine for not working and everyone else accept it is a machine problem and not user error. The anesthetist won't be busy for hours on end so you can't have an epidural for 4 hours.

Until maternity services improve, women will chose the best option for them.

I’m happy to DM you where?

I need a drains checking and changing every four hours, Pain medication And food frankly.
It got there eventually, but it certainly was of no higher standard than the NHS.
And the other post should’ve said it was the night nurses that were sat watching television with the buzzers basically turned off

I don’t think it’s quite that easy. Is there even any data that separates the elective c-sections for medical reasons that obviously carry higher risk and the electives by maternal request where the mother is low risk? When I was pregnant I found that impossible to find which surprised me as it seems like pretty crucial information. Granted not an expert though! But better and more easily accessible information would only be a good thing. In the end I went ELCS, I went private and the consultant was very pro section.

@Icecreamandcoffee great post. With maternity services in this state @childofthe607080s women will accept the small increased risks of CS for a planned experience.

I think it can be misleading to see elective surgery as the same as by maternal request. Most breech babies are born by elective c section, but it's done for safety reasons, not preference. Elective just means planned rather than emergency.

Possibly the rising age of first childbirth , plus people having smaller families has a lot to do with it. C sections used to be avoided where possible, as it becomes more dangerous to have multiple childbirths afterwards, but if women are only likely to be having one or two due to maternal age the balance of safety tips towards c section.

Also older women are more likely to have twins, which make c section more likely.

IVF pregnancies also seem to be more likely to result in c section.

There's been a big drive in recent years to reduce stillbirth rates, e.g. the Saving Babies' Lives initiative which started in 2016 - https://www.tommys.org/research/research-topics/stillbirth-research/saving-babies-lives-care-bundle. A big part of that is more/earlier interventions based on risk profiles (e.g. maternal medical history, Doppler measurements at 12 weeks, etc.).

It's a balancing act, isn't it - some interventions will prove unnecessary/harmful and others will save the life of the mum and/or the baby. My first child probably wouldn't be here without the extra monitoring that resulted from the above and similar, and potentially I wouldn't either. They get more data all the time so I expect the assessments will become more nuanced. Meanwhile I have to roll my eyes at suggestions that the increased rates are due to people's social calendars!

My daughter is nearly 18 months old and other than me every woman on my postnatal ward had a c section, only one was elective. All of us bar 1 were induced. If I had to guess, the amount of inductions increasing is what is leading to a higher % of c sections, emergency ones especially.

Currently pregnant with number 2 and from very early on induction was mentioned as “the plan” by consultant, we have declined and will continue to decline until/unless an actual issue presents itself which means induction is needed for baby but there is a lot of worry now, risk averse, easier for the hospital to plan for section/induction vs natural births.

I had an emergency c-section and am very grateful for it. However I do think this all leads back to UK having extremely poor gynae prior to pregnancy. Women need to know what they are dealing with - I have a tilted uterus and if I had known that beforehand (many hard to reach smears still didn't cause anyone to mention it to me before pregnancy) I wouldn't have planned a home birth, for example. The front end of female health from teens is shockingly poor and all costs more further down the road as we are patched up with Prozac rather than given full blood tests to find the root cause, meaning we go back again and again for issues that would have been easily fixed years prior.

Roll on Women's Health Hubs where we can get a one stop smear/mammograms/blood tests/HRT discussion in one place at one appointment rather than having to take time off work and sort childcare.

I'd also add Cameron was meant to be adding 15k midwives way back, never happened. Midwives are opting out of the system because they can see it isn't being funded well. With that more medically managed births have to happen as otherwise the low staff levels make more natural births long drawn out and unsafe.

I don't think there'll be a drive to lower CS rates, no. There's an increasing awareness of what treating that as a goal in itself leads to. If nothing else, the legal costs are going to force change.

The rate isn't something that especially surprises me either. Not when the birthing population is getting older, heavier and less likely to anticipate more births in the future.

For me mostly poor maternal care honestly… first birth had a ‘maternal requested c section’ according to my notes but in reality I was 41+5 waiting for labour with no signs and getting a bit of white coat hypertension (never over 150/95) from them wanting to over monitor me a lot and yes I have a slight apprehension of hospitals…. then them saying I NEED to stay in or I may have a stroke (I know in hindsight the risk was low low it wasn’t pre eclampsia at all) then to them saying induction or c section as baby needs to be out in 12 hours, induction would likely (80% quoted) lead to c section… so that’s what I requested and bam I’m a maternal request!

Currently pregnant with a second, 2 years difference… went for a consultant review to tell them I wanted VBAC, well you’d never guess, they’ve already booked me a c section (obvs I declined this for now as I want that VBAC) and he was just flabbergasted that I didn’t straight up accept it… what can we do eh!

I wish I had had a c-sec. My fanny is a wreck and it's destroyed my confidence and my sex life.

Usually the first one will be an emergency and the second one will be elective, because VBAC is dangerous. So the numbers of elective are high probably because they are reopening the previous section.

I was pretty much forced to have a section for my second baby despite pleading to let them let me try. I will never forgive them.

I had an elective c section although it was elected an hour before it happened because I was overdue and for medical reasons I couldn’t be induced. So elective doesn’t always mean that the mother is choosing, often it’s the only viable option.

Inductions ending in c-sections is one of those oft quoted facts that muddies cause and correlation. Pregnancies that are judged to need inductions for medical reasons do more often need c-sections but those pregnancies if left to continue naturally could very well end up with a c-section anyway, regardless of the induction aspect.

If you have no medical need for an induction, but go for one anyway at 39 weeks, the rates of c-section are no higher than if that pregnancy was left to continue naturally and rates of birth injury are lower in women who opt for inductions. This was shown in a controlled experiment with mothers randomly assigned to induction or non induction group and validated with a review of thousands of pregnancies.

Even though it’s natural to draw that conclusion, studies show otherwise - I wouldn’t be afraid of induction as long as I had good care during the induction, including a midwife/obgyn who correctly judged position of baby and had a plan to get baby into the correct position for a successful vaginal birth. Unfortunately this isn’t usually the case in UK maternity wards where you are just left alone for hours during the induction process.

If I was being induced for medical need then I would probably opt for a c-section instead though. This is a good summary of the science https://www.unimelb.edu.au/newsroom/news/2023/may/mothers-choosing-to-induce-labour-at-39-weeks-have-better-health-outcomes

The problem with birth is you don’t know which method would be better until you have done it. Induction and forceps left me with an undiagnosed 3rd degree tear that has never been able to be repaired. If I had been allowed a c-section as the sonographer recommended due to my baby’s head size I would have been better off physically and mentally. 17 years of bowel incontinence and prolapse later and it’s been a real struggle.

The regret is real and the shame at my body will never leave me. And it’s very hard not to sarcastically say ‘but at least I didn’t increase the c-section rate hey’

I have cost the NHS tens of thousands of pounds in treatment costs already and that will be for the rest of my life as well. Doesn’t make the financial saving of vaginal vs c-section in my case look too smart does it.

Giving women a choice is the right thing whatever anyone might say.

This is a very selective analysis. There are risks and benefits to both planned VB and ELCS, and it's simply a question of which the woman finds more acceptable.

The WHO have been very problematic on this question- hopefully we all remember how they withdrew that ludicrous 15% claim years ago, sadly with much less fanfare than they introduced it. The concept that a planet with such wildly varying conditions when it comes to healthcare and birthing population could have one single set of figures with global applicability is ludicrous. One has to be marinated in ideological rather than evidence based beliefs to accept it.

Lastly, you can't possibly think the entire 42% of women who have a CS will then be back having more babies? With a TFR of 1.41, and older women more likely to have CS than younger? The reality is that planned family size is one of the things women take into account when deciding whether to attempt VB or go for an ELCS.

When I had mine 3 years ago, vaginal delivery, the care was dire to non existent. I'm not surprised by the statistics at all which is a sad state of affairs considering

Shocking! I had no idea it was that many. I was nearly forced into one with DC1 because my waters had broken but labour hadn't started. I was given a deadline of 6am the following day to go into labour plus a 40 minute punishment monitoring .... luckily DC1 put in an appearance overnight.

Are a lot of ladies electing for c sections because they have had terrible birth experiences?
I had my first child in 1989. NHS under Thatcher wasn't the best but the birth wasn't a terrible experience. Induction but still VB. 2nd child 1991 NHS no better no worse 55 minutes VB birth all good.
Third child 1997. Induction VB care ok
My DD had her first child 2009 very quick labour very good care.
Her 2nd child in 2018 maternity ward refused to admit her saying she was weeing when her waters were leaking in the 5th and 6th. When she returned on the 9th they begrudgingly gave her a trolley left her till the tenth when at 4pm they decided the babies heart had a poor trace and whipped her down for a CSection. DD nearly died. Baby had meningococcal septicemia. He lived after treatment. He's death from the sepsis. He has autism. So he will be dealing with that all his life.
Her third child born in 2022 nearly a similar scenario. They took her in for a section but services were so short and understaffed she was meant to have it Tuesday it turned into an emergency Friday with near death for mother and child.
Fourth child in 2024 hospital tried hard to not fuck up. Took her in for a planned c section and did it almost to plan.
Piss poor maternity services from austerity cuts. And it makes me so bloody angry that in the 21st century women and babies are in more risk at childbirth than the better services in the 1980s.

Are you sure they were telling you the truth or the whole of it? I chose an elective because I had recurrent miscarriage and couldn't stand the idea of something going wrong right at the end. The fear of coming away from labour without a baby in my arms was too much for me.

I don't tend to tell people that though. I also would make up a silly, self-deprecating reason when asked about my birth story.

One thing that never fails to amaze me in today's medicalised world is why every woman is not scanned when they present in labour or shortly before the due date to assess the cord, whether wrapped or too short and the position of the baby. It would surely avoid a great many issues.

I’m currently pregnant with my second baby so had a birth debrief as well as being consultant led and actually when discussed the facts show that inductions do lead to what they call a cascade of interventions, and that can increase your chances of needing a c section.

Once you start down that path, there is a higher chance it will end in a c section than if you had just been left to go naturally (if safe to do so). One example being that for an induction they often manually break your waters and once your waters are gone your 24 hour clock starts ticking after which baby HAS to come out. If left to go naturally you avoid that and can wait for the natural break of waters, when your body is actually ready, and often when your labour has actually started to progress. Position of the baby isn’t everything, if you can’t dilate fully, quickly enough, baby cannot come out that way.

Another example is that the hormone drip used for inductions causes artificial contractions, typically much stronger & closer together than natural would be, and that puts lots of babies into distress. Once they are in distress you’re more likely to need a section if they cannot cope with the contractions- again, avoided if you can go naturally. As advised by my consultant.

There are lots of other things, and I’d really recommend any woman who is offered induction to get all of these gritty details beforehand to make an informed decision. We were really pushed into one the first time and were incredibly naive, I can’t say I would have chosen an elective section even if I’d had the choice but at least having all the facts would have made everything less scary.

It could have been somewhere in the middle. I can't imagine it would have been scheduled for Wimbledon, but mum may have expressed as at least it meant she knew she'd be home in time for Wimbledon!

Oh you might be right and it was something he she just said to cover the real reason.

I liked that having a scheduled date in meant I could organise childcare for my first, go for a lovely date with my husband the night before, and attempt a decent night sleep before meeting my baby. That wasn't the reason why obviously, but you may as well enjoy the perks.

Perhaps she was given a choice on dates (I was), was a tennis nut and included that in her reasoning. If she was given a choice then it doesn't matter really whether it's what people would deem a worthy reason or not.

I think some people get grumpy at how planned sections can be scheduled for everyone's convenience (within reason). That's just a perk of it. If someone wants to be at the mercy of potentially having a baby at any date over a month period, and the excitement, but also the unpredictability that comes with that, well they can choose a natural labour!