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.

Thats simply because it’s a surgery - if vaginal birth was taken as seriously there would be more restrictions.

It isn't necessarily the case at all.

Out of my NCT group I had my baby last with a planned section. When we met up a week later obviously I was the most recent birth. I was the only planned section.

I was absolutely fine.
The woman who had forceps was still in pain and traumatised.
The woman who had ventose was still in pain and traumatised.
The woman who was induced and tore badly was still in pain and traumatised.
The woman who had a quick birth with only a graze was ok but still more sore than me.
The one with a protracted labour and emergency section was still in pain.

Not everyone recovers quicker, but many of us do. I've honestly had worse periods, and when I hear friends talk about their 3 day labours and tears, I just stay quiet because I dodged it all.

Everyone saying they had to have a section because their baby was breech, were you not offered an ECV? because I had one and I'm so glad I did, went on to have a completely straightforward delivery with no need for major surgery!

This has come up before. Here is research indicating that planned CS is £785 cheaper on average.

https://www.researchgate.net/publication/347709746_The_true_relative_financial_cost_of_Planned_Caesarean_Birth_PCB_versus_Planned_Vaginal_Birth_PVB_in_England_for_the_year_201819_taking_into_account_litigation_and_compensation_for_harm_a_sensitivity_a

I think when NICE looked at it in the 2010s they found attempted VB was a little cheaper, but that was without legal costs.

It's interesting that the assumption tends to be ELCS being more expensive. But the most expensive births for the NHS are VB attempts that get complicated. Nobody has an EMCS or a forceps delivery if they weren't attempting to birth vaginally.

@NikkiPotnick But asides from the financials? And did this factor in stays after birth? I can only comment on my experience for vaginal births as I had 2/3 in hospital - first out next day and second out within 5 hours. I have no idea re length of an average CS stay, however?
The cheapest option if financials were the only thing that mattered would of course be an unassisted birth which again is of course the choice of the woman.
I had a home birth with my third but paid for that myself and didn't get any NHS care at any point throughout my pregnancy. Partly through choice but partly because it was at the height of the pandemic so f2f appts pulled.

I agree more info is needed. I’ve had 4 electives but I know of 4/5 friends, family and a colleague who had an emergency followed by an elective instead of a VBAC.

Afaik both this and the NICE analysis did, yes, but by all means look it up. I've not seen the NHS publish stats on the length of stay for ELCS as against EMCS, there's a tendency to throw the two in together into one big CS umbrella. But it's possible someone here may have seen something I haven't.

In terms of non-financials, presumably you mean things like staff time. The way to get your head round this is that some of the women attempting vaginal birth will end up with births that use more staff resources than an ELCS. This is because attempting vaginal birth doesn't mean you get one, let alone a cheap one. It's crucial to distinguish the two. We can all say that it's cheaper if women have more straightforward births, but this doesn't mean attempting them costs less overall. And legally expensive births are also more likely to be attempted VB than ELCS, for obvious reasons.

There's also the change in the birthing population to be factored in. Older women have more sections and are less likely to have straightforward, cheap vaginal births than younger, as a cohort. But we're getting older. So it's probably not something that will stay static. There's a lag in this appearing in research, and it can take time to become apparent.

Most C-sections aren’t really a woman’s choice are they? But once they’ve had one they often have another with their other children too, that’s a choice, but things could have been different if they swathes of us weren’t being pressured into unnecessary inductions or pressured into surgery because our babies were breech

If you want to, you can also choose to have a c-section instead of a vaginal birth but you're correct, not a choice for everyone.

I didn't feel pressured into an induction and I'd rather an elective c-section over risking an ECV. Which is why choices for women are important when it's possible.

We can't forget that many babies lives are saved thanks to emergency c-sections too.

I've just posted about breech, weren't you offered an ECV though?

Only low-risk pregnancies will be offered ECVs and only about 50% of them are successful.

My DC2 was transverse. I wasn’t offered one anyway as I had a EMCS with DC1 and had asked for ELCS anyway. But she was VERY VERY stuck and they even had to work hard to get her out during the c section. No way would an ECV have been successful.

Agreed both of mine were “elective” c sections but neither were by “choice” - I had a complex medical condition that made natural birth risky. I still feel a little disappointment as it wasn’t the birth I would have chosen and I found the recovery very difficult, but I am incredibly grateful to have 2 healthy children and to have had c section as an option!

I had one, baby crashed, and had to have an emergency section under GA. They're not all straightforward flip baby and come back in a fortnight for birth.

I think it’s great news. Thanks for sharing the article, nice to read something positive for a change.

The recovery after a C Section is also much longer! The suggestion that anyone other than a celebrity getting a tummy tuck at the same time would choose major abdominal surgery to attend a party is shocking. The reality is most C sections are medical emergencies or pre planned for people who have existing health conditions where a prolonged natural childbirth could put both at risk.

Not for everyone. I was out of hospital within 24 hours and up and about as basically normal, even went out for lunch on day 3. It really varies. My friend tore badly with a natural birth and was incapacitated for a good week. Really can’t say one size fits all. Yes it’s major surgery but hammering that it’ll take you weeks to be mobile again isn’t helpful because on many cases it’s untrue.

No 2 births are the same. I found my sections very easy recovery wise whereas I’ve seen some close friends struggle for quite some time afterwards following vaginal tears.

Also can you even have a tummy tuck at the same time as a section? Wouldn’t your enlarged uterus be in the way? I know a few ladies who’ve had surgery to repair their stomach muscles after pregnancy, and the results were amazing akin to a tummy tuck, but it was done well after their last baby and when their youngests were toddlers so less likely to need picking up.

I appreciate everyone's experience is different, but as a general rule of thumb the recovery after a CS is much longer. I also don't think it's hammered that you will be immobile, I think they rightly err on the side of caution with the 6 weeks recovery advice, which is standard for most operations. Ultimately the individual will do what they feel up to doing, whether that is after one week or a couple of months.

yes but that’s my point I suppose. They can err on the side of caution but also give more balanced information- in many cases women recover very quickly after a c section. Of course you have to be prepared that you may not, but I’m sure it would reassure a lot of women who want to consider a c section or a worried about ending up having one that it may not be the case at all and your recovery could well be straightforward.

Yes it's going to be longer than an easy, tear and complication free birth, but the vast majority of births aren't that.

I don't know why people don't listen to those if it's who have had planned sections and say they often really aren't difficult to recover from.

Vaginal births with tears and complications can also have easy recoveries. I had a year and a major pph but I was up and walking around within a couple of hours (slowly) and could have got up within minutes if I had to. It was a little uncomfortable sitting down and getting up for the first few days.
Tears are common but serious tears are fairly rare, even for women who are having medicalised births (induction, epidural, lithotomy etc).

Can you post research on why the vast majority of natural births are apparently complicated because this is all hearsay otherwise.
My first labour was long and painful but I didn't tear and pushed him out within 20 minutes, he was back to back so my only gripe would be I didn't get the epidural straight away as once that was in it was bliss. I recovered and was up and about within hours after delivering ds naturally with no long term issues. He came 8 days late so 1 day before my induction was due.
I would never opt for a caeserean over natural unless there was a good medical reason, it's major abdominal surgery.. The two women I know who have had sections took weeks to recover at least to a basic degree and spent longer in hospital also it's worse when you have multiple kids and can't just lie on the sofa with your firstborn.
With this pregnancy she is optimal facing and I have said I refuse induction until 42 weeks as so many have a high failure rate ending in cs. That is my choice and I think there is too much emphasis on unnecessary interventions nowadays as the NHS is so risk averse..rather than waiting for nature to take it's course. My mum delivered all 3 of me and my siblings at 42 weeks with no problems..nowadays they would push for induction before then which I think is part of the rise in Cs births.

Today in The Times was a concerning article:

Births by caesarean section have overtaken “natural” deliveries for the first time, NHS data has revealed.

About 45% of births in England last year were caesareans, and nearly half of these were elective operations, planned in advance.

I had to wait 26 hours for a bed on the labour ward when in labour with DC1 (having arrived after 12 hours labour with contractions under 5 minutes apart as instructed by my midwife), nearly 9 years ago. Contractions stopped and I couldn't get them going again naturally so I was then induced but after another 12 hours on the drip still wasn't dilated enough. I didn't realise, but another mum later told me that stress can cause contractions to stop. So I wonder if PP is correct in that lack of adequate care is a contributory factor. DC2 was also an emergency c-section, because baby's heart rate was below 40bpm. Had to wait for an available theatre before it could go ahead, or they would have delivered sooner. I'm not a medical person by any stretch but I can imagine the lack of available staff/beds/care doesn't help. I know they are trying their best but it's quite sobering, friends of mine have suffered worse. I daresay that there are a lot of contributory factors. The figures are higher than I realised but I'm also not entirely surprised. When my mum or older relatives say they stayed in for a week after birth it blows my mind!

Have you forgotten to mention the concerning part, @everychildmatters?