More than half of women giving birth in Britain now do so with medical intervention, according to an audit of NHS maternity care. Of 592,594 births in 2023, 50.6% involved either a caesarean section or the use of instruments such as forceps or a ventouse suction cup.
The rise is largely driven by a sharp increase in caesarean births, which have risen from 25% of births in 2015-16 to 38.9% in 2023. Induction rates also increased, from 29.3% to 33.9%, while instrumental deliveries fell from 12.3% to 11.1% over the same period.
Experts link the trend to more complex pregnancies, with rising rates of older mothers, obesity, diabetes, and pre-existing medical conditions. Dr Shuby Puthussery, associate professor at the University of Bedfordshire, said the shift was “worrying” but tied to demographic changes, particularly among ethnic minority groups and those living in poverty. She called for better access to antenatal care to detect problems earlier.
However, Prof Asma Khalil, vice-president of the Royal College of Obstetricians and Gynaecologists, said the increase in caesareans is “not necessarily a cause for concern” as long as services adapt with adequate staffing and facilities. The report noted that there is no “ideal” caesarean rate, and that 23.1% of births were emergency caesareans while 16.4% were planned in 2023.
The audit also confirmed falling fertility rates: the number of births in England and Wales was the lowest since 1977, with a fertility rate of 1.44 children per woman. Scotland recorded its lowest ever total fertility rate of 1.3 babies per woman in 2023.
