One in four births in England are now delivered by emergency caesarean

One in four births in England are now delivered by emergency caesarean,

One in four babies are now delivered in emergency operations, with experts suggesting the rise in older mothers, obesity and high profile maternity scandals being to blame.

Analysis of NHS data shows that the rate of emergency caesarean operations have risen significantly over the last five years.

The unplanned surgeries have increased by eight percentage points, while the rate of elective caesareans has also increased.

Experts have ranked the level of planned and unplanned caesarean’s from 42 comparative countries; in 2020, England was 14th but by 2025, it was up to 9th.

NHS England says ‘decisions are made by considering individual circumstances and clinical advice to ensure the safest and most appropriate approach for each birth.’

A caesarean section, or C-section, is a cut through the mother’s tummy and womb.

Emergency C-sections are graded from the most urgent – where there is an immediate threat to the life of the woman or the baby – to those where labour is not progressing well.

Older women are more likely to suffer complications and have prolonged labour as their uterine muscles may not work as effectively, leading to weaker contractions.

This can result in doctors advising them to have an elective c-section, or an emergency c-section if problems become evident during labour.

Each unplanned surgery comes with weeks of physical recovery, the chance of mental trauma and a small but serious risk of complications in future pregnancies.

Studies have also shown babies born this way are more likely to become obese, suffer from allergies, or develop asthma, type 1 diabetes or leukaemia.

Analysis of NHS data by the BBC shows that The most common way to have a baby is still a vaginal delivery where medics don’t use instruments such as forceps to help pull the baby out – but that has fallen from 53 per cent to 43 per cent of births.

Planned caesareans now make up 20 per cent of births and there has been a steady increase in emergency caesareans – from 18 per cent to 26 per cent.

Figures from other parts of the UK are not as up to date, but put emergency caesarean rates at 22 per cent in Scotland, 20 per cent in Wales and 16 per cent in Northern Ireland.

Experts are now investigating why there has been a significant rise in C-section’s in the UK.

Prof Marian Knight, director of the National Perinatal Epidemiology Unit, believes that recent maternity scandals may have contributed in part.

Older women are more likely to suffer complications and have a prolonged labour as their uterine muscles may not work as effectively, leading to weaker contractions

Recent maternity safety scandals in Morecambe Bay, East Kent and Shrewsbury and Telford all heard similar, devastating stories of mothers and babies dying and a reluctance to do caesareans. Ongoing inquiries in Nottingham and Leeds are likely to have similar concerns.

‘We also need to recognise the potential impact of rising fear among women, families and staff, which may lead more to choose or to recommend caesarean birth,’ says Professor Knight.

Over the last five years, there has also been an 11 per cent increase in the number of legal claims against the NHS for maternity problems.

‘Legal cases typically question why caesareans are not undertaken or not undertaken sooner,” Prof Knight says.

‘Doctors and midwives are rarely criticised for performing an early caesarean.’

Prof Knight is investigating whether factors like age, obesity and pre-existing medical conditions are contributing to the increase.

Experts say that the rise in C-sections means that hospitals need to be better equipped to deal with the rise.

The cost of a planned C-section is about £4,000 – around £800 more than a natural birth – while an emergency C-section is the most expensive at up to £6,000 per birth, according to NHS tariffs that set out how much hospitals are paid.

Dr Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, said: ‘The caesarean birth rate in England and globally, has steadily increased over the past decade.

‘There are varied and complex factors contributing to this, including improvements in our ability to detect when a baby’s wellbeing is deteriorating during labour, and therefore respond appropriately.

‘The observed increase in caesarean rates means we must ensure that services are appropriately prepared, with the right staffing levels, training and facilities to manage increasingly complex births and increasing interventions.

‘Adequate staffing and appropriate theatre resources will be vital to ensuring that all babies and women receive safe, high quality, personalised and compassionate care.’

Experts also say that the rise in C-sections means that parents need to be informed to make the right decision about their birth.

Fiona Gibb, director of midwifery at the Royal College of Midwives, said: ‘Caesarean births have been steadily rising over recent years and now make up nearly half of all births, which could reflect a change in maternal population needs, choice of parents-to-be and systemic pressures.

‘Every woman should be supported to make informed choices about the type of birth they want and what is best for them.

‘No birth is entirely without risk, including caesarean, so ensuring women have the right information to make the right choice for them is imperative.’

An NHS spokesperson says: “The increase in the number of emergency caesarean births is influenced by many factors, and our priority is always the safety and wellbeing of both mothers and babies.

“Decisions are made by considering individual circumstances and clinical advice to ensure the safest and most appropriate approach for each birth.”

The Department of Health and Social Care says it was committed to improving maternity and neonatal safety and pointed to Health Secretary James Murray’s role as chair of the national maternity taskforce.