One in four births in England is now emergency caesarean, BBC analysis shows

One in four births in England is now emergency caesarean, BBC analysis shows 13 minutes ago Share Save Add as preferred on Google Catherine Burns , Health correspondent and Maryam Ahmed , BBC Verify BBC sees emergency C-sections in maternity unit A quarter of all babies in England are now delivered by emergency caesarean operations, BBC analysis shows - marking a significant rise over the last five years. The unplanned surgeries have increased by eight percentage points, while the rate of elective caesareans has also increased. At the same time, the rate of vaginal births without instruments has fallen - from more than half of all deliveries to 43%. Prof Marian Knight, director of the National Perinatal Epidemiology Unit, which researches the care of women and babies in pregnancy and birth, says the rise represents a "total change in how women give birth" in England, and that it has not been replicated in other European countries. The NHS does not publish data on why an emergency C-section is performed, and experts say there is no single, clear explanation for the increase. However, some have told the BBC they are concerned a culture of fear in maternity units and among pregnant women is driving up the number of procedures. The Royal College of Obstetricians and Gynaecologists, which represents maternity doctors, says pressure on staff and operating theatres means the system is "really struggling" to meet the increased demand. 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. BBC Verify has tracked the changes in births in England over five years. 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% to 43% of births. Planned caesareans now make up 20% of births and there has been a steady increase in emergency caesareans - from 18% to 26%. Figures from other parts of the UK are not as up to date, but put emergency caesarean rates at 22% in Scotland, 20% in Wales and 16% in Northern Ireland. Prof Knight's unit has compared how caesarean birth rates - both planned and emergency - have changed across 42 countries. Her team ranked each country on the proportion of C-section births, from highest to lowest. In 2020, England was 14th out of 42 countries - but by 2025, it was up to 9th. She says the other countries are generally not seeing such sharp increases. Despite the rise in emergency C-sections since 2020, stillbirths and neonatal mortality have remained largely unchanged. Shakila Thangaratinam, professor of women's health at the University of Liverpool and a consult