More babies are being born by caesarean section in England than delivered naturally – without assistance – for the first time.

Latest NHS data for 2024-25 shows that 45% of births were by C-section, compared to 44% which were spontaneous, a term used to describe a natural vaginal birth. Another 11% needed extra support and interventions like forceps.

Nearly half of the caesaereans – when the baby is delivered by surgeons cutting into the mother’s abdomen and womb – were planned in advance.

NHS England says the increase is influenced by many factors, including women choosing to have this kind of birth and a rise in pre-existing conditions such as diabetes and obesity.

Experts say the picture behind the figures is “very complex”.

Dr Donna Ockenden, who is chairing an independent review into maternity services at Shrewsbury and Telford Hospitals, says it has been an “evolving picture over time”.

“We know there is an increasing maternal age, we know there is rising ill health. I also think previous experience will play a part.

“Birth trauma and having a caesarian section first time, may influence their decision to have a C-section the second time round.”

For many women, having a C-section (also known as a caesarean) is a matter of choice.

Over the past 10 years, the number of caesareans has doubled.

Dr Alison Wright, president of the Royal College of Obstetricians and Gynaecologists said part of this was down to improvements “in our ability to detect when a baby’s wellbeing is deteriorating during labour, and therefore respond appropriately”.

Soo Downe, a professor of midwifery studies at the University of Lancashire, says there are many factors contributing to the rise.

“The average age of being a mother has only gone up by one year over the past decade, and women’s BMI [Body Mass Index] has only increased very slightly.

“This doesn’t explain this very rapid rise that has happened over the last 10 years.”

She suggests part of the picture is a growing number of women who feel a caesarean is the “the least worst option” because there is a fear they might not get the support they need for a “safe straightforward positive labour”.

Maternity services in England have been heavily criticised, with reviews into maternity care ongoing at 14 NHS trusts.

An NHS spokesperson said: “All women should receive safe, personalised maternity care in line with best practice guidance and clinical evidence.

“The priority should always be the safety and wellbeing of both mothers and babies, and decisions about how a baby is born are made through informed discussions that consider individual circumstances, clinical advice and a woman’s preferences, ensuring the safest and most appropriate approach for each birth.”