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

Roughly one in four babies in England is now delivered by emergency caesarean, according to a BBC analysis of NHS data. The broadcaster reports the rate has climbed from about 15% in 2014-15 to about 24% in 2024-25, an increase of around a third.

Emergency caesareans are decided after labour has started and differ from planned operations. NHS classification defines four urgency categories: from category 1, where the life of the mother or baby is in immediate danger, to category 4, where the operation is urgent but not life-saving.

Professor Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG), told the BBC the rise had "multiple causes". Older maternal age, higher average body mass index and a greater share of pre-existing medical conditions all play into the trend.

Staffing pressure is another factor cited by clinicians. NHS England's most recent workforce data shows around 2,500 midwifery vacancies. Staff said shifts without enough midwives mean labour can be escalated to surgery later than ideal.

Gill Walton, chief executive of the Royal College of Midwives, told the BBC: "If there isn't a midwife on the labour ward, monitoring is delayed. Delayed monitoring leads to delayed escalation and ultimately to category 1 caesareans." She added that the NHS workforce plan is running behind its decade of promised hiring.

Clinically, emergency caesareans carry higher risks than planned ones. Rates of additional bleeding, infection and placenta accreta in subsequent pregnancies are higher. Maternal post-traumatic stress symptoms and neonatal respiratory distress are also reported more often.

The rise sits alongside an increase in planned caesarean rates. The overall caesarean rate has climbed from 26% to 42% in a decade; on the BBC's count more than four in ten births now involve surgery. The World Health Organization said in 2015 that 10-15% was a reasonable benchmark, while warning that "a rate is not a target in itself".

Experts emphasise that a high caesarean rate is not necessarily bad. Caesareans have contributed to lower stillbirth rates and to better management of high-risk pregnancies. But Professor Thakar said reducing emergency operations that are not clinically necessary is a priority for both mothers and the NHS budget.

The regulator, the Care Quality Commission (CQC), said in its latest review that around half of England's maternity units require improvement and one in eight were rated inadequate. Health Secretary Wes Streeting said the government is working on a new maternity safety plan that would accelerate midwifery hiring.

This information is not medical advice. Decisions about pregnancy care require individual clinical assessment; families with concerns are advised to contact their NHS maternity team or family doctor.