The BBC highlights findings from a new NPEU short report comparing published maternity data from England with international trends. The analysis shows a marked increase in caesarean births in England since 2020, particularly emergency caesareans, which now account for around a quarter of all births. Over the same period, the proportion of births delivered vaginally without instruments has fallen from 53% to 43%.
By comparing data across 42 countries, the report provides important international context for these changes. While caesarean birth rates have increased in some countries, the rise observed in England has been notably steeper than in many comparable European nations. England moved from 14th to 9th among 42 countries ranked by caesarean birth rates between 2020 and 2025.
Professor Knight said the findings represent a "total change in how women give birth" in England and noted that similar increases have not been seen across much of Europe.
Understanding the drivers of change
The report seeks to understand the factors that may be contributing to these trends, drawing on evidence about changes in maternal health, wider pressures on maternity services, and the broader context of maternity care in England.
The researchers also highlight the need for better evidence on the reasons behind emergency caesarean births, as national data on the indications for these procedures are not routinely collected. The NPEU's next phase of work will examine the potential drivers of these changes in more detail, including the role of maternal age, obesity and pre-existing health conditions, as well as wider influences on decision-making in maternity care. The research will also explore the implications of changing birth patterns for women, babies and maternity services.
The report
Click here to view the 2026 Report - NPEU International Caesarean rates
Ambia, J; Alderdice F, Knight, M, Rowe R, Sanders J, Carson, C. Short Report: International comparison of caesarean birth rates, 2020 – 2025, National Perinatal Epidemiology Unit, Nuffield Department of Women's and Reproductive Health, University of Oxford. 02 June 2026. http://www.doi.org/10.5287/ora-z6obzn5pq
Further information
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