A new State of the Nation report published today by the National Maternity and Perinatal Audit (NMPA), analyses data from 593,475 women and birthing people who gave birth to a singleton baby in NHS maternity services across Great Britain in 2024 and shows continuing shifts in how babies are being born.
- The proportion giving birth vaginally without instruments was 46.4% in 2024, down from 49.4% in 2023 and 62.3% in 2015/16.
- Caesarean birth rates continued to increase, with 42.8% of women and birthing people having a caesarean birth in 2024, up from 39.5% in 2023 and 25% in 2015/16.
- Of women and birthing people who had previously given birth by caesarean, the rate of giving birth by caesarean again was 83.1% in 2024 compared with 81.8% in 2023.
Recognising the impact of changing birth trends, the NMPA recommends maternity commissioners and networks use data on local demand and the needs of women using their services, to ensure maternity units are appropriately staffed and resourced. This reflects major maternity investigations across England, Wales and Scotland, which have all considered the significant changes in patterns of maternity care on the ability of services to offer safe, high-quality care to every woman and baby.
The report includes recommendations on other important aspects of care, including:
- Mandating national maternity datasets capture information on decision-making around mode of birth and birth interventions in England, Scotland and Wales, to improve understanding of drivers for these significant shifts.
- Action to support a continued reduction in the number of babies born small for gestational age at/after term. The proportion of babies who were small for gestational age and born at or after 40 weeks fell by 14 percentage points, from 55.4% in 2015/16 to 41.4% in 2024.
- Improving data capture on blood loss experienced by women so NMPA can report rates for all three countries. Among providers with sufficiently complete data, 3.5% of women and birthing people experienced a postpartum haemorrhage of 1500 ml or more. Incomplete recording currently prevents comparable reporting across all three countries.
Dr Alison Wright, President of the Royal College of Obstetricians and Gynaecologists, said:
“The RCOG is proud to support the National Maternity and Perinatal Audit (NMPA), which provides essential data on childbirth trends, and makes evidence-based recommendations on how the system can continue to improve care for women and babies.
“This latest report highlights significant changes in patterns of maternity care, including increasing rates of planned and unplanned caesarean birth, compared with previous reports.
“Multiple independent investigations have identified growing service demands, and workforce shortages as key contributors to poor care experiences and preventable harm. We urgently need services to be supported to adapt to changing patterns in childbirth, with appropriate staffing, training, facilities, and sustained investment.
“We also need to better understand the factors behind these changes, and this report makes an important recommendation that national maternity datasets should capture information on the reasons behind decision-making around labour induction and caesarean birth.
“This will all help us to ensure that every woman and every baby receive the right care and have the best possible outcome.”
Gill Walton, Chief Executive of the Royal College of Midwives, said:
"This report raises a number of important issues. We know that trends like rising caesarean and induction rates mean the needs of women using maternity services are evolving fast and services must keep up. Women need midwives with the time and capacity to give them the individualised support they deserve.
"We're also concerned to see Black women are more than twice as likely as white women to book maternity care after 10 weeks and that women in more deprived areas face similar barriers - this inequality in access must be addressed.
"None of this is possible without the right staff. Safe staffing must be the priority for investment, so that every woman gets the care she needs, when she needs it."
Dr Sam Oddie, NNAP Clinical Lead, Royal College of Paediatrics and Child Health, said:
“This report sheds important light on how babies are safely delivered across the NHS. The rising proportion of babies delivered by caesarean section has real implications for children's doctors and nurses, and sometimes for babies themselves.
“Paediatricians would like to see better data on why intervention rates continue to rise, so the system can properly understand and respond to this trend. We're also concerned that many women are not booking their pregnancies early enough to meet current guidelines, and that this is more common among ethnically minoritised women. Understanding what's driving these disparities in maternity and neonatal care is an important next step.”
The NMPA report is based on the data of 593,475 women who gave birth to a singleton baby in NHS maternity services and is the largest quality improvement programme for maternity and neonatal services in the world, providing a unique picture of birth trends and outcomes in England, Scotland and Wales.
To coincide with the launch of the report, NMPA will also launch NMPA Online, allowing users to explore data spanning 2020 to 2024, compare results over time, across measures, and between individual sites, trusts and national figures.