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In the past week, new figures have shown the number of childbirths that happen by Caesarean section are continuing to rise, now accounting for about four in 10 births in England in the last year.
But this ignores the reasons for the increase – and is founded on several other misconceptions about birth. Some of the popular advice for pregnant women either contradicts findings from medical research or glosses over facts that most women would want to know about.
According to NHS England, 42 per cent of births were by Caesarean in the year ending in April 2024. In a little over half of these cases, 25 per cent of the total, the operation was a planned one. The rest were emergencies, carried out after labour had begun.
Caesareans can be life-saving if the baby gets stuck during labour. But they can also take longer to recover from, and raise the risk of complications in later pregnancies, research has shown.
But the main cause of the rise in Caesareans are two major demographic changes, the Royal College of Obstetricians and Gynaecologists (RCOG) said this week.
This is coupled with another health trend – populations are getting heavier, and obesity also makes vaginal childbirth more difficult.
Both the UK government and the WHO have since torn up their Caesarean targets. Women are also allowed to choose a caesarean in advance, even if there are no medical reasons, according to NHS guidelines.
Babies will be born when they’re ready
After 40 weeks – the average length of pregnancy – women may resort to a range of home remedies to try to kickstart labour, such as herbal teas, hot baths or even having sex. NHS guidelines say none of those approaches are supported by evidence.
Rates of inductions are also on the rise, now accounting for 33 per cent of all births, in the latest figures. Critics say that staff have become too keen to induce, and that the birth is more likely to go well if the labour begins naturally.
The danger of letting a pregnancy go overdue is that the rate of stillbirth increases the longer a pregnancy progresses, accelerating upwards even more steeply after 40 weeks. This is probably because the placenta deteriorates as pregnancy continues.
An NCT spokesperson said: “Our NCT antenatal course content is refreshed frequently, most recently in 2023, to ensure all types of birth are explored with a focus on parents making informed decisions about their care.”
They can have side effects like nausea and skin itching and they also have a practical drawback, in that the patient usually then has to stay lying down.
But research has shown that with current forms of epidurals, there is only a small effect on duration of labour, prolonging it by about 45 minutes (when labour can typically take most of a day, or even several days). The same studies have shown they also don’t cause Caesareans.
Hypnobirthing can help you avoid an epidural
The evidence is mixed about how effective hypnobirthing is. Many of the studies have included only small numbers of women or have not been in the form of randomised trials, the best kind of medical evidence.
There are also possible downsides, said Catherine Roy, of the Maternity Safety Alliance, a group that campaigns for childbirth care to be safer.
Recent guidelines from the National Institute for Health and Care Excellence say hypnobirthing should not be offered, although women who want to do it should be supported.
The baby being too big is more common in shorter women, who tend to have a narrower pelvis, and in women with obesity, diabetes, or who are older – all of which can make the baby grow larger.
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I’ll be taking a two-week break from Everyday Science over Christmas, but I’ll be back in your inboxes on 2 January.
This is Everyday Science with Clare Wilson, a subscriber-only newsletter from The i Paper. If you’d like to get this direct to your inbox, every single week, you can sign up here.
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