more births, more intervention: what the uk maternity system looks like- and your choices
- Pooja Mistry
- Oct 6
- 4 min read
Birth is meant to be natural. But in the UK today, more than half of births involve some form of medical intervention. That can feel jarring, especially when expectations are for serenity and empowerment. In this post, I want to lay out the statistics clearly, explore what “interventions” mean in practice, how the first decision — when you leave home for hospital or birthplace — can affect the course of labour, and how you can be more in control in spite of a maternity system under pressure.
the numbers: what we know
Recent audits and NHS data paint a clear picture of rising intervention rates.
In 2023, out of the 592,594 births in England, Scotland, and Wales, 50.6% involved either a caesarean section or assisted delivery (forceps or ventouse). The Guardian
Caesarean births, especially, have increased sharply: from about 25% in 2015-16 to 38.9% in 2023. RCOG
In England alone, in 2023-24, 42% of all deliveries were by caesarean. BBC+1
Of those, roughly 23.7% were emergency caesareans, and ~18.7% were elective (planned) caesareans. BBC
How labour begins is also shifting:
These rising numbers reflect several factors: older maternal age, higher rates of obesity, more pregnancies with pre-existing medical conditions, changes in clinical practice, capacity pressures, and risk-averse policies. But statistics alone don’t capture how interventions feel, or how they change the birth journey.
the first intervention: deciding when to leave home
One of the earliest “interventions” often isn’t medical in the surgical sense, but a decision: when you leave home and go to hospital (or the birth centre/other birthplace). Leaving too early, when labour is still in early phase, can increase the chance of further interventions. Staying at home longer (if safe and supported) can sometimes help labour progress more naturally before entering the hospital environment, reducing the cascade of medical interventions.
What do the studies say?
An observational UK study found that women admitted to hospital in early labour (rather than active labour) may be exposed to higher likelihoods of avoidable interventions. BioMed Central
Another large meta-analysis showed that women who plan to birth at home (low risk, supported settings) are significantly less likely to experience obstetric interventions — including caesareans, epidurals, and instrumental births — compared with low-risk women planning hospital births. The Lancet
So the timing of hospital arrival can matter a lot: early admissions often lead to more monitoring, more checks, more decisions to intervene (e.g. augment labour, break waters, offer pain relief, etc.), especially in busy units. Sometimes policies or staffing pressures influence these decisions too.
why the rise in caesareans?
Caesarean sections are of course life-saving and absolutely the right choice in many situations. But the extent of their rise merits examination.
In England, Wales, and Scotland, caesarean birth rose from ~25% in 2015-16 to almost 39% in 2023. RCOG
Reasons given in reports include:
More pregnancies are medically complex (older maternal age, obesity, pre-existing conditions) which increase risk factors. The Independent
Changes in onset of labour (more inductions, more planned caesareans before labour). NHS
Variation between trusts in practice and thresholds for intervention.
what all this means for you and how to remain in control
It’s easy to feel overwhelmed when you see the statistics. But knowing your options, being informed, and having support can make a big difference. Here are some ways you can remain more in control of your birth, regardless of how it unfolds.
Know the onset of labour options. Discuss with your midwife what early labour looks like for you, signs to wait at home, when hospital admission is advised, etc.
Have a birth plan that includes decisions about intervention (pain relief, augmentation, when to move to hospital/birth unit), and rehearse asking questions. For example: “If labour isn’t progressing, what are our options before augmentation or surgery?”
Choose your birthplace with care if you are low risk (home birth, midwifery unit). These settings tend to have lower intervention rates. But they require that you feel safe, that services are well supported, and that you have backup plans.
Consider continuity of care & support. A doula, or Hypnobirthing, can give you the emotional, physical, and informational support that helps you feel more empowered, less rushed, more able to labour on your terms.
Stay flexible. Sometimes interventions are necessary for safety. Being realistic doesn’t mean expecting a perfect birth, but having options and knowing when to accept help.
I am not anti-intervention. Interventions save lives; they relieve suffering; they are essential in many births. But I am realistic about the maternity system: about rising medicalisation, staffing pressures, policies that may push for earlier admission or induction, fear of litigation, etc.
You may not know how your birth will unfold. But this is precisely why it matters to know how it can unfold, what interventions are possible, what their risks and benefits are — so you have agency to ask the right questions and make informed choices.
Over 50% of UK births in 2023 involved a medical intervention. Caesarean births have risen substantially in recent years.
Labour onset patterns are shifting: fewer spontaneous starts, more inductions and planned caesareans.
The decision of when you leave home (or enter hospital) is one of the first “interventions”, often unrecognised, that can influence the path of your labour.
Having balanced information, support, and plans helps you stay more in control.
If you attend my Hypnobirthing course or use my doula services, I can’t promise a birth
without all interventions — because sometimes they are indeed needed — but I can promise that you will be given balanced, up-to-date information about how the system works, what your options are, what questions to ask, so that you feel more confident, more empowered, and better prepared.
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