A major new report out this week from the National Maternity and Perinatal Audit (NMPA) confirms what many of you are seeing on shift every day – birth in Great Britain is changing, fast.
The RCM is one of the partner organisations behind the audit, alongside RCOG, RCPCH and the London School of Hygiene and Tropical Medicine.
Based on almost 600,000 births in 2024, it’s a large-scale audit of NHS maternity services across England, Scotland and Wales. Here’s what you need to know.
1. Caesarean birth rates have climbed steadily over the past decade
Caesarean birth rates have climbed steadily over the past decade – 25% in 2015/16 to 42.8% in 2024, up from 39.5% in 2023.
Vaginal births without instruments fell from 62.3% to 46.4% over the same period. Where a woman has had a caesarean before, a repeat caesarean now follows in over 83% of cases, up from 81.8% in 2023.
2. Black women and women in deprived areas face significant barriers to timely care
Black women were 2.1 times more likely than white women to have their first booking appointment after 10 weeks of pregnancy – a critical window for early scans and screening.
Women in the most deprived areas were also significantly more likely to book late than those in the least deprived areas.
The report highlights language and communication barriers, socioeconomic deprivation and fear of judgement from healthcare staff as contributing factors.
Gill Walton, RCM Chief Executive, says: “We’re concerned to see Black women are more than twice as likely as white women to be booked for maternity care after 10 weeks and that women in more deprived areas face similar barriers – this inequality in access must be addressed.”
3. Services are under growing pressure to keep pace with change
Rising rates of caesarean birth and induction place increasing demands on the maternity workforce and on resources such as theatres and postnatal ward capacity.
This shows 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.
4. We still don’t know enough about why interventions happen
National maternity datasets don’t currently capture the reasons and decision-making behind inductions and caesarean births.
The NMPA is recommending this change, so that services can better understand what’s driving these shifts and target support where it’s needed most.
5. Blood loss data is incomplete – and this matters for safety
In 2024, 3.5% of women experienced a postpartum haemorrhage, a leading cause of maternal deaths.
Data on blood loss isn’t consistently captured across all three countries and the NMPA is calling for this to improve so it can report rates in full.
Underpinning all of this, is the need for the right staff.
Gill Walton, added: “Safe staffing must be the priority for investment, so that every woman gets the care she needs, when she needs it.”
The NMPA State of the Nation report is based on data from 593,475 women who gave birth in Great Britain in 2024. Read the full report here
