Caesarean births (surgical births) have overtaken vaginal deliveries in England for the first time, with 45 per cent of births now by caesarean, NHS data show.

Last year, 44 per cent of births were through natural vaginal deliveries and 11 per cent were assisted with instruments such as forceps or ventouse, according to data published on Tuesday covering April 2024 to March 2025. Assisted deliveries use instruments to help the baby out during birth.

More than four in ten caesareans carried out by NHS England were elective, planned operations. For women under 30, natural vaginal birth remained the most common method, while for women aged 30 and over, caesareans were most common. For women aged 40 and over, 59 per cent of births were by caesarean.

In total, 20 per cent of births in 2024-25 were planned caesareans and 25.1 per cent were emergency, with both figures at record highs.

There were 542,235 deliveries in NHS England hospitals during this period, down from 636,643 in 2014-15. One in four births were to mothers aged over 35.

In 2014-15, caesarean deliveries made up 26.5 per cent of births. The increase over the past decade has been attributed to growing numbers of complex pregnancies, linked to factors including rising obesity rates and women waiting until they are older to have children.

Donna Ockenden, one of the UK’s most senior midwives who is leading the inquiry into maternity failures in Nottingham, told BBC Radio 4’s Today programme that the rise was a “complex” and “evolving picture over time”.

She said: “The thousands of women I’ve spoken to want a safe birth above everything else, so we should not vilify or criticise women who make those decisions.”

“In the reality of today’s maternity services – where women are living in poverty, deprivation, they’ve got pre-existing illnesses – obstetricians, midwives, nurses can only do so much, and we don’t always do enough in all cases to optimise women’s health prior to pregnancy.”

Soo Downe, a professor of midwifery at the University of Lancashire, added: “In some cases women are going for caesarean sections as a kind of least-worst option because they don’t really believe they’re going to have the kind of support they need to have a safe, straightforward, positive labour and birth in hospital.

“Or because their birth centres are being closed … or because they go into labour wanting a home birth and the midwife isn’t able to come to them because the midwife’s called somewhere else.

“But for some of them, it becomes the only choice on the table … and for other women, they choose a caesarean because they really want one, and that’s absolutely fine.”

A large real-world study has found that an AI-powered digital tool developed by Megi Health can significantly reduce blood pressure over time while maintaining high long-term patient engagement –  a combination that has remained a major challenge in hypertension care.

The peer-reviewed research, published in JMIR mHealth and uHealth, analysed real-world data from more than 5,000 adults using Megi’s digital blood pressure management platform as part of their everyday lives.

The results showed meaningful reductions in systolic blood pressure, with the greatest improvements seen in people who started with higher readings.

Crucially, the study found that outcomes improved the longer people stayed engaged with the platform.

Dr Petroula Laiou, chief scientific officer at Megi and senior author of the study, said: “High blood pressure can’t be managed through occasional GP visits alone.

“This study shows that ongoing, easy-to-use digital support can help people control their blood pressure in the real world –  particularly those at highest risk.

“It also demonstrates how combining digital tools with routine clinical care creates a more effective ‘phygital’ model for managing long-term conditions.”

Around half of users were still active after one year, while patient feedback showed high satisfaction, greater confidence in self-managing blood pressure, and reduced anxiety around monitoring.

Rather than relying on a tightly controlled clinical trial, the study examined how people actually use digital health tools in real life.

Users interacted with Megi through WhatsApp, receiving reminders to measure their blood pressure and take medication, and entering readings directly into the chat.

This approach enabled continuous tracking of blood pressure, engagement and outcomes over time.

The research was led by a multidisciplinary team from King’s College London, King’s College Hospital NHS Foundation Trust, Megi Health, the Magdalena Clinic for Cardiovascular Diseases in Zagreb, and the University of Zagreb.

The cohort included both women and men aged 17 to 95, with more than 90 per cent of participants regularly submitting blood pressure readings.

The findings add to growing evidence that home-based digital monitoring can overcome many of the limitations of clinic-based blood pressure checks, which are often affected by white-coat or masked hypertension.

By combining regular home readings with behavioural support, digital tools such as Megi could play an increasingly important role in long-term cardiovascular care.

Dr Nina Šesto, CEO of Megi Health, said: “What’s striking is not just the blood pressure reductions, but how long people stayed engaged.

“That level of sustained use is exactly what hypertension care has been missing.

“As health systems move towards prevention, home monitoring and long-term condition management, this approach aligns closely with the direction set out in the NHS 10-Year Health Plan.”

A team of UK researchers has published a new study examining how middle-aged, middle-class British women describe the effects of regular open water swimming on their wellbeing, including its impact on menopause symptoms and mental health.

The University of East London research uses in-depth interviews to understand women’s own accounts of swimming in outdoor water and how they feel it supports their lives.

The study looks at the patterns that emerged when women talked about what open water swimming meant to them.

Across the interviews, four themes appeared consistently.

Although menopause was never introduced by the researchers, several participants volunteered that cold water and the routine of swimming helped them feel calmer, more emotionally balanced and more in control during a major life transition.

Women felt it supported their mental wellbeing, with many describing a clear “reset” effect, a lift in mood, more energy and an increased sense of what their bodies could do, all expressed in their own terms.

They also spoke about health, strength and resilience.

Participants said the experience of swimming outdoors helped them feel more capable and better able to deal with difficult moments, including bereavement, illness and daily stress.

Finally, Interviewees emphasised the community around the lake and said that the confidence and clarity they gained often carried over into work, relationships and everyday decision-making.

This is the first qualitative study to examine open water swimming through “flourishing” a recognised psychological framework, and that participants’ accounts aligned closely with its components.

Mr James Beale is lead author and Programme Leader for the MSc Applied Sport and Exercise Sciences at the University of East London.

He said: “We are seeing a major shift in women taking up open water swimming, and many are now speaking openly about how it connects to menopause.

“Until now, this discussion has been largely anecdotal.

“Our study shows that women repeatedly link outdoor swimming with emotional steadiness, confidence and coping during this stage of life.

“That points to an emerging area of women’s health that deserves greater attention.”