Across the country, we can see how strained services are shaping the care women receive. Staff shortages mean fewer opportunities to build trusting relationships with families. Limited resources mean less time for individualised care. In such conditions, more labours tip into emergency territory. Our bodies have not changed since the 1960s and early 1970s when the rate was under 10 percent (Caan, 2002). The rise in emergency caesareans is no longer just a statistic. It’s an alarm bell that maternity care is overstretched and not fit for purpose.
Yet the story has a new element now. Data from the Nuffield Trust (Ogunlana & Taylor, 2025) shows that Black and Asian women continue to face significantly higher rates of emergency caesarean than White women. Crucially, these differences remain even when deprivation is taken into account. In fact, the least deprived Black women are still more likely to experience an emergency caesarean than the most deprived women in other groups.
This tells us that poverty alone cannot explain the disparities. The rise in emergency caesareans is a system-wide problem. When the system falters, inequities deepen. And women from minority ethnic groups are suffering.
Why is this happening? Research and lived experience suggest several factors at play. Underlying health conditions may contribute, but they cannot explain the whole picture. Delays in recognising complications, concerns being dismissed, communication barriers, and bias within care systems all increase the likelihood of emergencies. Meanwhile, the dismantling of continuity of carer models, a proven approach to reducing interventions and improving outcomes, has removed a vital safeguard for women most at risk of inequitable care (Kapadia et al, 2022).
- A maternity system under immense pressure.
- Structural inequities that amplify risks for some groups more than others.
Both demand urgent action. We must restore safe staffing levels and continuity of carer models so that women receive relational, personalised support. We must ensure that women’s voices are heard and acted upon without delay. And we must face the uncomfortable truth that inequities in maternity care are not accidental. They are systemic. Tackling bias and building equity into every layer of maternity services is essential if we are to create a system that truly serves all women and families.
Here’s how you can help:
Write to your MP – demand urgent investment in maternity services, the restoration of safe staffing levels, and support for continuity of carer models. Personal letters make an impact.
Champion continuity of carer – share the evidence that continuity saves lives, reduces interventions, and improves outcomes for women from minority groups. Celebrate services that are doing it well and challenge cuts where you see them.
Support midwives and maternity staff – speak out against unsafe workloads, share our campaigns, and back the call for fair working conditions.
Amplify women’s voices – listen to and share stories from mothers and families about their experiences of postnatal care and emergency interventions. These voices are powerful tools for change.
Join ARM – connect with a community of midwives, students, and birth enthusiasts committed to woman-centred care. Together, we can push for a system rooted in equality, dignity, and trust.
Because Midwifery Matters
References:
- Caan, W. (2002). Caesarean section rate in England and Wales. BMJ, 325(7365), 1085–1086. https://doi.org/10.1136/bmj.325.7365.1085
- Kapadia, D., Zhang, J., Salway, S., Nazroo, J., Booth, A., Villarroel-Williams, N., Bécares, L., & Esmail, A. (2022). Ethnic Inequalities in Healthcare: A Rapid Evidence Review. NHS Race and Health Observatory. Retrieved from https://www.nhsrho.org/wp-content/uploads/2023/05/RHO-Rapid-Review-Final-Report_.pdf
- NMPA Project Team. (2025). National Maternity and Perinatal Audit: State of the Nation. Based on births in NHS maternity services in England, Scotland and Wales during 2023. Royal College of Obstetricians and Gynaecologists. Retrieved from https://maternityaudit.org.uk/FilesUploaded/Ref%20545%20SON%202023%20data_VF.pdf
- Ogunlana, A., & Taylor, B. (2025). Are emergency C-sections more likely among certain ethnic groups? Nuffield Trust. Retrieved from https://www.nuffieldtrust.org.uk/resource/are-emergency-c-sections-more-likely-among-certain-ethnic-groups
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