The number of caesarean births in NZ has hit a record high

One in three babies are now delivered by caesarean section in New Zealand, according to latest Health NZ figures.

Statistics show 34 percent of babies were born via caesarean section in 2024, up from 32 percent in 2022 and 26 percent a decade ago.

While a record high, New Zealand College of Midwives Midwifery Advisor Te Paea Bradshaw told rova the increase is part of an ongoing trend, both here and overseas. 

"What we're seeing in Aotearoa isn't unique," Bradshaw said. "There is an international pattern of rising caesarean rates worldwide over the past few decades."

In Australia,  41 percent of births were by caesarean section in 2023, while recent NHS figures show caesareans accounted for almost half (45 percent) of deliveries in England. 

Changing Demographics Driving the Change:

New Zealand’s national increase has occurred across both emergency and elective caesareans.

Emergency caesareans accounted for 20.3 percent in 2024— about one in five deliveries — almost double the rate recorded a decade ago. 

Bradshaw said there is no single reason behind the ongoing rise, but rather a complex mix of clinical, demographic, and systemic factors.

“What we do know is that our maternal population is changing, the average maternal age is increasing, there are more complex health profiles, and we are also seeing more assisted reproduction, which is a good thing as access and technologies have improved,” she said.

“These health factors naturally increase the rate of medical interventions, including caesareans.”

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) also acknowledged the continued increase in caesarean rates across New Zealand and Australia, saying it appears to be driven by multiple factors, although research into the causes remains limited.

“It is uncertain if health system factors such as workforce shortages impact on caesarean rates, although we do know that when timely access to a caesarean in an emergency situation is less reliable, the decision to do a caesarean section needs to be made earlier,” said RANZCOG New Zealand Vice President Dr Emma Jackson. 

Health NZ Acting Chief Midwife Emma Farmer said research shows that where women give birth and model of care can influence caesarean rates.

"People who have a healthy pregnancy are more likely to have a normal birth if they give birth in a Primary Birthing Unit. For women with complex pregnancies, hospital births provide the multi-disciplinary care that is needed, and this includes caesarean section where clinically appropriate," said Farmer.

"While there is no correlation between a higher caesarean section rate and a lower perinatal mortality rate, there is a lower tolerance of risk," she said.

A Focus on Quality Maternity Care:

The World Health Organization previously suggested an ideal population caesarean section rate of 10 to 15 percent. However, it no longer recommends a specific national target, instead emphasising that caesareans should be available whenever they are medically necessary. 

The New Zealand College of Midwives says New Zealand has a world-class maternity system, with midwives working alongside obstetricians and GPs to support women in all birthing settings.

"Part of our system is that midwives collaborate with doctors as needed, and this collaborative approach is absolutely positive and crucial," Bradshaw said.

"I don't think the goal is to reduce the number of caesareans at all costs, but it is to ensure every caesarean is the right one, at the right time and for the right reason," she added.

Dr Jackson echoed that stance, saying RANZCOG does not support arbitrary caesarean section rate targets.

"The focus should remain on ensuring each woman and whānau receives the right care for their individual circumstances, rather than pursuing a specific population-level rate," said Dr Jackson.