Caesarean birth rates hit record highs in NZ

Latest figures show one in three babies are now delivered by caesarean section in New Zealand.

Health NZ statistics show 34 percent of babies were delivered via caesarean section in 2024, up from 32 percent in 2022 and 26 percent in 2014.  

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, with 20.3 percent— about one in five — ending in an emergency caesarean in 2024, nearly double the rate recorded a decade ago. 

Bradshaw said there is no single reason for 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,” Bradshaw explained. 

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 multifactorial, but that research is 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. 

“RANZCOG supports further research and better data collection to better understand local drivers,” she added. 

A Focus on Quality Maternity Care:

The World Health Organization previously suggested an ideal population caesarean section rate of 10 to 15 percent. However, WHO now says it does not recommend a specific national target rate and instead emphasises that caesareans should be available when medically necessary. 

Dr Jackson echoed that stance, adding that while caesarean sections remain a safe and often life-saving intervention, RANZCOG does not support arbitrary rate targets.

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