Objective To explore the maternal demographic factors associated with operative births (instrumental vaginal births or caesarean section), after adjustment for health, interpersonal, pregnancy, labour and infant covariates. Design Nationally representative cohort study. Setting Women giving birth in the UK, during the period 2000–2002. Sample A total of 18 239 mother–infant pairs. Methods Multinomial logistic regression models were estimated to explore the relationship between demographic characteristics and mode of birth, stratified by parity. Main outcome measures Self‐reported mode of birth, defined as unassisted vaginal birth, instrumental vaginal birth, emergency caesarean section and planned caesarean section. Results For primiparous women, operative births rose steeply with increasing maternal age. Women from lower occupational status households were at an increased risk of planned caesarean section. Mode of birth differed significantly by ethnicity. For multiparous women, a younger age at first birth was protective of a later caesarean section or instrumental vaginal birth at the cohort birth. Women with qualifications normally taken at the age 18 years were at an increased risk of planned caesarean section compared with women with degree‐level qualifications. Mode of birth differed significantly by ethnicity, and non‐UK born women were at an increased risk of emergency caesarean section. Conclusions The sociodemographic characteristics of UK women independently predict mode of birth. Further research is needed to establish to what extent sociodemographic differences in mode of birth are a reflection of the attitudes and behaviours of women, or health professionals, and are therefore amenable to change.

Objective UK abortion law allows terminations for fetal abnormality without gestational limit. This study aimed to understand the decision-making experiences of fetal medicine professionals working within this legal framework.Design Qualitative study using semistructured interviews.Setting Four English fetal medicine units.Sample Fifteen doctors and midwives working in fetal medicine units and the Director of a related voluntary sector group. Methods Thematic analysis of transcribed interviews.Main outcome measures Attitudes to abortion legislation; how decisions are made about the offer of late abortion and feticide.Results Fetal medicine specialists acknowledged the difficulties of ensuring that they worked within the law and within their own ethical frameworks when making decisions about offering terminations after viability. Practice regarding which abnormalities meet the legal criteria appeared to be governed largely by consensus between colleagues within their own and other units and in discussion with other specialists. Study participants reported individual differences about abnormalities where they personally would not wish to be involved in a termination, and also noted a shift in general attitudes over time as to conditions that meet the legal criteria. A proscribed list was believed to be both unworkable, given the variability in diagnoses and unhelpful, leading to reduced patient care.Conclusions Research is needed to monitor attitudes to, and interpretation of, UK abortion legislation, which permits termination after a late diagnosis of fetal abnormality without gestational limit. If attitudes are changing, it is important to understand why, and what the consequences will be for parents and for health professionals.