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Private hospitals may soon be forced to display on their premises the number of cesarean deliveries conducted by them in order to be empanelled under the Central Government Health Scheme (CGHS).
A senior CGHS official told PTI that under a new process to be completed in a month, hospitals seeking to be empanelled by CGHS, which is under the ministry of health and family welfare, may have to publicly display the number of such deliveries.
A new agreement between the government and hospitals will also have a provision for punitive measures -- including being dropped from the empanelled list -- if the hospitals do not fall into line.
"Under the existing memorandum, we have asked all hospitals to voluntarily put out this information. However, when we launch the new empanelment process, it will be made mandatory," the senior CGHS official said.
He said that with this move, the government wanted to raise awareness about cesarean deliveries and help would-be parents decide on their choice of hospital for a delivery.
A c-section, or cesarean section, is the delivery of a baby through a surgical incision in the mother's abdomen and uterus.
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"It's a great step by the government and will help expose the unscrupulous use of this technique during child birth. Often, in hospitals, the relatives are told about fetal distress or maternal health risk to force them into giving consent for a c-section.
"It is true that such surgeries are way higher than expected and its a great step forward," said Dr Y K Sandhya of Sahayog, a non-profit based in Uttar Pradesh that works on women's health and rights as well as sexual health.
The World Health Organization (WHO) prescribes that such deliveries should be ideally 10-15 per cent of the total number of deliveries in a country.
However, 74.8 per cent of private sector deliveries are by c-section in urban Telangana, 58 per cent in Tamil Nadu, and 41 per cent in Kerala, according to a report by the Chennai-based ICMR School of Public Health.
In the US, such surgeries are 20 per cent of the total births while it is 16 per cent of births in Finland and 24 per cent in the United Kingdom.
The move to include such a clause comes two months after Women and Child Development (WCD) Minister Maneka Gandhi raised the issue in a letter to the Health and Family Welfare Ministry.
In April, she sent another mail to the ministry, asking them to make it a mandatory provision for hospitals under CHGS.
The agreement for CGHS empanelment has to be renewed every two years by hospitals. Currently, there are 1,000 private hospitals and diagnostic centres which are empanelled under the CGHS across the country.
"The number of such surgeries has gone through the roof and in many states it is as high as 70 per cent. Why undergo such surgery unnecessarily when there a perfectly natural way to deliver babies," Gandhi said.
In February this year, a petition was started on Change.Org, an Internet advocacy platform, which appealed to both the ministries for more transparency in data regarding c-sections.
"Even though serious complications were not detected, I was cut open to deliver my baby. I wanted to have a natural birth but had to undergo a c-section as it was presented to be more 'scientific, modern and risk-free'.
"I was misled, manipulated, confused and my choice was overridden," the petitioner wrote, drawing Gandhi's attention.
Studies show that c-sections have a higher risk of post- partum depression and lower breastfeeding rate in women and can lead to obesity and diabetes in children.
