A recent study conducted by researchers at the Indian Institute of Technology Madras (IIT Madras) has found a significant increase in the number of caesarean section (C-section) deliveries across India between 2016 and 2021.
Despite a decrease in pregnancy complications, there has been a significant rise in the number of C-section cases. They increased from 17.2 per cent to 21.5 per cent during the five-year period, according to findings published in the BMC Pregnancy and Childbirth Journal.
The study, which involved researchers from the Department of Humanities and Social Sciences at IIT Madras, analysed data from the National Family Health Survey conducted during 2015–2016 and 2019-21.
The rise was despite a decrease in the proportion of women experiencing pregnancy complications, suggesting that non-medical factors may be driving the rise in C-section deliveries.
Caesarean sections, while sometimes medically necessary, can pose risks to both mothers and babies when performed unnecessarily. The study also revealed that nearly half of all deliveries in private hospitals were C-sections.
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The study reflected a stark difference in C-section rates between public and private healthcare facilities. Women delivering in private hospitals were four times more likely to undergo a C-section compared to those in public hospitals.
This trend was even more pronounced in states like Chhattisgarh, where the odds of a C-section delivery in private hospitals were 10 times higher. Those in Tamil Nadu had a three times higher chance for this.
The researchers also identified demographic factors influencing C-section delivery. Women who were overweight and older (aged 35-49) were found to be twice as likely to have C-sections.
Moreover, better-educated women residing in urban areas were also more prone to C-section deliveries, suggesting that factors beyond medical necessity play a significant role in this trend.
Additionally, a lack of adequate infrastructure and staff in public hospitals may be influencing women to opt for private care, which often involves a higher rate of C-sections.
Prof. V R Muraleedharan, Department of Humanities and Social Sciences, IIT Madras, said, “The place of delivery, whether public or private, had the greatest impact on whether a C-section was performed. This indicates that 'clinical need' factors were not necessarily the primary driver for surgical deliveries.”
The World Health Organization (WHO) recommends a C-section rate of between 10 to 15 per cent. The IIT Madras study findings suggest that India is exceeding these recommended levels, and the reasons behind this trend warrant further investigation.
The researchers recommend that policymakers implement guidelines for C-sections while considering regional variations and the medical necessity of the procedure.
They also highlight the need to address the concerning number of C-sections performed on low-income women in private hospitals in Tamil Nadu.