NEW DELHI: During her regular pregnancy check-ups at a top private hospital in Delhi, Nisha Saxena (name changed) had categorically told her gynaecologists about her preference: normal delivery. Even hours before the childbirth, the doctors had assured the 29-year-old professional, considering her ‘normal’ clinical parameters.
But due to ‘some last-minute complications’, the doctors converted her normal delivery into caesarean section and she was suddenly wheeled into the operation theatre. They took Nisha’s thumb impression on the consent letter inside the OT. After she got discharged, Nisha consulted another doctor who told her that the C-section was unwarranted.
Nisha is not alone. Almost 1,80,000 women, who have faced similar experience and want the government to curb commercialisation of C-section delivery, have signed a petition on change.org. And an RTI reply has exposed the labour room intrigues, highlighting that caesarean deliveries are new ‘normal’ in Delhi’s private hospitals.
While the World Health Organization (WHO) prescribes the ideal rate of C-section as 10-15 per cent, the national capital’s private hospitals conduct 65 per cent C-section deliveries. From April 2016 to January 2017, as many as 9,208 deliveries at these hospitals were C-section, of the total 14,612 cases.
The number of C-section has been increasing since 2011 in the city’s private hospitals, according to the reply to a RTI query. However, public hospitals, which conduct almost 10 times more deliveries than their private counterparts, have resorted to C-section only in 20 per cent of the cases, according to the RTI query filed by east Delhi resident Zeshaan Haider. They conducted 1,01,103 deliveries from April 2016 to January 2017, of which 79,479 were normal. Only in 21,624 cases doctors conducted C-section deliveries.
In February, Union Women and Child Development Minister Maneka Gandhi had raised the concern of increasing caesarean deliveries in private hospitals and its commercialisation with Health Minister J P Nadda. “We would need some methods to solve this issue. We need to mandate the nursing homes and hospitals to publicly display the number of C-section deliveries vis-a-vis the normal deliveries,” Maneka wrote in her letter to Nadda. She also said that we should ‘name and shame’ such gynaecologists and hospitals who perform caesarean deliveries for money.
Like Nisha, thirty-year-old Anjali Mishra (name changed) also went through the same ordeal. Doctors allegedly under the ‘last-minute complication ploy’ performed C-section on her. “Everything was normal. Doctors, after performing all the required tests, told me that I will have a normal delivery and the baby is also healthy. Later they told us that they have to perform C-section. When asked about the reason, they said a bone which is very close to the baby can harm it,” Anjali said.
According to the RTI reply, the rate of C-section deliveries has increased by almost 50 per cent, but rate of normal deliveries are almost same in private hospitals since 2011.
“Caesarean rates are higher not only in Delhi but also in other metropolitan cities. If places like Delhi and Mumbai will have increasing C-section rate, how will things improve in small cities? The government has to treat this problem as soon as possible,” said Subarna Ghosh, an activist who has filed a petition signed by 1,80,000 people on change.org, demanding making it mandatory for hospitals to declare caesarean rate.
But, according to Indian Medical Association president KK Aggarwal, one should not focus on the number of caesarean deliveries done but the survival rates and need of such deliveries. “Some doctors treat only critical cases, so their caesarean rates will be higher. One should not generalise the intention of the doctors. If someone is doing caesarean deliveries to earn profits, he/she should be suspended and punished but caesarean doesn’t mean that doctors have done it deliberately. Private hospitals cater to more critical cases than government hospitals. If we are focusing on caesarean rates, we should also focus on death rate of mother and babies in government and private hospitals,” Aggarwal told The Sunday Standard.
Subarna, however, contradicted. She said doctors should at least acknowledge that there is some problem. “If you will ask the women who have delivered babies in your neighbourhood, you will find there is some problem. If doctors are not ready to acknowledge that there is some problem how can they treat it? No one is asking doctors not to perform caesarean in emergency cases but one should understand that every caesarean has a life threat. There are problems that is why almost 1,80,000 people have signed the petition,” Subarna said.