NEW DELHI: A global study, which also picked two districts in India, has revealed a high percentage of “unnecessary”, Caesarean Sections (C-Sections) even in rural and low-resource settings. According to the study, which audited C-sections between 2010 and 13 in Nagpur and Belgaum as part of an assessment in six low- income countries, about 30 per cent surgeries were carried out for reasons that were not life threatening.
Interestingly, two weeks ago, BJP MP, Maheish Girri, had highlighted in Parliament the alarming growth in number of C-Section deliveries, which rekindled the demand for putting stricter measures in place to check the unhealthy trend.
The National Family Health Survey 4 (2015-16) data released last year showed that about 30-35 per cent babies in urban India are born through surgeries and in some southern states like Telangana, this figure is a whopping 41 per cent. At the all-India level, the rate of C-sections has doubled in ten years, while in the last 20 years, it has risen six times.
“In our analysis we found that while in some cases, the surgeries were not done despite being required, in others they were done in spite of no clear indication,” said Sivaprasad Goudar, co-author of the study published in Lancet.
According to WHO norms, a rate of 10-15 per cent is considered appropriate for C-sections as per medical indications. Indian figures indicate that C-sections are being conducted for non-medical reasons for commerce or for convenience of doctors. “It is sad that the new normal is surgery and its happening because of complete lack of accountability on part of doctors and the government,” said Puneet Bedi, a gynaecologist and obstetrician at Apollo Hospital, Delhi.
“The fact that C-section rates are higher in private hospitals as compared to public ones is clearly linked to profits and the unregulated nature of private hospitals,” Bedi added.
However, Neelam Singh, a Lucknow-based gynaecologist, says the reason for growing C-Sections is also risk aversion by doctors. “Any medical procedure has some risks and when there is unwillingness to share that risk from the patients’ side, doctors go for what they consider a safer option,” she said.
Jaydeep Tank of Federation of Obstetric and Gynaecologists Societies of India, said many times, patients ask for elective surgeries.
This, Bedi says, is a lame excuse. “Patients decide based on suggestions by doctors. Do doctors tell them that C-Sections increase risk of excessive bleeding, infection leading to death, urinary tract infections, disturbed sex life?” he asks.
What is the way out then? Anant Bhan, a researcher in global health, bioethics and health policy suggests that accreditation of hospitals can possibly be based on rates of C-Sections. Bedi, however, recommends a mandatory yearly audit of all child births by state health departments.