Alarming hike in surgical births: Health ministry

This growing trend of C-sections in India contradicts the WHO mandate, which says that no nation should have more than 10 per cent of such deliveries.
Image used for representational purpose only. (File Photo)
Image used for representational purpose only. (File Photo)

NEW DELHI: India is witnessing an alarming rise in Cesarean or C-section deliveries. Both public and private health facilities contribute to the spike in surgical births. 

While over 15 percent of deliveries in public hospitals were Cesarean in 2021-22, the number touched almost 38 percent in private facilities, according to health ministry data.

This growing trend of C-sections in India contradicts the World Health Organization (WHO) mandate, which says that no nation should have more than 10 percent of such deliveries. 

“It is ..observed that higher percentage of C section deliveries were found in private facilities ..a trend of a very higher percentage of C-section deliveries in private hospitals as compared to C- section deliveries in public facilities,” said the latest report of Health Management Information System (HMIS), which is an exclusive source of information for facility level health data nationwide. 

The highest percentage of C-section deliveries in private institutions reported in HMIS till March 2022 was reported in Andaman and Nicobar Islands, followed by Tripura for two consecutive years. 

In 2020-21, Andaman reported 95.45 percent of such deliveries in private facilities, the following year, it went up to 95.56 percent. Similarly, Tripura in 2020-21 recorded 93.72 percent of such deliveries. The figure touched 93.03 percent in 2021-22.

West Bengal and Odisha have reported a high percentage of C-section cases performed in private facilities. While West Bengal recorded 83.88 percent of cases in 2021-22, Odisha reported 74.62 percent in the same year.

Many states saw a five to 10 percent rise in C-sections in these two years in private facilities. 

One of them is Sikkim. While 54.85 percent of such deliveries were reported in 2020-21, it went up to a whopping 70.62 percent the following year. Madhya Pradesh also recorded 39.86 percent cases in 2020-21, which went up to 45.39 percent the following year.

Both Kerala and Karnataka saw a slight rise. In Kerala, in 2020-21, the figure was 42.2 percent; it went up slightly to 42.19 percent in 2021-22. Similarly, Karnataka reported 44.04 percent in 2020-21; the figure touched 44.11 percent the following year.

But Telangana and Andhra Pradesh reported a dip in C-section cases in private facilities. In Telangana, 65.34 percent of cases were reported in 2020-21, which decreased to 61.08 percent in 2021-22.

Andhra Pradesh reported 47.69 percent of cases in 2020-21, which went slightly down to 47.52 percent the following year.

All the northeastern states have reported over 50 percent of C-sections, with only Mizoram recording 38 percent of cases in 2021-22.

However, health officials said the true picture of how many C-sections have been conducted in private facilities has not come out as only 14,000 such mapped facilities data has been uploaded by the states in the HMIS.

The public health facilities – over 2 lakh – also showed a rising trend in Cesarean deliveries, according to the HMIS analytical report.

States like Lakshadweep (47.29%), Telangana (47.13%), Jammu and Kashmir (43.45%), Sikkim (43.3 %), Kerala (42.89%), Chandigarh (36.56%), Dadra and Nagar Haveli and Daman and Diu (36.02%) and Goa (35.33%) recorded the highest number of C-section in public health facilities. 

Like other states, Delhi too had a high rate of C-sections. The national capital recorded over 61.61 percent Cesarean deliveries in private facilities in 2021-22 from 59.47 percent the previous year. In public health facilities, the figure stood at nearly 28 percent in 2021-22.

Interestingly, the largest state in India – Uttar Pradesh – has recorded a significantly lower percentage of C-sections in both private and public facilities. While in 2021-22, 20.11 percent of such deliveries were reported from private facilities, it was just 4.7 percent in public facilities in the same period. 

The report said, “Unnecessary caesarean sections also pull resources away from other services in an overloaded health system.”

Speaking with TNIE, Dr S. Shantha Kumari, past president of the Federation of Obstetric and Gynecological Societies of India (FOGSI), which has over 250 societies and 39,000 members, said they are looking into “optimizing” Caesarian section rates.

“FOGSI encourages our members to audit their cases and we are also working with the government to address this issue,” Kumari, who is based in Telangana, said.

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The New Indian Express