Birthing Trouble: Caesarian-section numbers rising alarmingly

Data from the first phase of the National Family Health Survey (NFHS) 2019-20 shows that there has been an alarming jump in Caesarian-section (C-sec) deliveries, especially at private healthcare facilities, over the past five years. Against the global healthcare community holding that only about 10-15% of overall deliveries require C-Sec—it is advised only as a medical requirement to avoid maternal and perinatal mortality and morbidity, not as a choice—in most states, the private healthcare facilities report more-than-50% incidence.

With the family size falling—C-sec in the first couple of deliveries complicates later deliveries—and increasing ability to bear costs out of pocket, pregnant women or their families are opting for C-sec even though there may not be a medical complication that makes it necessary.

A paper in JAMA Network Open showed that India’s C-sec deliveries had become twice as frequent in the 10 years to 2016; also India’s growth of C-Sec deliveries was twice as fast as that of the rest of world. While the study was categorical that there was a marked positive correlation with household wealth—“a substantial deficit of cesarean deliveries among underprivileged groups and almost 2 million excess … among more advanced sections of the population”—with the Ayushman Bharat-PM-JAY offering C-sec coverage for beneficiaries, underprivileged groups are likely to see increased representation.

Research talks of a link between exposure to birth canal microflora and immune system development; the C-Sec rise could mean an increased health burden for the nation.