January 17, 2021

The ‘dangerous’ trend of very high C-section births, the survey says

Written by Udit Misra, Nushaiba Iqbal, Anuradha Mascarenhas | Pune |

Updated: December 15, 2020 2:00:31 AM


According to the NFHS-2019-20, C-sections have increased in the majority of 22 states. (Representative)

According to the latest estimates of the National Family Health Survey 2019-20, there has been an increase in the number of cesarean (C-section) deliveries in most states. Telangana, West Bengal, Himachal Pradesh and some states in the Northeast have seen an improvement in C-category deliveries over the past five years, especially in private health facilities.

The International Health Organization estimates that the optimal rate for a caesarean section is between 10 percent and 15 percent. When clinically justified, maternal and perinatal death and morbidity can be effectively prevented by cesarean. However, an analysis shows that in most states it accounts for more than 50 per cent of private health care facilities, Dr KS James, director of the International Population Science Institute (IIBS) in Mumbai, told The Indian Express.

C-sections have increased in the majority of the 22 states according to NFHS-2019-20. There has been an increase in the number of corporate distributions, and the increase in C-segments is likely to fall, ”said Dr James.

Usha Ram, a professor in the Department of Public Health and Mortality Studies at IIBS, said the drive to make money, especially in the private healthcare sector, could be one reason for the sharp rise in C-segment distributions in India.

According to Professor Ram, there is another important aspect to understand: C-section technology is readily available and affordable for most people, making it convenient for women to avoid experiencing severe long labor pain. “It should be noted that the family size in India has dropped significantly and couples can spend for C-sections for one or two deliveries without fear of any medical complications in subsequent deliveries,” Professor Ram said.

The Federal Ministry of Health and Family Welfare has recently released the first package of the fifth and most recent round NFHS conducted in 2019-20. The first findings have been published for only 22 states and Union Territories, including the larger states of Maharashtra, Bihar and West Bengal. Data from Uttar Pradesh not included.

In Maharashtra, 94.7 per cent of distributions were institutionalized, up from 90.3 per cent in 2015-16, according to NFHS 2019-20 data. C-category births increased from 20 per cent in 2015-16 to 25.4 per cent in 2019-20.

Of the private health facilities in Maharashtra, at least 39 per cent of deliveries were through the C-category, up from 33 per cent in 2015-16, according to NFHS data 2019-20.

Of the private health facilities, Telangana was born between 2019.5 per cent and 81.5 per cent through C categories in 2019-20. West Bengal has also noted a similar trend, where the percentage of births through C-category in private healthcare facilities has increased from 70.9 per cent in 2019-2020 to 82.7 per cent.

In Himachal Pradesh, at least 88 per cent of distributions were institutionalized, up from 76.4 per cent in 2015-16. Private health care facilities increased from 44.4 per cent of C-category births in 2015-16 to 51.4 per cent through C-category in 2019-20.

This trend is also seen in Jammu and Kashmir, where institutionalized deliveries have increased from 85.4 per cent in 2015-16 to 92.4 per cent in 2019-20. At least 41.7 per cent of deliveries through the C-category were in private health facilities in 2019-20, up from 33.4 per cent in 2015-16.

In Karnataka, 31.5 per cent births were through C-sections in 2019-20 and 23.6 per cent in 2015-16. Among private health facilities, 5-205 per cent of births were through C categories in 2019-20 and 40.3 per cent in 2015-16.

Kerala recorded 99.8 per cent institutionalization, with a slight increase in the number of deliveries through C categories. In 2019-20, at least 38.9 per cent of births were through C-sections, as against 35.8 per cent in 2015-16. The number of births through C-sections in the Union Territory of Ladakh has increased from 16.1 per cent in 2015-16 to 37.6 per cent in 2019-20.

In Meghalaya, births via C-category in private health facilities increased from 31.4 per cent to 40.8 per cent in 2019-20.

In Manipur too, the number of deliveries through C-segments increased from 46.2 per cent to 53.2 per cent in 2019-20. Sikkim showed a similar trend with births through C-sections, increasing from 49.3 per cent to 55.4 per cent in private health facilities.

Significant exceptions to this trend were the decline in the number of births through C-sections in Lakshadweep and Nagaland private health facilities, which fell from 38.4 per cent in 2015-16 to 31.3 per cent in 2019-20, from 31.5 per cent in 2013-20 to 23.6 per cent in 2019-20.

According to Dr. Bharathi Dorepat, former vice-president of the Indian Association of Obstetricians and Gynecologists, social pressure can sometimes be overwhelming. “There are late marriages, women are in their late 20s or early 30s. There is pressure from families to get a C-section because of pelvic girdle and safe techniques during pregnancy,” Dr. Torepat said.

Meanwhile, doctors say the C-section ratio has increased due to the Govit-19 infection.

At the Jahangir Hospital in Pune, Dr. Nina Mansukhani, a gynecologist who has assisted normal delivery for many Govt positive women, said that due to the infection, a large number of patients have asked for C-sections.

“The epidemic has increased the C-section rate due to unnatural fears. With C-section, there is an idea that you can get out of the hospital quickly and easily, ”said Dr. Manzukani.

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