A recent study published in The Lancet Regional Health-Southeast Asia highlights that more than 21% of deliveries in India are via caesarean section (C-section). The study reveals significant variations across the country, with private healthcare facilities showing much higher C-section rates compared to public ones. Conducted by researchers from The George Institute for Global Health in New Delhi, the study analyzed data from 7.2 lakh women across 28 states and eight union territories.
The study found that C-section rates in India vary greatly by region, with rates ranging from just 5.2% in Nagaland to a striking 60.7% in Telangana. On average, over 21% of all deliveries in India are C-sections, reflecting a broad trend in medical practices.
The study highlights a sharp divide in C-section delivery rates between private and public healthcare facilities. Across all income groups, C-sections were more commonly performed in private facilities compared to public ones. Interestingly, even within the private sector, there are disparities: wealthier individuals tend to have higher C-section rates, while lower-income groups have fewer C-sections. This shows that financial access plays a significant role in the decision for a C-section delivery.
C-section rates differ drastically across India’s states, with southern states like Tamil Nadu and Telangana reporting higher rates, and some northeastern states, such as Arunachal Pradesh, showing lower rates. In Arunachal Pradesh, for instance, the C-section rate was only 14.5%, with minimal inequality between wealth groups. In contrast, states like Telangana showed a much higher C-section rate but with lower disparities across income groups.
What Influences C-Section Rates in India?
The significant variations in C-section rates can be attributed to several factors, including:
- Access to Healthcare: States with better healthcare infrastructure and higher literacy rates tend to have higher C-section rates, as expectant mothers have more access to medical care and safer delivery options.
- Economic Disparities: The wealthiest groups in nearly 70% of Indian states have C-section rates at least twice as high as those in the poorest groups, particularly in private healthcare settings.
- Cultural and Social Factors: Cultural preferences also play a role in the rising number of C-sections. Some women may opt for C-sections due to fears of pain during vaginal delivery, or in hopes of having a baby on an “auspicious” day. There is also a growing preference for painless delivery methods and smaller families, which may influence decisions towards C-sections.
- Affordability and Recovery Time: In states like Bihar, where a significant portion of the population belongs to lower-income groups, vaginal deliveries are still more common due to their affordability and shorter recovery time compared to C-sections, even when medical professionals recommend a surgical delivery.
A Growing Trend with Disparities
The study underscores the growing trend of C-sections in India, particularly in private healthcare settings, and points to the widening gap between rich and poor in terms of access to medical interventions. While C-sections can be lifesaving, the study suggests that their overuse may stem from a combination of factors like healthcare access, cultural beliefs, and financial status. Addressing these disparities is essential to ensure that all women, regardless of their economic status, have access to safe and appropriate childbirth options.
