In its recent report, the National Family and health Survey(NFHS) has found that the number of Caesarean section deliveries in the majority of Indian states has increased. In the past five years, states which have shown a spike are- Telangana, West Bengal, Himachal Pradesh and some of the north-eastern states.
|| Shubh Mathur
C-section is practised to significantly reduce prenatal and maternal morbidity and mortality. The ideal rate for C-sections recommended by the international standards is between 10 per cent and 15 per cent. Owing to C-section deliveries, newborns can suffer from various complications including breathing problems, accidental hurt from surgical instruments, et al. For mothers, C-sections can lead to infections, adverse reactions due to anaesthesia and complications in subsequent pregnancies.
NFHS 2019-20 data shows that in Maharashtra, 94.7 per cent of deliveries were carried out through C-section, as against 90.3 per cent in 2015-16. C-section births have risen from 20 per cent in 2015-16 to 25.4 per cent in 2019-20.
“C-sections have increased in the country in a majority of the 22 states according to NFHS -2019-20. There has also been a rise in the number of institutional deliveries and a fall-out could be the increase in C-sections,” said Dr James, director of the International Institute of Population sciences.
Although monetary benefits can be the reason behind hospitals’ push for C-sections, Dr Usha Ram believes there is another important aspect that needs to be taken into account.
“It is also important to note that the family size in India has reduced substantially and the couple can afford to spend for C-sections for one or two deliveries, unlike previous times, without fear of any medical complications in the subsequent deliveries,” said Prof Ram.
Statistically, the jump in Telangana was recorded- from 74.5 per cent to 81.5 per cent in 2019-20 in private healthcare facilities. West Bengal, too, noted a familiar trend where the percentage of births via C-section at private healthcare facilities rose from 70.9 per cent to 82.7 per cent in 2019-2020.
In Meghalaya, births via C-section at private healthcare facilities climbed from 31.4 per cent to 40.8 per cent in 2019-20.
Notable exceptions to this trend are- Lakshadweep and Nagaland which have shown a decline in the number of births via C-sections at private healthcare facilities. In Lakshadweep, the number has slumped from 38.4 per cent to 31.3 per cent while Nagaland registered a decrease from 31.5 per cent to 23.6 per cent.
According to some doctors, Covid has also played its part in affecting the rate of C-sections in India. “The pandemic has resulted in an increased C-section rate due to unnatural fears. There is a perception of a quick in and quick out of hospital, with a C-section,” observed Dr Mansukhani, consultant gynaecologist in Pune.
The survey has also found that there has been an increase in child marriages in states like Tripura (40% from 33.1% in 2015-16), Manipur (16.3% from 13.7% in 2015-16) and Assam (31.8% from 30.8% in 2015-16) which is directly linked to the rise in teenage pregnancies.
The data analysis of NFHS shows that the nutritional status of the number of children below five years of age has declined significantly. Kerela, considered as a role model in public health has also registered an increase in the number of children with stunting- 23.4 per cent from 19.7 per cent in 2015-16.
Despite one of the world largest public health programme- Integrated Child Development Scheme, India has not been able to move up the ladder of nutritional status of the children and the latest survey confirms that there are a lot of gaps to be plugged and reforms needed in the public health sector.