Cesarean delivery rise from 17.2 % to 21.5% in five years in India

There has been a sharp increase in the number of caesarean section deliveries between 2016 and 2021 in the country, as per a new study published in the BMC Pregnancy and Childbirth.

The study has revealed that the prevalence of C-sections across India increased from 17.2 per cent to 21.5 per cent in the five years leading up to 2021. In the private sector, these numbers stand at 43.1 per cent (2016) and 49.7 per cent (2021), meaning that nearly one in two deliveries in the private sector is a C-section. The odds of a caesarean delivery among overweight women and those aged 35-49 were twice those for underweight women and those aged 15-24, respectively. The proportion of overweight women giving birth increased from 3 per cent to 18.7 per cent, while that of women aged 35-49 decreased slightly from 11.1 per cent to 10.9 per cent, the study has revealed.

The study was undertaken by researchers from the Department of Humanities and Social Sciences at IIT Madras. The team included Ms. Varshini Neethi Mohan and Dr. P Shirisha, Research Scholars, Dr. Girija Vaidyanathan and Prof. V R Muraleedharan. In an analysis of Tamil Nadu and Chhattisgarh, the researchers found that despite the fact that both pregnancy complications and high-risk fertility behaviour were more prevalent in Chhattisgarh, Tamil Nadu had the higher prevalence of C-sections.

Elaborating on the findings, Prof. V R Muraleedharan, said, “A key finding was that the place of delivery (whether the delivery was in a public or a private facility) had the greatest impact on whether delivery was by C-section, implying that ‘clinical need’ factors were not necessarily the reason for surgical deliveries. Across India and Chhattisgarh, the non-poor were more likely to opt for C-sections, while in Tamil Nadu, the case was surprisingly different, as the poor were more likely to have C-sections in private hospitals.”

According to the study, the proportion of those with pregnancy complications decreased from 42.2 per cent to 39.5 per cent, implying that the increased rate of C-section delivery was largely influenced by non-clinical factors. Women’s own preferences, their socio-economic level and education, and risk-averse physicians practising conservative medicine could be some of these non-clinical factors.

Overall, in India, women delivering at private healthcare facilities were four times more likely to have a C-section over the period of study between 2016-2021. In Chhattisgarh, women had a ten-times higher chance of delivering by C-section in a private hospital while in Tamil Nadu, they had a three-times higher chance.

The researchers collated and analysed data from the National Family Health Survey (NFHS) conducted in 2015–2016 and 2019-21 to arrive at the conclusion.