India delivers poor results C-sections go up 7 times

India delivers poor results C-sections go up 7 times

At least 14 states, including Karnataka, recorded a number way beyond the benchmark fixed by WHO.

In the last 25 years, the number of caesarean deliveries in India went up by seven times with at least 14 states, including Karnataka, recording a number way beyond the benchmark fixed by the World Health Organisation (WHO), according to new research.

The global health body estimates that 10-15% of births medically require a C-section due to complications, suggesting that its average use should lie between these levels. India’s national average is 18%, but there is wide variation among the states.

Telangana tops the list with a whopping 58% C-section births out of all births between 2011 and 2016. Only 23% of them were emergencies requiring caesarean section.

Andhra Pradesh follows with 40% caesarean (15% emergency) delivery, Kerala with 36% (13% emergency) Tamil Nadu with 34% (13% emergency), Goa with 31% (15% emergency) and Karnataka with 24% C-section (only 10% emergency). The other states with high C-section numbers are Maharashtra, Gujarat, Punjab, Manipur and West Bengal.

Worldwide, the number of babies born through C-sections almost doubled between 2000 and 2015 — from 12% to 21% of all births. The analysis was published in a set of three papers in The Lancet on Thursday.

South Asia witnessed the most rapid increase in the use of C-section (6.1% per year) in the last 15 years.

The procedure was underused in 2000 but being overused by 2015 (increasing from 7.2% to 18.1%). The trend is reflected in India.

Way back in 1992-93, only 2.6% of all live births were done through caesarean. The number slowly increased to 7.1% by 1998-99, then to 9% in 2005-06 and jumped to 18% in 2015-16, says the Lancet study that uses data generated by India’s latest national family health survey. There are short and long-term risks associated with C-sections for mothers and children, and there are no benefits of C-section in cases without a medical indication.

“Given the increasing use of C-section, particularly cases that are not medically required, there is a crucial need to understand the health effects on women and children. C-section is a type of major surgery, which carries risks that require careful consideration. Its growing use for non-medical purposes could introduce avoidable complications,” says Jane Sandall, a professor at the King’s College London and one of the authors of the papers.

The unhealthy trend was visible for the first time last February when the country-wide NFHS data was released. The increase in number is mainly because of a rise in unnecessary C-sections in private clinics. Almost 41% deliveries in private clinics and hospitals are through C-section, according to NFHS data. Ten years ago, the number was 27.7% in the private sector. On the contrary, the number of C-section decreased in the public sector in the last 10 years.

While the life-saving surgery is still unavailable for many women and children in low-income countries and regions, the procedure is overused in many middle- and high-income settings.