Caesarean section delivery in India: causes and concerns

The rising trend of caesarean section (CS) delivery throughout the world has become a serious public health issue. In India the rate of CS has increased from 3% to 10% between 1992-93 and 2005-06 (IIPS, 2007). The present study seeks to explore the level and trend of caesarean section delivery in India. It also attempts to identify the causes of alarming growth rate of CS in some parts of India. The analysis is based on third District Level Household and Facility Survey and three rounds of National Family Health Survey conducted in India. Logistic regression model is used to understand the net impact of various explanatory variables on woman’s experience of CS. A number of doctors and patients from different public and private institutions were interviewed to identify the underlying causes of high growth rate of CS. Besides the profit maximization tendency of the private medical institutions, rise in institutional deliveries and patients’ choice for CS, poor doctor-population ratio, 24 hours unavailability of obstetricians in the medical institutions, poor infrastructural support for normal delivery, constant threat of case suits and physical harassment against doctors are cited as some of the important causes of increase in caesarean section delivery.