How private hospitals in India forcing moms into unnecessary C-sections surgeries

In India, nearly half of all deliveries in private hospitals are C-sections. This is three times the World Health Organization’s (WHO) recommended rate. It raises questions about whether millions of mothers are getting unnecessary surgeries. Many private hospitals in India often function like business entities where the entire focus is on making more money than taking care of patients who need good treatment. Usually, certain tests are performed again and again, ultrasound in case of pregnancy, to make more money. Sometimes pregnant women are mistreated by doctors who have no time for normal deliveries as it is a time-consuming process and often less costly compared to c-section surgeries in India.

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What is a C-Section?

A Caesarean section, or C-section, is a surgical delivery method. It’s used when vaginal delivery is risky for the mother or baby. But, unnecessary C-sections can harm health and cost a lot due to longer hospital stays and extra fees.

The Rising Trend of C-Sections in India

Research from the Indian Institute of Technology Madras (IIT Madras) shows a big jump in C-sections in India from 2016 to 2021. The national rate went from 17.2% to 21.5%. In private hospitals, it rose from 43.1% to 49.7% by 2021. This means almost half of private hospital deliveries are now C-sections.

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.

Why Are C-Sections Rising?

Medical reasons like fetal distress or pre-eclampsia justify some C-sections. But, WHO says C-sections should only be 10-15% of all deliveries. In India, private hospitals do more C-sections, possibly for profit, as they cost more and involve longer stays. High-risk behaviors like being under 18 or over 34, or having short intervals between births, can also justify C-sections. Yet, the sharp increase in private hospitals has raised concerns about unnecessary surgeries.

While C-sections may be needed in some cases, India’s rising trend, especially in private hospitals, suggests many are not needed. This is not just an ethical issue but also a financial burden on families and the healthcare system. WHO’s guidelines stress that C-sections should only be used when absolutely necessary to protect mother and child.

Government’s Intervention is Needed

It is high time that the government authorities wake up from their slumber and start checking the birth registers of these private hospitals where the c-section rates are very high. This is very easy and government authorities can access this data and find out what is happening in these hospitals. When a woman goes to a hospital, she is subjected to screaming and unnecessary pressure to immediately undergo the c-section as there will be a risk to her and the baby otherwise. This fear is created to ensure that the woman accepts the surgery procedure.

Here are some steps the government can take:

Track Data: Establish a national database to track C-section rates in both public and private hospitals. Use this data to identify trends and intervene where necessary.

Provide resources that help women ask the right questions about whether a C-section is truly necessary in their case, and empower them to seek second opinions when needed.

Launch nationwide campaigns to educate expectant mothers and families about the risks and benefits of C-sections versus vaginal births. Encourage informed decision-making and birth planning.

Cap on Fees: Introduce a cap on how much private hospitals can charge for C-section deliveries to reduce profit-driven motivations for performing the surgery unnecessarily.

Penalties for Unjustified Surgeries: Impose penalties or fines on hospitals that exceed a certain threshold of medically unjustified C-sections, as determined by audit findings.

Mandatory Reporting: The government can mandate that all hospitals, particularly private ones, report the number of C-sections performed along with justifications for each surgery.

Regular Audits: Conduct regular audits of hospital records to assess whether C-sections were performed based on valid medical reasons.

Third-Party Review Boards: Establish independent review boards to examine high surgery rates in specific hospitals and identify cases of unnecessary procedures. 

Singapore based news channel did a wonderful documentary on this subject which you can watch here:

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