C-section rates double across Asia, with India showing steepest rise

C-section in India: The number of caesarean deliveries in India has more than doubled in the past two decades, climbing from 8.5 per cent of births in 2005 to 21.5 per cent in 2021, far higher than levels recommended by the World Health Organization (WHO).

The findings, published in The Lancet Regional Health – Southeast Asia, show that unnecessary caesarean deliveries not only extend hospital stays but also drive up costs and may expose children to long-term health risks such as asthma, type 1 diabetes, obesity and allergies.

A caesarean section, or C-section, involves making a surgical incision in the mother’s abdomen and uterus to deliver the baby. While it can be life-saving when medically necessary, the WHO has consistently noted that rates above 10 per cent at a population level are not associated with lower maternal or newborn mortality.

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The new analysis, led by researchers from the Institute of Public Health, Bengaluru, and the Christian Medical College, Vellore, reviewed 75 previous studies, most from India, with additional data from Bangladesh and Pakistan.

The researchers also found that families in India pay around ₹43,000 for a C-section in private hospitals compared with about ₹8,500 in public facilities. “Unjustified caesarean deliveries place significant strain on both families and health systems across South Asia,” the authors wrote.

The study identified a range of factors behind the rise, like weak regulation, limited insurance coverage, financial incentives for providers, scheduling convenience, and medico-legal concerns. On the patient’s side, maternal education, economic status, age, and family preferences played a role in driving demand.

The upward trajectory is not limited to India. Caesarean deliveries in Bangladesh jumped from 18 per cent in 2011 to 45 per cent in 2022, while Pakistan saw rates grow from about three per cent in 1990 to 20 per cent in 2018. Overall, the proportion of births by C-section in Asia rose from 4.4 per cent in 1990 to 19.5 per cent in 2014, reflecting a continent-wide surge.

(Source: The Lancet Regional Health – Southeast Asia)