Question : C-section Surgery

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the Government is aware that World Health Organisation has recommended that C-section surgeries should normally constitute 10-15% of the total deliveries and if so, the details in this regard;

(b) whether the Government has expressed deep concern about the increasing trend of hospitals forcing expecting mother to undergo C-section surgery for delivery of their babies and if
so, the details thereof;

(c) whether the National Family Health Survey-4 (NFHS-4) reports indicate that the said percentage is much higher in the country, if so, the details of the report and the reasons therefor, State/UT-wise;




(d) whether the Government is aware of an online petition signed by more than 1.3 lakh people seeking accountability and Government intervention over the alarming rise in caesarean section surgeries in India, mainly in private hospitals, if so, the details thereof;

(e) whether the Government has conducted any study on the impact of mother on C-section surgery and if so, the details thereof; and

(f) whether the Government has also received suggestion to mandate public disclosure of information regarding C-section surgeries as compared to the normal deliveries in all hospitals and nursing homes and if so, the response of the Government thereto?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI FAGGAN SINGH KULASTE)

(a) & (b): World Health Organisation (WHO) in its statement released in April, 2015 has said that at population level, Caesarean section rates higher than 10% are not associated with reductions in maternal and newborn mortality rates.

Government of India (GoI) has already written to all States and UTs sharing the latest WHO statement. In addition, States have been informed to conduct periodic prescription audit in the private health facilities under the Clinical Establishment Act. They have also been informed that prescription audits can be extended to public health facilities.

A communication has also gone to Federation of Obstetrical & Gynecological Societies of India (FOGSI) which is the largest professional body of Obstetricians and Gynecologists in India for sharing the WHO guidance note to all their State chapters and the Obstetricians and Gynecologists registered with them.

(c): As per NFHS-IV, the incidence of C-section in India is 17.2%. State/UT wise details are placed at Annexure.

There are multiple reasons for higher rates of C-section. Nowadays the family size is small, hence, every pregnancy is precious. Some common and important indications for C-section includes foetal distress, prolonged labour, Oblique presentation of the foetus, a woman who is pregnant for the first time and previous C-section and C-section on demand by some patients. It is observed that due to good antenatal care, more high risk pregnancies are identified which also leads to high C-section.

(d): A petition has been signed by more than 1.3 lakh people on change.org website.

As per the petition, Caesarean deliveries have become a business and hospitals and doctors are making money from unsuspecting women and pushing them towards surgical deliveries. Petitioner also talks about the higher rate of C-sections in private hospitals than public hospitals.



(e): Government has not conducted any such study.


(f): Government has received the suggestion from the above mentioned petition.

The Government of India has enacted the Clinical Establishments (Registration and Regulation) Act, 2010 with the objective of registration and regulation of health care institutions including those in the private sector. 10 States and 6 UTs have adopted the Clinical Establishment Act.

Health being a state subject, it is the responsibility of the state to effectively implement the act.