Why are C-section deliveries increasing in India?

More than a quarter of India’s births now happen through Caesarean-section (C-section) deliveries, driven primarily by high rates of surgical intervention in private hospitals.

A part of this increase may reflect better access to emergency obstetric care, experts say. As more women deliver in health facilities, doctors are better able to identify complications that require surgical intervention. But coercion and commercialisation are to blame for unnecessary C-section deliveries, they say.

Nationally, the share of births by C-section increased from 21.5% in 2019-21 to 27.2% in 2023-24, according to the sixth National Family Health Survey, the NFHS-6. In public hospitals, which see about three in five births, the rate is 17%. This is close to the globally accepted optimal level, said Kranti Vora, adding that it reflects their improved capacity to provide emergency obstetric care. Vora is a visiting faculty at the Society for Education, Action and Research in Community Health, which provides healthcare in Gadchiroli district.

But in private hospitals, 54% deliveries were by C-section. The World Health Organization (WHO), in a 2015 research note, said C-section rates above 10% do not reduce maternal or newborn mortality at the population level.

Conditions such as failure to progress in labour, foetal distress, placenta previa and breech or transverse presentation may necessitate a C-section delivery,...

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