There has been an increase in the number of Caesarean section (C-section) deliveries in Mumbai as per estimates of the National Family Health Survey 2019-20. The percentage at private facilities has gone up to 39.1 percent from 37.6 per cent in the last survey (2015-16), while the caesarean deliveries at government hospitals has marginally increased in the last five years. Doctors have attributed this rising trend to various reasons, including late pregnancies, increasing use of reproductive techniques, more obesity and lifestyle changes and overall demand by patients to avoid complications.
Dr Danny Laliwala, Consultant, department of Obstetrics and Gynaecology said there are several factors which have led to an increase in the caesarean section rates. Moreover there is a rise in high risk pregnancies like hypertension, diabetes, growth restricted babies, pregnancies occurring after prolonged Infertility, elderly mothers, to name a few. Such pregnancies may benefit from a caesarean rather than a normal delivery. Also, there is an increase in preterm deliveries. These babies may not be able to take the stress of labour. In these too, a caesarean may be beneficial
“There are instances where the pregnancy is high risk for both the mother and the child, where a caesarean would be beneficial. We have seen cases where the mother is scared of the labour pains, in spite of assurance given to them and also the availability of epidural analgesia, but the mothers would like an elective caesarean. Some of them want to time the birth with a muhurat, so they too opt for a caesarean. The family size has been reduced to 1 or maximum 2 babies. The couples too feel that they should avoid trauma to the mother and the baby during delivery and opt for elective caesarean. Also, because of the increasing medico legal cases, many doctors would advise a caesarean, at the smallest risk,” he said.
Senior obstetrician and gynecologist said nowadays pregnant women fear long hours of labour pain during the delivery. They prefer C-sections to reduce the pain. The demand for caesarean has increased tremendously in the last 5-6 years.
“Though caesarean is a big achievement for the medical field, it’s not good for women's health. However, doctors also opt C-section to save time and avoid any risk during delivery which is not right,” she said.
“It is also important to note that the family size in India has reduced substantially. Couples can afford to pay for C-sections for one or two deliveries, unlike previous times, without fear of any medical complications in the subsequent deliveries,” she said. However, in our country there is a need for such authentic guidelines so that the government and judiciary can agree for protection towards the doctor in the event of medico legal issues.
Social Worker and health activists said the Maharashtra government had formed a joint committee to look into the issue, but it has not been of any use so far. “The government should conduct an audit of all hospitals and share the data of Caesarean delivery on the public platform. This will make it easier for people to decide where to deliver them,” she said.
There are also social pressures at times that can be tremendous. “There are late marriages, with women in their late 20s or early 30s. The pelvis can get rigid during the pregnancy and due to safer techniques, there is also pressure from the families to get a C-section,” she said.