Safe child birth? 41% of all deliveries in private hospitals are caesarian, 28% in urban India; WHO norm: 10-15%

A new research paper published in a prominent journal has raised the alarm that, while the World Health Organization (WHO), at a 1985 interdisciplinary conference on appropriate technology for birth, unanimously accepted a 10-15% caesarean section (CS) rate "as reasonable" to assist women to deliver safely in the face of complications, in India's urban areas it has reached a whopping 28.3% as against the national average of 17.2%.

Titled "Rising Caesarean Births: A Growing Concern", the paper, authored by a group of scholars led by Prashant Kumar Singh, a Max Planck-India fellow, Max Planck Institute for Demographic Research, Germany, shows that in urban areas the CS rate in Telangana is 63.2%, followed by Jammu & Kashmir (J&K) 53.1%, Andhra Pradesh 48.4%, Kerala 37.1%, West Bengal 36.6%, Tamil Nadu 36.1%, Himachal Pradesh 29.9%, Karnataka 29.6%, Gujarat 27.8%, Maharashtra 26.3%, and so on.

Suggesting that this is mainly due to privatization of the healthcare system, the paper says that in private health facilities, CS rate across India has reached a whopping 40.9% as against 27.7% a decade ago. As against this, in the public health facilities, the CS rate has actually come down from 15.2% to 11.9%. Here also, the figures culled out by the paper show, there is a sharp inter-state divide.
Thus, 75.5% of all deliveries in private facilities in J&K are through CS, followed Telangana 74.9%, West Bengal 70.9%, Andhra Pradesh 57%, Odisha 53.7%, Assam 53.3%, Tamil Nadu 51.3%, Himachal Pradesh 44.4%, Madhya Pradesh 40.8%, Karnataka 40.3%, and so on.
Overall, the paper shows, India has witnessed an increase of 102% in caesarean deliveries during the last one decade, from 8.5% in 2005-06 to 17.2% in 2015-16, which is marginally higher than the WHO standard, underlining, however, that "this could be attributed to the fact that the availability of CS facilities is relatively higher in urban areas than in rural settings."
Pointing towards inter-state imbalance in CS rate, and basing on data from the National Family Health Survey (International Institute for Population Sciences, 2017), the paper says, the CS rate is "highest in Telangana (58%) and lowest in Bihar (6%)", adding, as many as 20 states "recorded CS rates higher than 15%, and the trend during 2005-15 indicates that the CS rate has doubled in 16 states."
Noting that "in a few states the CS rates in public health facilities were higher than the national average —Telangana (41%), Jammu and Kashmir (35%), Kerala (31%), Tamil Nadu and Andhra Pradesh (26%)", the paper says, "An analysis of these trends revealed that during 2005-16, the CS rate in public health facilities had declined, but an increase was observed in the case of private health facilities across many states."

According to the paper, "In India, a very small section of women choose to have CS, being cognisant of the fact that vaginal delivery is an option. This phenomenon is termed as too posh to push' which is prevalent among educated, rich and urban women who want to avoid labour pain during childbirth and are convinced that CS is safer, faster and less likely to affect the quality of sexual life than vaginal birth."
As for the rural women who "uneducated, lack awareness and come from a low socio-economic strata of society, do not have any decision-making power about having a baby", the paper says, "physicians play a crucial role as they have to decide whether it should be a vaginal delivery or CS."
It adds, "This opportunity gives physicians a window to convert vaginal delivery to CS, as a CS procedure will enhance the physicians’ income or time spent in patient care. The fact that referring patients from a government hospital to a private facility for CS can earn commission for government doctors has also been reported."

Comments

Shyam Benegal's Mathan a propaganda film that supported 'system'? No way

A few days ago, I watched Manthan, a Shyam Benegal movie released in 1976. If I remember correctly, the first time I saw this movie was with Safdar Hashmi, one of the rare young theater icons who was brutally murdered in January 1989. Back then, having completed an M.A. in English Literature from Delhi University in 1975, we would often move around together.

Beyond the Sattvik plate: Prof Anil Gupta's take on food, ethics, and sustainability

I was pleasantly surprised to receive a rather lengthy comment (I don't want to call it a rejoinder) on my blog post about the Sattvik Food Festival, held near the Sola Temple in Ahmedabad late last year. It came from no less a person than Anil Gupta, Professor Emeritus at the Indian Institute of Management-Ahmedabad (IIM-A), under whose guidance this annual event was held.

Would Gujarat Governor, govt 'open up' their premises for NGOs? Activists apprehensive

Soon after I uploaded my blog about the Gujarat Governor possibly softening his stance on NGOs—evidenced by allowing a fisherfolk association to address the media at a venue controlled by the Raj Bhawan about India’s alleged failure to repatriate fishermen from Pakistani prisons—one of the media conference organizers called me. He expressed concern that my blog might harm their efforts to secure permission to hold meetings on state premises.

No to free thought? How Gujarat's private universities are cowing down their students

"Don't protest"—that's the message private universities across Gujarat seem to be conveying to their students. A senior professor told me that students at the university where he teaches are required to sign an undertaking promising not to engage in protests. "They simply sign the undertaking and hand it over to the university authorities," he said.

'Potentially lethal, carcinogenic': Global NGO questions India refusing to ban white asbestos

Associated with the Fight Inequality Alliance, a global movement that began in 2016 to "counter the concentration of power and wealth among a small elite", claiming to have members in the United Kingdom, South Africa, Kenya, Zambia, the Philippines, and Denmark, the advocacy group Confront Power appears all set to intensify its campaign against India as "the world’s largest asbestos importer".

In lieu of tribute to Pritish Nandy, said to be instrumental in collapse of Reliance-controlled daily

It is widely reported that Pritish Nandy , journalist, author, animal activist, and politician, has passed away. While it is customary to pay tributes to a departing soul—and I, too, have joined those who have posted heartfelt condolences on social media—I cannot forget the way he treated me when he was editor of the Reliance-controlled Business and Political Observer (BPO), for which I had been working informally in Moscow.

Challenging patriarchy? Adopting maternal and marital surnames: Resistance continues

Anandiben Patel The other day, I was talking with a group of family friends. The discussion revolved around someone very close to me who had not changed her official name in documents, including her Aadhaar and passport, after her marriage. However, on social media and within her husband's family, she had adopted her husband's surname as a suffix to her own. I mentioned that there is a growing trend—though not yet widespread—where women prefer to retain their maiden names or add their maiden surnames alongside their husband's surname. Another emerging trend is where men choose to add their mother's name, or even their wife's name, to their own. This revelation surprised my family friends.

Barred premise allowed? 'Modi govt fails to seek release of fishermen languishing in Pak jails'

Are the Indian authorities or their Gujarat counterparts softening their stance toward NGOs that flag human rights concerns? I can't say for sure, as only recently the foreign funding license of one of the most prominent NGOs, Janvikas, headed by the well-known civil society leader Gagan Sethi, was canceled. This NGO has been working on livelihood issues for underprivileged sections of society for several decades.

Sattvik Food Festival: Shouldn't one question notion of purity, cultural exclusion in food choices?

Recently, I visited the Sattvik Food Festival, an annual event in Ahmedabad organized by Anil Gupta, professor emeritus at the Indian Institute of Management-Ahmedabad (IIM-A). I have known Prof. Gupta since 1993, when I sought an appointment to meet him a few months after joining The Times of India in Ahmedabad—one reason why I have always been interested in the activities he is involved in.

Search This Blog