The rise of C-sections reflects a booming birth business
₹5,000 crore. This assumes that only 17% of all such deliveries are medically necessary, with the rest adding up to extra costs. It takes into account the costs of C-sections indicated in the National Sample Survey 75th round for 2017-18 (i.e., ₹16,475 higher than a natural childbirths in rural areas and ₹19,548 higher in urban settings).
The NSS data reveals that private hospitals charge 6-7 times more, and this ratio may have changed since. An all-India uptick in institutional deliveries appears to be linked with an increase in C-sections, raising questions about what motivates these recommendations. The growth of private and government-backed insurance schemes creates a financial safety net for patients, but it also inadvertently incentivizes doctors to recommend more expensive procedures.
Knowing that insurance will cover the costs may lower the barrier for decision-makers to opt for this more costly surgical approach, even when not medically necessary. This not only has potential health risks, but also puts an unnecessary strain on healthcare resources. Health being a state subject, the onus of curbing this trend lies with the state.
On its part, the Union government has undertaken several measures. Advisories have been sent to state and Union territory health officials and the Federation of Obstetrical and Gynaecologists in India, urging them to adhere to WHO guidelines on C-sections. Further, a CS audit initiative called LaQshya has been rolled out in public hospitals to ensure judicious use of the procedure.
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