6 In 10 Deliveries In Karnataka's Private Hospitals Performed Via Caesarean Section

Karnataka's Caesarean deliveries surged from 25% (2.6 lakh) in 2016 to 46% (4.7 lakh) in 2023, raising concerns about maternal and child health.

Bengaluru:The number of deliveries through Caesarean section (CS) in cities and towns of Karnataka has been increasing at an alarming rate raising concerns about maternal and child health. In the last eight years, Caesarean deliveries have almost doubled from 25% ( 2.6 lakh CS out of 10.6 lakh total births) in 2016 to 46% (4.7 lakh CS out of 9.6 lakh total births) in 2023 as per eJanMa, a government entity that maintains the registry of deaths and births in the state.

Private hospitals have been contributing significantly to this worrying trend accounting for more than 60 per cent of overall Caesarean deliveries in 2023, up from 43% in 2016. As per Karnataka Health Minister Dinesh Gundurao, in some hospitals, the percentage of surgical deliveries is dangerously as high as 90%.

Of the 60% surgical deliveries in 2023, private hospitals in cities and towns account for a whopping 96% underlying the fact that educated women from the middle and upper middle class are more prone to undergo this what doctors call an avoidable procedure.

The government hospitals, too, are not lagging behind as the percentage of Cesarean deliveries has gone from a mere 13% ( 84,037 CS out of 6.4 lakh total births) in 2016 to 29% (1.67 lakh CS out of 5.6 total deliveries) in 2023. Sources in the state health department said the rate of surgical deliveries for the current year is expected to touch 34%.

Why are C-Sections on the rise?

As per the gynaecologists and obstetricians, health issues arising out of sedentary lifestyles are largely contributing to the rise in C-Section births. "People are suffering from lifestyle diseases like hypertension, obesity and diabetes at a very young age these days. This is in turn resulting in medical disorders of pregnancy like gestational diabetes that increases the weight of the child forcing doctors to opt for surgical deliveries to avoid complications," said Dr C Savitha, Medical Superintendent, at Vani Vilas Hospital, the busiest government hospital in Bengaluru.

Changing preferences of women and late marriages also play a significant role, she says. "Women are concentrating more on education and career. As a result, a lot of women are marrying after 30 years, whom we consider elderly persons (medically) to give birth to a child. Such women are prone to develop complications while giving birth," she adds.

There are also instances where women voluntarily opt for C-Section deliveries as they lack tolerance capacity (to undergo labour pain) and patience. Their minds are programmed for CS making them believe they are safe and painless, says Dr Vijeta, another gynaecologist practising in a private hospital in Bengaluru.

Greed for money, a reason?

Some people attribute the increasing number of CS in private hospitals to financial considerations. “Even when normal delivery is possible, private hospitals go for CS citing complications. Gullible patients and their relatives will be left with no choice but to give their consent,” says Madhusudhan, a health worker in a private hospital.

A Caesarian delivery cost ranges from Rs 85,000 to Rs 2 lakh in private hospitals and in case of a complication, the cost even escalates to Rs 3 lakh while a normal delivery costs maximum up to Rs 1 lakh.

Dr Hemalatha, a gynaecologist running her hospital in Sanjayanagar, dismisses the charge saying normal deliveries are more stressful than Caesarean deliveries. Besides, the Caesarean procedure comes with the risk of excess bleeding and infections. “So no doctor will go for Caesarean unless it is needed,” she said.

Creating awareness is key to avoiding CS

Caesarean deliveries will have an impact on the health of the mothers. If the first delivery is through CS, then the chances of the second delivery being normal are negligibly less. “Excess bleeding, infection, flattening of placenta etc are the issues the women undergoing CS may encounter,” adds Savitha.

In order to arrest the increasing number of CS procedures, the experts stress preparing women mentally and physically for normal deliveries. Keeping with this opinion, the Union government has started the National Midwifery Training Programme for healthcare providers, especially nurses, to counsel and prepare low-risk pregnancy cases to undergo normal delivery.

“These units identify low-risk mothers, counsel them, provide them with necessary advice on nutrition, exercises and prepare them for normal deliveries,” Savitha said.

A midwifery-led care unit (MLCU), which has been functioning in the Vani Vilas Hospital since January 2023 is carrying out an average of 100 normal deliveries a month. Similar units are set up at Mysuru and Belagavi. “About 25 nurses are undergoing Midwifery training. Once their training is complete, MLCU units will be set up in district hospitals in Kolar, Bengaluru, Davanagere, Mandya and Tumakuru," Minister for Health and Family Welfare Dinesh Gundu Rao said in the Legislative Council during the recent session held in Belagavi.