Is there a push for C-sections over normal deliveries?

When former Miss World Aishwarya Rai had her child through a normal delivery some years ago, much was said of the message she was sending out to prospective moms-to-be about being not “too posh to push”.

But a recent survey by ICICI Lombard has revealed that about 52 per cent of health insurance claims from the top 10 cities in the country were for caesarean (C-section) deliveries.

So, are Indian women increasingly opting for the easy way out by choosing c-section deliveries to avoid going through labour pain? In fact, the latest National Family Health Survey tells us that private hospitals conduct over twice as many deliveries through C-section than government hospitals. In private hospitals, 40.3 per cent of births are done through C-section, while in public hospitals, this figure is 16.9 per cent.

Healthcare experts worry whether this increase has more to do with economics, as hospitals earn significantly more in C-sections. According to Lombard, in 2015, the average claimed amount was around ₹50,000 for a C-section compared with ₹27,000 for a normal delivery. Gynaecologist Kaushiki Dwivedee explains, that for a doctor, if you can deliver a baby in 20 minutes by a caesarean, spending 20 hours for a normal delivery doesn’t mean any more incentive with an added stress of monitoring the labour process and sleepless nights that goes unaccounted for when things go wrong.

An infertility specialist points to an unhealthy practice that pushes women to C-sections for their childbirth.

“While there is no doubt that ultrasound scanning is extremely helpful during pregnancy to confirm the well-being of the baby, the commonest racket is to get the ultrasonographer to over-report minor variations as abnormalities, and then scare the patient that the baby’s welfare is at stake.” he alleges.

Not all gynaecologists, though, agree with the view that doctors tacitly push women towards C-sections. Mumbai-based gynaecologist Sudha Marwah says that in her 34-year career, barely four women have opted for C-sections.

Besides, she adds, the remuneration for the gynaecologist is the same for both deliveries and additional charges are paid for the operation theatre, anaesthetist and the increase in the duration of stay. Dwivedee, who works in Australia currently and has worked as a consultant in Max Hospital, Gurgaon, also agrees that normal deliveries are more popular in India. Having worked for about two years with the Australian Public Healthcare System as a consultant, she says, “I find that in comparison, Indian women are keener to have normal deliveries.”

Lifestyle and increasing stress, fertility issues and a history of abortions make women and doctors opt for C-section, observes Mangala Patil, a gynaecologist at Wockhardt Hospitals. For women with diabetes or hypertension too, a C-section is a safe option, she says, adding that after all, every birth is precious.

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