The Government has taken several steps to ensure that the unwarranted increase in C-Section surgeries can be kept in check.
The Minister of Women and Child Development Maneka Sanjay Gandhi, had expressed concern to the Union Health Minister in February 2017 about the unusual increase in recent years in C-Section surgeries reported from different States.
While the recommendation of WHO suggests that deliveries through C-Section should normally be in the range of 10-15% of the total deliveries, some States are reporting extremely high percentages. Tamil Nadu reported this to be 34% and Telangana 54%.
It is worrisome that the percentage was even higher for the private nursing homes across the States.
In response to the letter of WCD Minister, the Union Minister of Health and Family Welfare, Mr. J.P. Nadda has stated that the concerns expressed are well founded and the Health Ministry is taking a series of measures to control this increasing trend.
C – Section Surgeries:
Caesarean section, also known as C-section or caesarean delivery, is the use of surgery to deliver one or more babies. A caesarean section is often performed when a vaginal delivery would put the baby or mother at risk. This may include obstructed labour, twin pregnancy, high blood pressure in the mother, breech birth, problems with the placenta, umbilical cord or shape of the pelvis, and previous C-section.
A trial of vaginal birth in some of these situations, including after C-section, may be possible. Some C-sections are also performed upon request.
The World Health Organization recommends that they should be done based on medical need and in many cases they are lifesaving for the mother and baby.
C-section typically takes 45 minutes to an hour. It may be done with a spinal block such that the woman is awake or under general anesthesia. A urinary catheter is used to drain the bladder and the skin of the abdomen is then cleaned with an antiseptic.
An incision of about 15 cm (6 inches) is then typically made through the mother’s lower abdomen. The uterus is then opened with a second incision and the baby delivered. The incisions are then stitched closed.
A woman can typically begin breastfeeding as soon as she is awake and out of the operating room. Often a number of days are required in hospital to recover sufficiently to return home.
Steps Taken by Indian Government:
As a first step, all the private hospitals empanelled under CGHS have been directed by the Health Ministry to prominently display the data of deliveries through C-Section vis-à-vis normal deliveries in the hospital, at the reception area.
A report titled “Deciphering the Determination and Impacts of Rising Rate of C-Sections and offering Potential Solutions” has been disseminated to all State Governments and UT Administrations to effectively get them to provide C-Sections only to those women who actually require it.
Federation of Obstetric and Gynecological Societies of India (FOGSI) has also been sounded off about the harmful effects of unwarranted C-Sections.
In addition, the States have been directed to conduct periodical prescription audit of the health facilities specifically on this issue.
It is hoped that these measures would help in bringing out the rate of C-Section deliveries back to the realistic levels.