India's Maternal Health: Progress Masking Overuse of C-Sections

India has achieved significant success in lowering its maternal mortality ratio, with deaths reduced by 86% over 33 years, a rate exceeding global reductions. However, this success story conceals a troubling trend: a dramatic rise in caesarean sections.

From a mere 6.4% of institutional births in 2008-09, C-sections now account for over 27% by 2024-25. This figure escalates to 47.4% in private hospitals and reaches an alarming 60.7% in Telangana. The World Health Organization suggests an optimal rate of 10-15%.

Financial motivations are a key driver, with C-sections costing significantly more than natural births and contributing substantially to gynaecologists' earnings. Cultural factors also play a role, with some families requesting surgery for auspicious dates. Unnecessary caesareans carry immediate risks like infection and future pregnancy complications, and potential long-term issues for children, including respiratory infections and obesity.

The article emphasizes the urgent need for professional midwifery, which supports natural birth and identifies when medical intervention is truly necessary. India's Nurse Practitioner in Midwifery program, launched in 2018, has produced only about 1,500 midwives, a fraction of the estimated 90,000 needed for the public health system alone. Both rural and urban women require safe birth practices that prioritize non-surgical interventions when appropriate.