Ahmedabad : ‘Unplanned C-sections in pvt hospitals 14% higher’

Ahmedabad: Births by C-sections (caesarean) in India at 17%, according to the National Family Health Survey 2015-16, was higher than the WHO-recommended rate. The rate has got almost doubled from 2005-06. However, what caught the researchers’ eyes was the fact that the probability of unplanned C-section for delivery was 14% higher in private hospitals compared to its government counterparts.

A working paper titled ‘Too much care? Private health care sector and surgical interventions during childbirth in India’ by IIM-Ahmedabad professor Ambrish Dongre and doctoral researcher Mitul Surana explored the phenomenon and claimed that there were potentially 0.9 million (9 lakh) preventable C-sections in the private sector in 2016.

According to the paper, the fourth round of NFHS added a question which was not part of earlier studies – when was the decision to have C-section made. The answer revealed that 53.6% of all C-sections were planned – something which was common across public and private sector. After excluding these cases, the research found that the likelihood of unplanned C-section birth was 13.5-14% points higher at a very conservative estimate.

While exploring the potential reasons for the phenomenon, researchers argued that a number of factors lead to C-section. One of the reasons is fear of legal consequences if it is a risky delivery whereas another is supplier-induced demand driven by financial incentives when the patient has limited information. According to NFHS, a natural birth in private facility costs an average of Rs 10,814 whereas a C-section costs about Rs 23,978.

“One of the ways to prevent such practice is to equalize the rate of normal and caesarean deliveries - which is being practised in a few countries. More study is needed to understand other dynamics of the phenomenon,” said Surana.