Increasing Trends of Caesarean Deliveries in India: Does the Private Sector Contribute to It?

Abstract

Caesarean deliveries are increasing worldwide at a faster rate. Although Caesarean deliveries can save the lives of mothers and babies, the caesarean section is often performed without medical need, putting women and their babies at-risk of short and long-term health problems. Why are caesarean section deliveries increasing? Does the private health sector have a role to play in it? This paper tries to answer all these questions by examining the patterns and determinants of caesarean deliveries and tries to understand the reasons for opting for caesarean deliveries in India. NFHS-4 data collected from 29 states and six UTs of India in 2015-16 was used to achieve this. Binary logistic regression models have been used to understand the determinants of caesarean delivery and emergency caesarean deliveries in India and its states. The results reveal that caesarean section deliveries in India have increased rapidly, which is more than a five-fold increase from NFHS-1 (1992-93) when it was three percent to 17 percent in NFHS-4 (2015-16). There are huge state variations in caesarean section deliveries ranging from six percent in Bihar to 58 percent in Telangana. About half of the states are above the national average of caesarean section deliveries in India crossing the 20 percent mark as against the average of 17 percent in India. Mother’s age, mother’s schooling, religion, wealth quintile, BMI, ANC visit, size of the birth, pregnancy complications and place of delivery were statistically associated with caesarean section deliveries in India. Undeniably, a majority of caesarean section deliveries are performed in the private sector; it clearly indicates that the private sector plays a significant role in the increasing number of caesarean section deliveries in India.