Curb 'needless' caesarean section surgeries, says Union Health Ministry to states

New Delhi: In the backdrop of the death of AIIMS nurse Rajbir Kaur following her caesarean delivery, concerns of unnecessary C-section births are being raised.

The nurse's untimely death led to questions being pointed at women's health and childbirth, while Women and Child Development minister Maneka Gandhi called out for the public display of records of caesarean section vis-a-vis normal deliveries.

Now, following a health survey that brought to the fore a sharp rise in such operations in the private sector, the Union Health Ministry has called out for doing away with 'needless' caeserean section surgeries.

According to the National Family Health Survey (NFHS-4) made available by the ministry today, the nationwide average Caesarean section surgeries rose from 8.5 percent (NFHS-3) among all deliveries in the 2005-06 survey to 17.2 percent in the 2015-16 survey.

In the private sector, Caesarean section surgeries made up about 40.9 percent of deliveries in 2015-16 from 27.7 percent in 2005-06.

Similarly according to NGHS-4, such surgeries in public health facilities declined from 15.2 percent during NHFS-3 to 11.9 per cent during 2015-16.

"We are trying to tell the states to convince the private sector to do Caesarean only when it is required," Union Health secretary C K Mishra told reporters here.

He said it is a very "dichotomous" situation where on one hand, the ministry is trying to create facilities to do caesarean operations in public health facilities while a lot of caesarean surgeries is happening in private sector which is elective.

Other health officials informed that the Ministry has been writing to the state governments and gynaecology associations and trying to suggest to them to use provisions of The Clinical Establishments (Registration and Regulation) Act and others to nudge the private providers whose caesarean rates are "excessive".

Recently, Union Minister Maneka Gandhi had written to Health Minister J P Nadda, saying the doctors who carry out Caesarean operations without a valid medical reason must be "named and shamed".

Gandhi wanted Nadda to make it mandatory for hospitals to display their rate of Caesarean, also known as C-section, deliveries in response to a Change.Org petition against hospitals and doctors profiteering by pushing women towards surgical deliveries instead of natural vaginal birth.

Notably, the central government had launched a campaign to

provide free and comprehensive antenatal care on the 9th day of every month under the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA).

Under the programme, pregnant women will be provided special antenatal check-up in their second or third trimester at government health care facilities.

Mishra said the high number caesarean surgeries taking place in private sector was the reason behind "refraining" from including private clinics of conducting the check up on 9th day of every month.

He said there were proposals by various associations of including the private clinics as well. "However, now we are doing it in our facilities and slowly the gynecologists are also coming and enrolling in public facilities," he added.

The NHFS also found that the sex ratio at birth (females per 1,000 males had improved from 914 to 919 at the national level over the last decade with the highest in Kerala (1,047), Meghalaya (1,009) and Chhattisgarh (977).

Haryana, too, had made a significant improvement from 762 to 836 females per 1,000 males during NHFS-4.

(With PTI inputs)