Abstract
Background: Caesarean section (CS) rate is increasing worldwide and India is also not excluded from this trend. We present the latest CS rates and trends over the last 23 years in India and its states.
Methods: The data for the present analysis comes from the four consecutive National Family Health Survey (NFHS).
Results: The changing trends in CS rates from 1992 to 2015 for India and different states along with calculating the average annual rate of increase (AARI) was also presented in the study. At all India level, the CS rate has increased from 2.9 percent of the childbirth in 1992-93 to 7.1 percent in 1998-99 and further rise to 8.5 percent in 2005-06 and a steady rise to 17.2 percent in 2015-16 and an AAIR of 8 percent. According to the recent NFHS 4, the average rate of C-section in India is 17.2 percent ranging from 5.8 percent in Nagaland to 58.0 percent in Telangana. The difference in C-section delivery from NFHS-1 to NFHS-4 shows that 7 states has CS rate that is more than 30%, eight states has CS rate in between 10 percent and 20 percent and nine states less than 10 percent.
Conclusions: There is an unprecedented level of rise in CS rates in India and interstate and regional variations in CS rates.
Keywords: Caesarean section rate, Trend, NFHS, India.
References
- World Health Organization. 1985. “Appropriate Technology for Birth” Lancet 326(8452): 436-37.
- BetránAp,Ye J, Moller A, et al. The increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014. PLoS ONE 2016;11(2):e0148343.
- Cavallaro FL,Cresswell JA, França GVA, et al. Trends in caesarean delivery by country and wealth quintile: Cross-sectional surveys in southern Asia and sub-Saharan Africa. Bull World Health Organ 2013;91:914–922.
- Stanton CK,Holtz SA. Levels and trends in cesarean birth in the developing world. Stud FamPlann 2006; 37:41–48.
- Robson M, Hartigan L, Murphy M.Methods of achieving and maintaining an appropriate caesarean section rate. Best Pract Res ClinObstetGynaecol 2013; 27:297–308.
- Ye J, Betrán A, Vela M, Souza J, Zhang J.Searching for the optimal rate of medically necessary caesarean delivery. Birth 2014; 41:237–44.
- Betrán, AP, Ye, J, Moller, AB, Zhang, J, Gülmezoglu, AM, and Torloni, MR.The increasing trend in caesarean section rates: global, regional and national estimates: 1990–2014., Brazil introduces new caesarean birth rules. BBC News. , July 7, 2015 ((accessed April 15, 2016)
- Langer, A and Villar, J.Promoting evidence based practice in maternal care. BMJ. 2002; 324: 928–929.
- Kambo I, Bedi N, Dhillon BS, Saxena NC. A critical appraisal of caesarean section rates at teaching hospitals in India. Int J GynecolObstet 2002; 79 : 151-8.
- Villar, J, Valladares, E, Wojdyla, D..., and for the WHO 2005 global survey on maternal and perinatal health research group.Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006; 367: 1819–1829.
- Lumbiganon, P, Laopaiboon, M, Gülmezoglu, AM..., and for the World Health Organization Global Survey on Maternal and Perinatal Health Research Group.Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet. 2010
- International Institute for Population Sciences, Mumbai National Family Health Survey (NFHS-1) 1992-93
- International Institute for Population Sciences, Mumbai National Family Health Survey (NFHS-2) 1998-99
- International Institute for Population Sciences, Mumbai National Family Health Survey (NFHS-3) 2005-06
- International Institute for Population Sciences, Mumbai (2017)National Family Health Survey (NFHS-4) 2015-16 India Fact sheet
- Potter, J., Berquo, E., Perpetuo, I., Leal, O., Hopkins, K., Souza, M. and Formiga, M. (2001) Unwanted caesarean sections among public and private patients in Brazil: prospective study.BMJ,323,1155–1156.
- Sreevidya S, Sathiyasekaran BW. 2003. “High caesarean rates in Madras (India): a population-based cross sectional study.” British Journal of Obstetrics and Gynaecology. Feb; 110(2):106-11.
- Duggal R, Amin S. Cost of Health Care —‘A Household Survey in an Indian District’. Mumbai: Foundation for Research in Community Health, 1989.
- Yassin K. Saida G. (2012). Levels and Determinants of Caesarean Deliveries in Egypt: Pathways to Rationalization. The Internet Journal of World Health and Societal Politics. Volume 7 Number 2.
- Rachatapantanakorn O. and Tongkumchum P. (2009). Demographic determinants for cesarean delivery in Pattani Hospital. Southeast Asian J Trop Med Public Health. 2009 May; 40(3):602-11.
- Bertain Pilar Ana et al, The increasing trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014’ PLos one. 2016:11(2)
- Neuman M et al, Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal: BMJ Open. 2014 Dec 30;4(12)
- Dilip Kumar Pal et al, Epidemiological Determinants affecting Caesarean Section in a Rural Block of West Bengal: IOSR Journal of Dental and Medical Sciences, Volume 14, Issue 11 Ver. VIII (Nov. 2015), PP 120-122.
- Mehta .A et al, Trends in Caesarean Section Rates at a Maternity Hospital in Mumbai, India: J HEALTH POPUL NUTR 2001 Dec; 19(4):306-312.
- S.Pukale, Prashant S. Joshi , Arathi M.S, A Cross Sectional Study of Rate, Trends and Determinants of Caesarean Section among Mothers Attending a Rural Medical College Hospital in Karnataka: Indian Journal of Obstetrics and Gynaecology Research 2016;3(1):13-17.
- Divyamol N, Lucy Raphael, Nileena Koshy, Caesarean section rate and its determinants in a rural area of South India: International Journal of Community Medicine and Public Health | October 2016 ; Vol 3 | Issue 10 Page 2836-2840.
- Deepti Shrivastava, Priyakshi Chaudhry, Rising Trend of Caesarean Section in Rural India: A Prospective Study: Global Journal of Medical Research: 2 015;
Corresponding Author
Dr K P. Vasanthakumari MD
Associate Professor, Department of Obstetrics and Gynaecology,
Government Medical College, Thiruvananthapuram, Kerala, India Mob: 9447101075
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.31
