Increasing Caesarean Births In Himachal

The percentage of caesarean deliveries conducted in private hospitals is 44.4% as compared to 16.4% in public hospitals

More pregnant women in the region prefer to go under the knife instead of waiting for a normal delivery, if the data provided by the National Family Health Survey (NFHS)-4 conducted in 2015-16 is of any indication. The number of babies born through the C-Section in the region comprising Himachal Pradesh, Punjab, Haryana and Chandigarh went up in the past 10 years. The trend has caught up in private health facilities but has taken a dip in case of public hospitals. Despite the recommended cap on the caesarean, the number of such delivery is on the rise. According to NFHS-4 survey on an average almost 16.7% of women in Himachal Pradesh prefer to go for C-section delivery compared to 12.6% as per NFHS-3 which was conducted in 2005-06. It is also revealed that urban women prefer going under knife as compared to rural women. The percentage of caesarean deliveries conducted in private health facilities was 44.4% to 16.4% C-section delivery was carried out in public hospitals.

While in Punjab, birth by caesarean was 24.6% as per NFHS-4 survey which was 16.5% in NFHS-3. Almost 39.7% deliveries were carried out in private hospitals in the state against 17.8% C-section deliveries conducted in government hospitals, states NFHS-4 survey. On the other hand, the state had registered 34.3% deliveries conducted in private hospitals against 31.5% deliveries carried out in public hospitals, as per NFHS-3 survey. Haryana and Chandigarh also did not present rosy picture on the matter. Haryana has recorded 11.7% caesarean deliveries in NFHS-4 as compared to 5.3% in NFHS-3. The percentage of caesarean deliveries carried out in private hospitals was 25.3% while only 8.6% deliveries were conducted in government hospitals. As per NFHS-4 survey in Chandigarh 22.6% births were conducted by caesarean. Of these, around 44% deliveries were carried out in private hospitals and 20.5% in government hospitals.

High Risk Of Maternal Death

Experts also warn that childbirth through the caesarean section has a 2.84-fold high chance of maternal death than a normal delivery. Studies show that 52% of maternal deaths are due to anaesthesia related complications in elective caesareans. “A first-birth by caesarean has a 30% chance of causing placental disruption in a later pregnancy. It is also known to be a potential short and long term risks for new born—injury during birth; breathing and breast feeding problems; risk of admission to neonatal ICIU. Birth by caesarean can have also long term health issues like asthma, allergies; diabetes etc. Mother can have pelvic pain, bowel obstruction, infertility and chances of another caesarean delivery. Despite these risks, it is not surprising that C-section is used as a last resort worldwide. The WHO report states in any society it should not account for more than 20% of all child births. With the percentage of caesarean delivery increasing, an official of the health department said that they were identifying the main reason to avoid normal delivery among women and to prevent any kind of complication.

About Four Percent Jump In Caesarean Deliveries

State                                C-Section Delivery       C-Section Delivery

                                     (NFHS-4 Survey)        (NFHS-3 Survey)

Himachal Pradesh         16.7%                           12.6%

Haryana                           11.7%                             5.3%

Punjab                               24.6%                           16.5%

Urban Women Prefer PrivateHospital

The survey also reveals that on an average almost 45% of urban Indian women prefer to go to private hospital for caesarean delivery. On the other hand, this percentage in public hospitals across the country is 20%. A gynaecologist at a government hospital in Chandigarh on the condition of anonymity said the number was high for private hospitals because of compulsions and parents wanting the child to be born on specific date. She added that caesarean delivery has more complications for the baby and mother. She further stated that for the past decade, the region has witnessed an increase of over 40% in pregnancy among women between the age group of 35-39 years and over 60% women have babies between the age group of 40-44 years. “Weight increase among women is the main factor for C-section delivery. Heavier women are likely to have bigger babies and in order to protect overly large babies from traumatic normal delivery, caesarean delivery is preferred,” she said.

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Y.S. Rana

The writer is a Hamirpur based Himachali settled in Chandigarh

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