The rate of Caesarean deliveries (C-sections) is skyrocketing across the globe, with alarming statistics coming from both India and the UK. Recent reports show C-section rates exceeding 50% in several districts of Kerala, India, and approximately 25% of births occurring via C-section across NHS hospitals in England.
According to the National Health Mission (NHM), Alappuzha district leads the way with 56% of births via C-section. Other districts, including Kollam, Pathanamthitta, Idukki, and Ernakulam, also register high rates, compiling to the state average of 44%. Meanwhile, northern Karnataka has seen its rates rise from 35% to almost 46% over the last three years, particularly affecting government hospitals.
Healthcare professionals attribute this trend to multiple factors. The reluctance of doctors to promote natural childbirth plays a significant role; they frequently choose C-sections to avert complications and emergencies—risking accountability if complications arise. Dr. Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists (RCOG), explained, "A major factor of this is the growing number of complex births. We are seeing national rising rates of obesity and people choosing to have children at later stages, both of which can increase the chance of complications."
The most recent figures reveal concerning figures; of the 398,675 births recorded in England last year, 101,264—about 25%—were C-sections. This marks an increase from both the 23% recorded just the year before, and significantly from 13% ten years ago. Specifically, elective C-sections rose from 61,030 to 67,100, with emergency C-sections also increasing from 29,315 to 32,463.
Among the controversies surrounding C-sections are incidents such as those reported at the Women and Child Hospital in Alappuzha, where complications arose following vacuum-assisted deliveries, raising doubts about the medical profession’s push for cesarean deliveries over natural methods. With approximately 11% of pregnant women classified as high-risk within the Alappuzha district, it raises questions about why so many are still choosing the surgical option instead of natural childbirth.
Backtracking to England, with one-third of all deliveries for 2023/24 induced through methods like membrane sweeps or hormone drips, the proportion of spontaneous deliveries has plummeted from 62% in 2013/14 to just 42% last year. Dr. Thakar stressed the need for supportive measures for expectant mothers: "Women should be supported to make informed decisions... The safety and care of the woman and baby during pregnancy, labour and birth should always be the main focus."
On the Indian subcontinent, the rising trend has first sparked government responses. Dinesh Gundu Rao, Karnataka’s Health Minister, revealed plans for implementing programs aimed at reducing C-section deliveries, citing the alarming increase. "We are encouraging normal deliveries..." he stated, addressing the rising trend seen mainly in private hospitals—where C-section rates can soar to between 80-90%.
Comprehensive training programs for healthcare professionals and public awareness campaigns are also on the agenda, which the government hopes will lead to more natural births where safe and feasible. With 60 out of 88 maternal and child hospitals now operating, officials are optimistic about making strides toward improved maternal care and lower surgical rates.
Some healthcare facilities, particularly inner-city taluk hospitals, remain hesitant to treat high-risk pregnancies, leading to many being transferred to larger medical institutions. This reluctance could also be partially responsible for the heightened C-section rates across Kerala and particularly its districts.
Looking at these worrying trends, it becomes evident there is no one-size-fits-all answer for childbirth methods. The stakes are high for mothers and infants alike, and as such, healthcare systems across both Karnataka and the UK are feeling the effects of rising intervention demands over natural processes.
Overall, it is imperative to analyze the plethora of factors swirling around the rising rates of C-sections—whether they stem from medical necessity or societal preference. Both patient education and the empowerment to make informed choices are pivotal moving forward.
The data collected signifies the urgent call for balance between(C-sections and natural births reigniting discussions on what constitutes safe and effective childbirth practices.
