City-based researcher Subarna Ghosh, whose online petition on the high rate of C-section deliveries has received 1.6 lakh signatures, has managed to make an impact. Private hospitals that are a part of the Central Government Health Scheme (CGHS) will soon be required to declare their rate of C-section deliveries. "We are here to improve the quality of maternal health and this is one step in the direction to regulate C-section deliveries," said Ghosh, who is a PhD researcher at the SNDT University. Her online petition on change.org sought to make it mandatory for hospitals to declare their rate of C-section deliveries.
While the new process for hospitals to be part of CGHS will be in place in a month according to senior health officials, Ghosh wants more. "I would want a blanket policy and a reaction from the health ministry which has not happened yet," she said. Ghosh met Minister for Women and Child Development Maneka Gandhi and has been consistently following up with the petition.
The latest National Family and Health Survey-4 shows that around 44.8 per cent of the deliveries in the urban areas that take place in the private sector are done via C-section. The figure is a worrying 37.8 per cent for deliveries taking place in the private sector in the rural hospitals.
The ideal rate of C-section deliveries according to the World Health Organisation (WHO) is close to 10-15 per cent.
"Vaginal delivery is best for both the mother and the child but a lot of young women are now scared of going through the process," said Dr Rekha Daver, former head of gynaecology department, JJ Hospital. "A normal labour takes as much as nine to ten hours during which you have to observe the patients. Smaller private hospitals might not have that much staff and the doctors to give in when patients' demand a C-section delivery," she added.
Doctors say that while the rates can go up to 25 per cent in major public hospitals since they receive a lot of referral cases, rates above that is of concern to the policy makers.
Gynaecologist and author of Dissenting Diagnosis Dr Arun Gadre attributed the high rates to the failure of private healthcare system. He blames both the parties for the issue. "While there is a rise in the consumerism among patients who want to choose the date and time of deliveries and pressure on the doctors to hurry up procedures there is also the other side. Medical practitioners find it easier to fleece illiterate patients in the rural areas. The private doctors also refer patients to each other and C-section procedures earn them higher commissions," he explained.
Susmita Chatterjee, a researcher with the Public Health Foundation of India (PHFI) had conducted a study that was published in the British Medical Journal (BMJ) in 2013 which looked at the cost of surgical procedures for the hospitals.
ACCORDING TO WHO
- Ideal rate for caesarean sections to be between 10-15 per cent
