There has been a sharp uptick in the number of caesarean section (C-sec) deliveries that took place across India between 2016 and 2021, according to a study by researchers at the Indian Institute of Technology (IIT) Madras.

The study, published in the peer-reviewed journal BMC Pregnancy and Childbirth, showed that from 17.2 per cent in 2016, the prevalence of C-sections across India increased to 21.5 per cent in 2021.

While C-Sec is a lifesaving procedure for high-risk pregnancies, the researchers on 1 April said that “clinical factors were not necessarily the reason for surgical deliveries,” particularly in Tamil Nadu and Chhattisgarh.

When not strictly necessary, a C-sec is known to increase the risk of maternal infection, uterine haemorrhage, infant respiratory distress, and hypoglycaemia, affecting both the mother and the child.

Further, the chances of C-sec delivery were found to be four times higher if the woman gave birth in a private hospital as compared to a public hospital.

In 2016, 43.1 per cent of women gave birth via C-Sec in the private sector. The number spiked to 49.7 per cent in 2021, meaning that nearly one in two deliveries in the private sector is a C-section. In Chhattisgarh, women had a 10-times higher chance of delivering by C-section in a private hospital while in Tamil Nadu, they had a three-times higher chance.

“Across India and Chhattisgarh, the non-poor were more likely to opt for C-sections, while in Tamil Nadu, the case was surprisingly different, as the poor were more likely to have C-sections in private hospitals,” said Prof. V R Muraleedharan, Department of Humanities and Social Sciences, IIT Madras, in a statement on 1 April.

The team attributed the rise in C-sec deliveries to women’s preferences, their socio-economic level, and education.

The study also showed that overweight women and women of advanced maternal ages (aged 35-49) were twice as likely to have C-sections as those who were not.

“There is an alarmingly high proportion of poor women undergoing C-sections in the private sector in Tamil Nadu. This requires further analysis and corrective action in case some of these are clinically unnecessary,” the researchers said.

The study is based on data from the National Family Health Survey (NFHS) conducted in 2015–2016 and 2019-21.