Caesarian section, or C-section is another way of delivering a child if a woman is unable to go through the traditional method of delivering a baby, which is vaginally. In a C-section, doctors make an incision in the mother's abdomen and extract a baby directly from the womb.
According to experts, this method of delivering a child is on the rise. A 2023 study by the International Institute of Health Management found that the rate of C-section deliveries has gone up from 16.72% in 1998-99 to 21.5% by 2021 in India. Talking to the OnlyMyHealth team, Dr Anish Pillai, Lead Consultant, Neonatology and Paediatrics, Motherhood Hospitals, Kharghar, Navi Mumbai shed light on the escalating rates of cesarean deliveries and the underlying factors contributing to this trend.
Elective C-section
Dr. Pillai emphasised, "One of the primary reasons for the surge in C-section rates is parental requests. People often think that a C-section is an easier way out, and sometimes doctors also find it convenient."
While acknowledging that patient preferences are crucial, Dr. Pillai underscored the importance of adhering to scientifically supported guidelines that indicate when a C-section should be performed.
Standard indications for a cesarean delivery include the disproportionate or large size of the baby, or the baby being in a difficult position so much so that it can not come out of the vagina. Another indication is when the labour has not been induced even after 38-39 weeks of pregnancy. So these and many other factors should be considered before doctors allow for an elective C-section.
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Maternal Weight and Obesity
Another significant factor contributing to the rise in C-section rates is maternal weight, particularly maternal body mass index (BMI) and obesity, which has gone up in India. Dr Pillai pointed out, "Higher maternal BMI automatically elevates the risk of cesarean deliveries."
A study published in BMC Pregnancy and Childbirth looked at 404 pregnant women in Baghdad, Iraq, and found that those who were obese in the control group had a higher chance of delivering via a C-section.
Pregestational and Gestational Diabetes
Dr Pillai stressed the need to address maternal health, including lifestyle-related diseases like diabetes, which has also been associated with the chance of a C-section delivery and is on the rise in India.
"Lifestyle-related diseases like type-2 diabetes have been rising among the general population. That is the same case for pregnant women, and it can lead to a C-section birth," said Dr Pillai.
The Centres for Disease Control and Prevention also stated the same. The organisation states that women with uncontrolled diabetes have a higher chance of delivering via a C-section.
Also Read: Navigating Postpartum: Expert Helps Understand Your Body's Journey After Childbirth
The discussion with Dr Pillai touched upon the balance between convenience and medical necessity. Dr. Pillai acknowledged that C-sections can be perceived as a more convenient option by both patients and healthcare providers. However, he emphasised the need for a careful evaluation of each case to ensure that cesarean deliveries are performed when medically warranted, rather than as a default choice.
Addressing maternal health, patient education, and medical decision-making processes are essential steps in navigating the challenges posed by rising C-section rates while ensuring optimal outcomes for mothers and their newborns.