Parliament Question: Rise of C-Sections in Private Hospitals

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO.1292 TO BE ANSWERED ON6thFEBRUARY2026 RISE OFC-SECTIONS IN PRIVATEHOSPITALS 1292#SHRIMADDILAGURUMOORTHY:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased tostate:

(a) the number of Normal Vaginal Deliveries (NVDs) and Caesarean Sections (C-sections) recordedannuallyduring the last two decadesinthe country;

(b) the corresponding Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) trendsoverthe last two decadesin the country,State/UT-wise;

(c) whether the Government has assessed the reasons behind the continuous rise in C-section deliveriesinprivate hospitals comparedtopublic hospitals andif so, the detailsthereof; and

(d) the steps being taken by the Government to regulate unnecessary C-sections, improve maternal andneonatal outcomes andstrengthen institutional deliveries underJanani Suraksha Yojana and LaQshya programmes to achieve the Sustainable Development Goal (SDG) targets by2030? ANSWER THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY WELFARE (SHRIPRATAPRAO JADHAV)

(a) The year-wise total number of reported deliveries and caesarean sections during the last twodecadesinthe countryisplacedat AnnexureI.

(b) Asperthe informationreceivedfrom theOfficeofthe RegistrarGeneral ofIndia,Ministry of Home Affairs, the data on Infant Mortality Rate (IMR) from the year2006 till 2023 is available in “SRS Statistical Report” placed at Annexure II and may be accessed at the

following link: https://censusindia.gov.in/census.website/data/SRSB The data on Maternal Mortality Ratio (MMR) from the year2007 till 2023 is available in the publication “Special bulletin on Maternal Mortality in India” placed at Annexure III and may

be accessed at the following link: https://censusindia.gov.in/census.website/data/SRSMMB(c) As per the report of Population Research Centre (PRC) - JSS Institute of Economic Research Dharwad, Karnataka, under Ministry of Health & Family Welfare (MoHFW), Government of India, a study conducted on “Understanding the Context of Caesarean Delivery from the Providers’ and Receivers’ Perspectives” in 2022, mentions the main reasons behindthe increasedrate of C-section Deliveriesinthe countryas:

 Clinical Decision-Making by Doctor: Clinical indications, such as maternal age, multiple pregnancies, fetal distress, previous C-sections, prolonged labour, placenta previa, as well as maternal complications have a greater likelihood of caesarean delivery.

 Patient/Community Preferences: Thesehave decision-makingroleinthematter

(d) Under the National Health Mission (NHM), the Government of India has taken various steps toregulate unnecessary c-sections which include:  CGHS empanelled hospitals are required to prominently display information regardingthe ratioof deliveries byCaesarean section vis-à-visnormal deliveries.

 Data Reportingandmonitoring hasbeenstrengthened at healthcare facilities.  Under LaQshya initiative, a dedicated C-section audit component is embedded in the LaQshya assessment checklist for Maternity OTsfor allGovernment Hospitals.

 Various training programs, including Daksh, Dakshta, Skilled Birth Attendant (SBA) and Nurse Practitioner Midwifery (NPM) have been instituted to ensure the availability of well-trained human resources, especially in remote areas in order to promote normal deliveries.

To improve the maternaland neonatalhealthoutcomes, strengthen institutional deliveries and to achieve the Sustainable Development Goal (SDG) targets, the Government of India has

takenfollowing initiatives underNHM:  Janani Suraksha Yojana (JSY) isa demand promotion andconditional cash transfer scheme for promotinginstitutional delivery.  Janani Shishu Suraksha Karyakram (JSSK) under which every pregnant woman andsick infant isentitled tofree delivery, includingcaesareansection, inpublic health institutions along with provision of free transport, diagnostics, medicines,blood,other consumables& diet.

 Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost assured and quality antenatal check up by a Specialist/Medical Officeronthe 9thdayof everymonth.

ExtendedPMSMA(e-PMSMA) strategy was launched for individual tracking of high-risk pregnantwomen till a safe delivery.  LaQshya improves the quality of care in labour room and maternity operation theatres to ensure that pregnant women receive respectful and quality care during deliveryandimmediate post-partum.

 Surakshit Matritva Aashwasan (SUMAN) aims to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of servicesfor every woman andnewborn visiting the public health facilityto endall preventable maternalandnewborn deaths.

 OptimizingPostnatal Care aims tostrengthen the quality of postnatal care by laying emphasis on detection of danger signs in mothers andincentivizing Accredited Social HealthActivists (ASHAs) for prompt detection,referral & treatment of such high-risk postpartum mothers.

 Monthly Village Health, Sanitation and Nutrition Day is an outreach activity at Anganwadi centers for provision of maternal and childcare including nutrition in convergence with the IntegratedChild DevelopmentScheme (ICDS).

 Outreach camps are provisioned to improve the reach of health care services, especially in tribal and hard-to-reach areas. This platform is used to increase awareness for Maternal andChild health services andcommunitymobilizationaswell astotrackhigh-risk pregnancies.

 Capacity Building of staff in Skilled Birth Attendance (SBA), Daksh, Dakshata along with BEmONC, CEmONC and LSAS to provide comprehensive quality care during deliveryat a health facility.  Strengthening of infrastructure, includingfunctionalization of First Referral Units

(FRUs), setting up of Maternal and Child Health (MCH) Wings, operationalization of Obstetric High Dependency Units & Intensive Care Units (Obst. HDU & ICU), establishment of Birth WaitingHomes (BWHs) in difficult terrain, remote and tribal areastoimprove accesstohealthcare facilitiesandpromote institutional delivery.

 The establishment of Special Newborn Care Units (SNCUs) and Newborn Stabilization Units (NBSUs) under Facility Based Newborn Care (FBNC) program to provide specialized care to sick and small newborns at district and sub-district levels, addressing neonatalhealth complications.

 ASHAs conduct scheduled home visits under Home-Based Newborn Care (HBNC) for improvingchild-rearing practicesandidentifyingsick newbornsfor timely referral andcare. *********************Annexure referred in reply to part (a) of Lok Sabha Unstarred Q. No 1292 to be answered on06.02.2026 Annexure I TotalNumberof TotalNumberof FinancialYear C-SectionDeliveries DeliveriesReported Reported 2008-2009 18826605 1202889 2009-2010 20786400 1526241 2010-2011 21254165 1704625 2011-2012 21126731 2098326 2012-2013 20228338 2319517 2013-2014 20457293 2479381 2014-2015 20218688 2726757 2015-2016 21172780 3252142 2016-2017 20710361 3462386 2017-2018 20783191 3588587 2018-2019 21118228 3949027 2019-2020 21410780 4152335 2020-2021 20386280 4098969 2021-2022 20410730 4533190 2022-2023 20963598 4993291 2023-2024 20351261 5143156 2024-2025 19789406 5434735

Source:DataasreportedbyState/UTsonHMISPortalAnnexure referred inreply to part(b)of Lok SabhaUnstarred Q.No 1292to beansweredon06.02.2026 Annexure II S.No. India/States 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 INDIA 57 55 53 50 47 44 42 40 39 37 34 33 32 30 28 27 26 25 1 AndhraPradesh 56 54 52 49 46 43 41 39 39 37 34 32 29 25 24 22 20 19 2 Assam 67 66 64 61 58 55 55 54 49 47 44 44 41 40 36 34 32 30 3 Bihar 60 58 56 52 48 44 43 42 42 42 38 35 32 29 27 27 26 23 4 Chhattisgarh 61 59 57 54 51 48 47 46 43 41 39 38 41 40 38 38 38 37 5 Delhi 37 36 35 33 30 28 25 24 20 18 18 16 13 11 12 12 12 14 6 Gujarat 53 52 50 48 44 41 38 36 35 33 30 30 28 25 23 21 20 20 7 Haryana 57 55 54 51 48 44 42 41 36 36 33 30 30 27 28 27 26 26 8 HimachalPradesh 50 47 44 45 40 38 36 35 32 28 25 23 19 19 17 17 17 14 9 J&K 52 51 49 45 43 41 39 37 34 26 24 23 22 20 17 16 14 14 10 Jharkhand 49 48 46 44 42 39 38 37 34 32 29 29 30 27 25 25 25 29 11 Karnataka 48 47 45 41 38 35 32 31 29 28 24 25 23 21 19 17 15 14 12 Kerala 15 13 12 12 13 12 12 12 12 12 10 10 7 6 6 6 7 5 13 MadhyaPradesh 74 72 70 67 62 59 56 54 52 50 47 47 48 46 43 41 40 37 14 Maharashtra 35 34 33 31 28 25 25 24 22 21 19 19 19 17 16 15 13 14 15 Odisha 73 71 69 65 61 57 53 51 49 46 44 41 40 38 36 35 32 30 16 Punjab 44 43 41 38 34 30 28 26 24 23 21 21 20 19 18 18 16 17 17 Rajasthan 67 65 63 59 55 52 49 47 46 43 41 38 37 35 32 31 30 29 18 TamilNadu 37 35 31 28 24 22 21 21 20 19 17 16 15 15 13 12 11 12 19 Telangana 35 34 31 29 27 23 21 20 18 18 20 UttarPradesh 71 69 67 63 61 57 53 50 48 46 43 41 43 41 38 37 38 37 21 Uttarakhand 28 33 33 34 38 32 31 27 24 23 21 20 22 WestBengal 38 37 35 33 31 32 32 31 28 26 25 24 22 20 19 18 17 17

Source:SampleRegistrationSystem(SRS),Registrar General of IndiaAnnexure referred inreply to part(b)of Lok SabhaUnstarred Q.No 1292to beansweredon06.02.2026 Annexure III MaternalMortalityRatio (per1,00,000 live births) S.No. India/States 2007-09 2010-12 2011-13 2014-16 2015-17 2016-18 2017-19 2018-20 2019-21 2020-22 2021-23 India 212 178 167 130 122 113 103 97 93 88 88 1 Andhra Pradesh 134 110 92 74 74 65 58 45 46 47 30 2 Assam 390 328 300 237 229 215 205 195 167 125 110 3 Bihar 261 219 208 165 165 149 130 118 100 91 104 4 Jharkhand 76 71 61 56 51 50 54 5 Gujarat 148 122 112 91 87 75 70 57 53 55 51 6 Haryana 153 146 127 101 98 91 96 110 106 89 89 7 Karnataka 178 144 133 108 97 92 83 69 63 58 68 8 Kerala 81 66 61 46 42 43 30 19 20 18 30 9 Madhya Pradesh 269 230 221 173 188 173 163 173 175 159 142 10 Chhattisgarh 141 159 160 137 132 141 146 11 Maharashtra 104 87 68 61 55 46 38 33 38 36 36 12 Odisha 258 235 222 180 168 150 136 119 135 136 153 13 Punjab 172 155 141 122 122 129 114 105 98 92 90 14 Rajasthan 318 255 244 199 186 164 141 113 102 87 86 15 Tamil Nadu 97 90 79 66 63 60 58 54 49 38 35 16 Telangana 81 76 63 56 43 45 50 59 17 Uttar Pradesh 359 292 285 201 216 197 167 167 151 141 141 18 Uttarakhand 89 99 101 103 100 104 91 19 West Bengal 145 117 113 101 94 98 109 103 109 105 104 20 Other States 160 97 96 85 77 77 71 81 86

Source: SampleRegistrationSystem(SRS),Registrar General of India