Parliament Question: Rising Caesarean Deliveries

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 3390 TOBE ANSWERED ON 7TH AUGUST2026 RISING CAESAREAN DELIVERIES 3390.DR. BACHHAVSHOBHADINESH: Will the MINISTER OFHEALTHAND FAMILYWELFAREbe pleased tostate: (a) whether the Government has taken cognisance of the consistently high and rising rates of caesarean section deliveries in private healthcare institutions, significantly exceeding the benchmarkrecommended by the WorldHealthOrganization; (b) if so, the details of caesarean and normal deliveries reported during the last five years with specific reference toMaharashtra; (c) whether the Government has undertaken any assessment of non-clinical factors contributing to this trend including institutional practices, financial incentives, medico-legal considerations and socio-cultural preferences influencing the elective caesarean procedures across the country, if so, the detailsthereof,State/UT-wise, and (d) the regulatory, monitoring and corrective measures taken/proposed to be taken by the Government to discourage unnecessary caesarean deliveries and safeguard maternal and neonatalhealthoutcomes? ANSWER THEMINISTEROFSTATEINTHEMINISTRYOFHEALTHANDFAMILY WELFARE (SMT.ANUPRIYAPATEL) (a) & (b) The rate of caesarean section deliveries in private healthcare institutions and the details of caesarean section and total institutional deliveries reported over the last five years for Maharashtra, are placedat the Annexure. (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’ andReceivers’ Perspectives’’, mentionsthe main reasons behind the increase rate 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), various measures/initiatives have been taken todiscourage unnecessary caesarean deliveriesacross allStates/UTs. The keymeasures are:  CGHS empaneled hospitals are required toprominently display information regarding the ratioof deliveries byCaesarean section vis-à-visnormal deliveries.  Data Reportingandmonitoring hasbeenstrengthened at healthcare facilities.  Under National Quality Assurance Standards (NQAS), a dedicated C-section audit component is embedded in the assessment checklist for Maternity OTs for all Government 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 maternal and neonatal health outcomes, the Government of India has taken following initiativesunder NHM:  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 services for 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 areas. *****Annexure Annexurereferred to in replyto parts(a) & (b)of Lok Sabha UnstarredQ.No. 3390 to beanswered on07.08.2026 Details of InstitutionalDeliveriesandC-sections inMaharashtra aspertheNational FamilyHealthSurvey(NFHS) NFHS-5 NFHS-6 S.No. Indicator (2019-21) (2023-24) 1 Institutional Births (%) 94.7 96.4 2 Births delivered byCaesarean Section(%) 25.4 33.6 Births ina Private healthfacilitythat were 3 39.1 48.5 deliveredbyCaesarean Section(%)