Balancing the knife: India debates the pros and cons of pushing caesarean sectionsBMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1915 (Published 03 August 2022) Cite this as: BMJ 2022;378:o1915
- Kavitha Yarlagadda, freelance journalist
Lakshmi was due to deliver her baby in a week, so her in-laws called an astrologer to find the perfect “muhurat”—an auspicious time and day—to have the baby delivered through caesarean section.
Muhurat deliveries have become a trend in India, with families believing that a task performed at a certain time on a given day gives a positive result. This belief, mixed with other reasons such as fear of labour and desire for a painless delivery, is pushing more Indian women to opt for caesarean sections to deliver their babies.
The rate of caesarean deliveries in India more than doubled from 8% in 2005 to 17% in 2016. According to the most recent (2019-21) data from the National Family Health Survey conducted by the Ministry of Health and Family Welfare, the number of caesareans performed in India rose from 17.2% in the previous (2017-19) survey to 21.5%. (For comparison, in the US 31.8% of live births were caesareans in 2020,1 while in the UK one in four women giving birth has a caesarean.2)
With one of the highest rates of infant mortality in the world—27 deaths out of every 1000 live births in 2021, according to data from the Organisation for Economic Co-operation and Development—the rise in caesareans should be a good thing. But measures seeking to make them more available to women in need are clashing with moves to cap the trend …