Childbirth trends in India concern me deeply—while C-sections are lifesavers in emergencies, alarmingly high rates in certain areas suggest over-medicalisation that endangers mothers without added benefits. The latest NFHS analysis highlights three districts with private hospital caesarean rates over 90%: Murshidabad and Nadia in West Bengal, and Karimnagar in Telangana—the highest nationally. These pockets showed little change from 2016 to 2021, even as public sector rates dipped slightly (1.2 percentage points) and private rose (2.1 pp).
Telangana leads with many districts above 95% across both sectors, while Tamil Nadu's public facilities also rank high. Nationally, private hospitals hit 48% caesareans versus 14% public. WHO guidelines stress rates above 10% offer no mortality reduction, yet India's variation is stark—northern states like Bihar remain low. Dr Subramanian notes state-level concentration demands targeted policies: mandatory audits, better public infrastructure, addressing beliefs around "good dates" and urban convenience.
In my view, profit incentives and fear of complications often override necessity—Lancet data shows maternal deaths 100 times higher post-surgery in LMICs. Encouraging some declines, but these hotspots need urgent intervention to protect natural birth options and maternal safety.
TL;DR
- Murshidabad and Nadia districts in West Bengal, along with Karimnagar in Telangana, record over 90% caesarean deliveries in private hospitals, making them India's top hotspots according to NFHS-5 and NFHS-6 data analysis.
- These high rates showed minimal change between 2016 and 2021 surveys, highlighting persistent over-medicalisation in specific regions despite national trends.
- Telangana stands out with numerous districts exceeding 95% caesarean rates across both public and private sectors in recent surveys.
- Tamil Nadu's public facilities also feature prominently in high-prevalence districts, with private sector rates rising from 30% to 50% in several areas.
- Nationally, private hospitals perform caesareans in 48% of deliveries compared to just 14% in public facilities.
- Public sector rates declined by 1.2 percentage points while private increased by 2.1 percentage points from NFHS-5 to NFHS-6.
- WHO recommends caesarean rates of 10-15% at population level, warning higher figures offer no additional mortality benefits.
- Excess surgeries often stem from non-medical factors like preferred "auspicious" delivery dates or convenience for doctors and families.
- Experts call for state-specific interventions including mandatory audits and improved public infrastructure to reduce unnecessary procedures.
- High caesarean rates linked to increased maternal and neonatal risks, especially in low- and middle-income settings per global studies.
