Take steps to reduce C-section deliveries: Health department to doctors

Doctors say fear of labour pain, parents wanting muhurat-based birth are reasons for increase in caesarean deliveries. Representation pic

The increasing number of caesarean deliveries in Maharashtra has prompted the state health department to again remind Federation of Obstetric and Gynaecological Societies of India (FOGSI) to ask its members to follow the modified criteria for deliveries as announced in 2017 to help reduce the number of C-section deliveries.

As per data from the state health department, private hospitals across the state conducted 7,88,882 deliveries in the 2017-18. Of this, 1,88,963 or 24 per cent were C-sections. This year till October, the number of deliveries at private hospitals across the state stood at 5,00,461 of which 1,76,126 or 35 per cent were caesarean deliveries. This means the state saw a 9 per cent rise in C-section deliveries in the past six years.

The health department, in its letter dated December 16 to FOGSI, stated, "A committee of experts was constituted under the implementation of Modified Robson's criteria of FOGSI in private hospitals according to the World Health Organization's criteria for caesarean delivery and updating the information of these hospitals on the website under the Manyata programme and informing all members about the guidelines and giving a checklist for C-section through FOGSI, reference was informed through a letter in 2017. However, we are again informed that since the subject is very sensitive, it is frequently asked and objected to at the government level as well as by various NGOs, so we have given instructions to all our members to implement Modified Robson's criteria for emergency caesarean delivery in private hospitals."

Also read: Mumbai: Two doctors booked for death of woman, baby after C-section in Ghatkopar

In 2015, WHO proposed the use of the Robson classification, also known as the 10-group classification, as a global standard for assessing, monitoring and comparing caesarean section rates both within healthcare facilities and between them. Doctors said there were various reasons behind the rise in caesarean deliveries such as fear of labour pain and parents' demand that babies be delivered based on muhurat (auspicious occasion).

Dr Ashok Anand, head of the department of obstetrics and gynaecology at JJ hospital, said, "Women these days don't want to bear labour pain and insist doctors do C-sections. Also many demands for Muharat delivery which is only possible through C-section. Many private hospitals don't have sufficient manpower to keep observing the patient in case of normal delivery which takes more time while C-sections are done within 1 or 2 hours. There might be a possibility that few hospitals do this to earn more. These practices should stop immediately."

"Doctors should encourage women to go for natural delivery. Though C-section is a big achievement for the medical field, it should not be undertaken when there is no valid need for it. Doctors also opt for C-sections to save time and not take risks, which is not right," said Dr Rekha Davar, senior obstetrician and gynaecologist. mid-day's attempts to get a response from FOGSI did not yield results. However, a member said, "In such a situation, the board will hold a meeting first and then the members are told to follow the protocol decided by the government and adopt the best practices to reduce C-sections in the state."

9
Percentage of rise in C-section deliveries in past 6 years