Regional Disparities and Determinants of Caesarean Deliveries in India

  • Bhawna Kathuria Assistant Research Officer, Department of Epidemiology, The National Institute of Health and Family Welfare, New Delhi, India.
  • Sherin Raj TP Assistant Research Officer, Office of the Dean, The National Institute of Health and Family Welfare, New Delhi, India. https://orcid.org/0000-0002-5478-669X
Keywords: C-section, Regional Disparities, Caesarean Delivery, India, Risk factors

Abstract

Background: The caesarean rate in India has been increased from 8.5% (NFHS-III) during 2005-06 to 17.2% (NFHS-IV) during 2015-16.

Objective: The main objective of the study is to assess the regional disparities and determinants of caesarean deliveries in India.

Material and Method: It is a descriptive study. The fourth round of National Family Health Survey, India (NFHS-4), conducted in 2015-16 has been analysed for the purpose of this study.

Result: The study found that the C-section deliveries are significantly higher in southern region followed by western region in India. Social factors such as higher education of mother, residing in urban area, belong to richest wealth group, mothers belong to non-SC/ST category are more likely to opt for C-section delivery. Evidence also indicates that risk factors like high age of mother, high birth order, complicated pregnancy, multiple births, size of child at birth, weight of child at birth significantly influences the decision of C-section deliveries. Institutional and Individual Behavioural Factors such as number of ANC visit, place of delivery, access to mass media are also significant determinants of opting C-section delivery. Delivering high quality timely care and counselling measures throughout the gestation period as a measure to minimise C-section deliveries is the responsibility of every midwife healthcare provider, is an effective way. There is an urgent need to monitor the deliveries in clinics and hospitals to find out the right balance between demand and provisioning of high quality health care services.

How to cite this article:
Kathuria B, Sherin Raj TP. Regional Disparities and Determinants of Caesarean Deliveries in India. Ind J Youth Adol Health 2020; 7(4): 15-23.

DOI: https://doi.org/10.24321/2349.2880.202018

Author Biography

Bhawna Kathuria, Assistant Research Officer, Department of Epidemiology, The National Institute of Health and Family Welfare, New Delhi, India.

Assistant Research Officer, Department of Epidemiology,

The National Institute of Health and Family Welfare, New Delhi -67

References

Betran AP, Torloni MR, Zhang JJ et al. For the WHO Working Group on Caesarean Section. WHO statement

on caesarean section rates: a commentary. BJOG, 2015.

World Health Organization. WHO Statement on Caesarean Section Rates, Department of Reproductive Health

and Research, 2015. 2019. Available from: https://apps.who.int/iris/bitstream/handle/10665/161442/

WHO_RHR_15.02_eng.pdf;jsessionid=E8750E7EFC1B4501D5B66BECB525A7CE?sequence=1.

Goer H. The thinking woman’s guide to a better birth: Penguin; Tarcher Perigee. The Barkley Publishing Group

Penguin Group (USA) Inc., New York. 1999.

Villar J, Valladares E, Wojdyla D et al. Caesarean delivery rates and pregnancy outcomes: the 2005

WHO global survey on maternal and perinatal health in Latin America. The Lancet 2006; 367(9525): 1819-29.

Mastaki JK. Social predictors of caesarean section births in Italy. Afr Health Sci 2011; 11(4): 560-5.

Khawaja M, Al-Nsour M, Khawaja M. Trends in prevalence and determinants of caesarean delivery

in Jordan: Evidence from three demographic and health surveys 1990-2002. World Health and Population, 2007.

Gibbons L, Belizan JM, Lauer JA et al. Inequities in the use of cesarean section deliveries in the world. Am J

Obstet Gynecol 2012; 206(4): 331.e1-19.

Betrán AP, Ye J, Moller AB et al. The increasing trend in cesarean section rates: global, regional and national

estimates: 1990-2014. PLoS One 2016; 11(2): e0148343.

International Institute for Population Sciences and ICF. National Family Health Survey (NFHS-4), 2015-16.

IIPS, Mumbai, India. 2017. Available from: https://dhsprogram.com/pubs /pdf/FR339/FR330.pdf. 2019.

Singh P, Hashmi G, Swain PK. High prevalence of caesarean section births in private sector health

facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health 2018; 18: 613.

Gilbert A, Benjamin A, Abenhaim HA. Does education level influence the decision to undergo elective repeat

caesarean section among women with a previous caesarean section? J Obstet Gynaecol Can 2010; 32(10):

-7.

Divyamol N, Raphael L, Koshy N. Caesarean section rate and its determinants in a rural area of South India. Int. J Community Med Public Health 2016; 3: 2836-2840.

Amjad A, Amjad U, Zakar R et al. Factors associated with caesarean deliveries among child-bearing

women in Pakistan: secondary analysis of data from the demographic and health survey, 2012–13. BMC

Pregnancy and Childbirth 2018; 18: 113.

Ghosh S. Increasing trend in caesarean section delivery in India: role of medicalization of maternal health. The Institute for Social and Economic Change, Bangalore.2010.

Chacham AS, Perpetuo HO. The Incidence of Caesarean Deliveries in Belo Horizonte, Brazil: Social and Economic Determinants. Reproductive Health Matter 2010; 6(11): 115-21.

Padmadas SS, Kumar SS, Nair SB et al. Caesarean section delivery in Kerala, India: Evidence from a National

Health Survey. Social Science and Medicine 2000; 51: 511-21.

Parikh U, Oza PR. Study of rate, trends and determinants of caesarean section among mothers attending a

tertiary care center in Ahmedabad, Gujarat, India. Int J Intg Med Sci 2018; 5(2): 577-81.

Kaur, J, Singh S, Kaur K. Current trend of caesarean sections and vaginal births. Advances in Applied Science

Research 2013; 4(4): 196-202.

Patel RV, Gosalia EV, Deliwala KJ et al. Indications and trends of caesarean birth delivery in the current

practice scenario. Int J Reprod Contracept Obstet Gynecol 2014; 3(3): 575-80.

Cavallaro FL, Cresswell JA, França GV, et al. Trends in caesarean delivery by country and wealth quintile:

cross-sectional surveys in southern Asia and sub-Saharan Africa. Bull World Health Organ 2013; 91(12):

-22D.

Khan MN, Islam MM, Shariff AA et al. Socio-demographic predictors and average annual rates of caesarean

section in Bangladesh between 2004 and 2014. PLoS One 2017; 11-12(5): e0177579.

Bayrampour H, Heaman M. Advanced maternal age and the risk of cesarean birth: a systematic review.

Birth 2010; 37(3): 219-26.

Neuman M, Alcock G, Azad K et al. Prevalence and determinants of caesarean section in private and

public health facilities in underserved South Asian communities: cross-sectional analysis of data from

Bangladesh, India and Nepal. BMJ Open 2014; 1-4(12): e005982.

Vieira GO, Fernandes LG, de Oliveira NF, et al. Factors associated with cesarean delivery in public and private

hospitals in a city of northeastern Brazil: across-sectional study. BMC Pregnancy Childbirth 2015; 15(1): 132.

Maktha VK, Ghatam A, Padamata H et al. Prevalence and factors associated with caesarean section: a

community based cross sectional study in rural parts of Rangareddy district, Telangana, India. International

Journal of Community Medicine and Public Health 2017; 3(8): 2054-7.

Sing SK, Vishwakarma D, Sharma SK. Prevalence and determinants of voluntary caesarean deliveries and

socioeconomic inequalities in India: Evidence from National Family Health Survey (2015-16). Clinical

Epidemiology and Global Health 2020; 8: 335-42.

Guilmoto CZ, Dumont, A. Trends, regional variations, and socioeconomic disparities in cesarean births in

India, 2010-2016. JAMA Network Open 2019; 2(3): e190526.

Srivastava S, Chaursaia H, Singh KHJK et al. Exploring the spatial patterns of cesarean section delivery in India: Evidence from National Family Health Survey-4. Clinical Epidemiology and Global Health 2020; 8: 414-22.

Published
2021-06-15