C-Section Rate in Private Hospitals Jumps to 56%, Far Above WHO Recommendations
Maharashtra has witnessed a dramatic increase in Caesarean-section (C-section) deliveries in private hospitals over the past five years, raising serious concerns among healthcare experts, policymakers, and public health activists. According to data from the state health department, the C-section rate in private healthcare facilities surged from 24% in 2021-22 to 56% in 2025-26, significantly exceeding the World Health Organisation’s recommended population-level rate of 10-15%.
The trend has triggered a debate over the growing reliance on surgical births, with critics questioning whether all procedures are medically necessary.
Government Hospitals Report Lower Surgical Delivery Rates
In contrast to private hospitals, government healthcare facilities recorded a comparatively moderate increase in C-section deliveries, rising from 24% to 33% during the same period. Maharashtra records approximately 14.13 lakh births every year, with deliveries almost equally divided between public and private hospitals.
Data shows that nearly 66% of births in government hospitals are normal deliveries, while only 43% of births in private institutions occur through natural childbirth.
Health Department Says Regulatory Powers Are Limited
Dr A.B. Gadikar, Assistant Director of State Health Services (Maternal Care), acknowledged the growing trend but stated that the health department has limited authority to intervene.
According to Dr Gadikar, while sample audits and guidelines are regularly issued, the department cannot prohibit the use of a life-saving medical procedure. He cited factors such as delayed pregnancies and clinical decision-making by doctors as possible reasons behind the increase.
He also noted that the state currently lacks a legal framework to penalise hospitals for performing excessive surgical deliveries.
Activists Raise Concerns Over Unnecessary Procedures
Public health activists have alleged that financial incentives may be contributing to the rising number of C-sections in private healthcare settings.
Health activist Dr Abhay Shukla described the phenomenon as “supplier-induced demand,” claiming that surgeries are sometimes encouraged even when they may not be medically required.
Activists have called for greater accountability and transparency in maternity care, arguing that patients often have little opportunity to verify medical decisions made during labour.
Mothers Share Experiences of Limited Birth Choices
Several women have reported feeling pressured into undergoing surgical deliveries despite their preference for normal childbirth.
One 29-year-old mother said she intentionally selected a doctor known for promoting natural births but ultimately underwent a C-section after her water broke. She said she was informed that her baby’s heart rate was falling but had no way to independently confirm the claim or seek a second opinion during labour.
Another woman, aged 34, alleged that she was not offered the option of a Vaginal Birth After Caesarean (VBAC) during her second pregnancy. According to her, the doctor scheduled a repeat C-section immediately after she reached full term, citing her previous surgical delivery as the reason.
Experts Cite Multiple Factors Behind Rising C-Section Rates
Medical professionals argue that the issue is more complex than simply blaming hospitals or doctors.
Dr Ameya Purandare, President of the Association of Maharashtra Obstetrics and Gynaecological Societies, pointed to several contributing factors, including delayed motherhood, previous C-sections, high-risk pregnancies, and increasing anxiety among expectant mothers.
Meanwhile, Dr Sanjay Gupte highlighted the growing fear of litigation and violence against healthcare professionals. He said many doctors choose C-sections because they are viewed as the safer legal option if complications arise during labour.
Calls Grow for Greater Transparency in Private Healthcare
Veteran gynaecologist Dr Arun Gadre noted that C-section rates in countries such as the United States and the United Kingdom generally remain around 30%, making India’s figures comparatively high.
He argued that stronger regulation of private healthcare facilities is necessary and advocated for oversight mechanisms similar to those implemented in England.
Health activists have suggested that private hospitals should be required to publicly display their rates of C-section and normal deliveries, allowing patients to make more informed decisions about maternity care.
Experts Stress Benefits of Normal Deliveries
Medical experts continue to emphasise that vaginal birth remains the preferred biological option in most uncomplicated pregnancies. Normal deliveries are associated with faster maternal recovery and provide newborns with important microbial exposure that helps strengthen immune system development.
Experts warn that while C-sections are essential and often life-saving in medically necessary situations, unnecessary surgical interventions can expose both mothers and babies to avoidable health risks.
Demand for Clinical Establishment Act Enforcement
Public health advocates believe that stricter implementation of the Clinical Establishment Act could help regulate delivery practices and improve transparency across private healthcare institutions.
With C-section costs in premium hospitals often reaching several lakh rupees, stakeholders are increasingly calling for data-driven monitoring and accountability measures to ensure that surgical deliveries are performed only when medically justified.
