Bengaluru: In an effort to curb the rising number of cesarean deliveries, the Karnataka Health Department is planning to introduce labour analgesia services in government hospitals, officials said. Currently, nearly 47 per cent of institutional deliveries in the state are C-sections, a figure far higher than recommended levels.
The proposed initiative focuses on reducing fear of labour pain, a key factor driving women toward surgical deliveries. The pain-management options under consideration include epidural analgesia and nitrous oxide (laughing gas).
Why the Move?
A pilot study in Tumakuru found that C-section rates significantly exceeded optimal levels, with fear of pain during childbirth emerging as a major deterrent to natural deliveries.
Principal Secretary (Health) Harsh Gupta said the findings showed C-section rates were higher than medically justified. “Introducing labour analgesia is expected to reduce anxiety and encourage women to opt for vaginal deliveries,” he said.
Pain-Relief Options
- Epidural analgesia: A regional anaesthetic injected into the lower back, relieving labour pain while keeping the mother awake and alert.
- Nitrous oxide: A self-administered gas-oxygen mixture that provides mild pain relief and reduces anxiety during contractions.
Gupta noted that epidurals will require additional trained anaesthetists, and the department is currently assessing manpower allocation. Nitrous oxide, meanwhile, can be administered by the mother herself during contractions, though availability remains a challenge.
Beyond Analgesia
The health department is also consulting experts on:
- Alternative birthing positions
- Expansion of water births, music therapy and aromatherapy, currently available at Vani Vilas Hospital, to other government facilities
Training programmes are being planned for doctors, nurses and midwives to promote vaginal births, including for women with previous C-sections. Expectant mothers will also be encouraged to maintain a healthy diet, exercise and yoga during pregnancy.
Concern Over Maternal and Neonatal Health
In 2024–25, 47 per cent of institutional deliveries in Karnataka were C-sections, which the government sees as a contributor to maternal mortality.
“Higher C-section rates increase the risk of complications such as sepsis, oxygen deprivation to the baby and maternal mortality. Studies also show immunity levels may be lower in babies born via C-section,” Gupta said, adding that such information will now be included in surgery consent forms to help mothers make informed choices, reports TOI.
Expert Views
Dr Pranathi Aravind, senior consultant (OBG) at Gleneagles BGS Hospital, said fear of labour pain—often shaped by stories from older generations—pushes many women toward elective C-sections. Labour analgesia, she noted, can significantly improve the birthing experience and encourage natural deliveries.
Dr Madhva Prasad, associate professor of OBG at St John’s Hospital, welcomed the move but cautioned that epidurals require investment in skilled anaesthetists. “Along with analgesia, counselling, a supportive birthing environment, availability of doctors, and allowing a birthing companion should also be prioritised,” he told TOI.
The programme is expected to be rolled out in phases as the state works to reduce unnecessary C-sections and improve maternal and newborn outcomes.
