Cesarean births on the rise in India but Mizoram, Nagaland defy trend: NFHS-5

C-section births in India increased 4.3% — to 21.5% (NFHS-5) from 17.2% (NFHS-4, 2015-16)   

By Taran Deol
Published: Thursday 25 November 2021

An increasing number of women in India have been undergoing a cesarean section (C-section) to deliver babies compared to five years ago, data from the National Family Health Survey 5 (NFHS) on delivery care has revealed.

C-section births in India increased 4.3 percentage points over five years: To 21.5 per cent (NFHS-5) from 17.2 per cent (NFHS-4, 2015-16). 

Nearly half the total C-section births (49.3 per cent) took place at private health facilities in urban areas; in rural areas the figure was 46 per cent. The total number of births increased 6.5 percentage points in private health facilities — up from 40.9 per cent (NFHS-4) to 47.4 per cent (NFHS-5).

As many as 22.7 per cent such births took place in public health facilities in urban areas and 11.9 per cent in rural areas. A jump of 2.4 percentage points has been recorded for such births in public health facilities — to 14.3 per cent (NFHS-5) from 11.9 per cent (NFHS-4). 

A closer look at state-wise data revealed that most states recorded an increase in cesarean births, and most people are choosing private health facilities over public ones. 

States that recorded a jump in cesarean births are:

  • Andhra Pradesh: To 42.4 per cent (NFHS-5) from 40.1 per cent (NFHS-4)
  • Arunachal Pradesh: To 14.8 per cent from 8.9 per cent
  • Chhattisgarh: To 15.2 per cent from 9.9 per cent
  • Assam: To 18.1 per cent from 13.4 per cent

Some states, however, defied this trend.

Goa, for instance, recorded an increase of 8.1 percentage points in cesarean births: To 39.5 per cent from 31.4 per cent, but a decrease in cesarean births at private hospitals (down to 50 per cent from 51.3 per cent).

More C-section surgeries were conducted at public health facilities: To 31.5 per cent from 19.9 per cent.

Tripura too recorded an increase in cesarean births: To 25.1 per cent from 20.5 per cent. But such births declined in private health facilities (down to 69.3 per cent from 73.7 per cent) — and up from 18.1 per cent to 22.7 per cent in the public ones.

Kerala recorded an increase in C-section births to 38.9 per cent from 35.8 per cent. While it has seen an increase in cesarean births taking place at both private and public health facilities, the margin is greater for the latter — 1.3 percentage points in private facilities in comparison to 5.8 percentage points for the public.

Nagaland and Mizoram painted an entirely different picture: They recorded a decrease in cesarean births. Cesarean births accounted for 10.8 per cent of total births in Mizoram (NFHS-5) [from 12.7 per cent (NFHS-4)] and 5.8 per cent in NFHS-5 in Nagaland [from 5.2 per cent in NFHS-40].

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