Telangana leads, Nagaland trails in India’s uneven C-section delivery rates

A recent report published in *The Lancet* reveals significant regional and economic disparities in caesarean delivery rates across India, with the national average standing at 21.5 per cent. Telangana records the highest rate at 60.7 per cent, followed by Tamil Nadu (44.9 per cent) and Andhra Pradesh (42.4 per cent), attributed to better healthcare access, higher literacy, and additional financial incentives beyond the government’s Janani Suraksha Yojana (JSY) scheme. In contrast, northeastern states like Nagaland (5.2 per cent), Meghalaya (8.2 per cent), and Bihar (9.7 per cent) have the lowest rates, where a preference for vaginal deliveries due to affordability and shorter recovery periods remains prevalent.

The report, based on data from the fifth National Family Health Survey, highlights that caesarean deliveries are significantly more common in private hospitals compared to public facilities across all economic groups. On average, 47.5 per cent of deliveries in private hospitals are conducted via C-section, compared to just 14.3 per cent in public hospitals. Wealthier populations have greater access to C-sections, with over two-thirds of Indian states showing at least double the C-section rates among the richest compared to the poorest. Assam reports the most significant gap between the wealthiest and poorest sections in caesarean deliveries.

Additionally, the report points out the growing reliance on private healthcare, particularly among high-income groups, while low-income populations predominantly depend on public facilities that often face resource limitations. Births in public hospitals decrease from the poorest to the richest groups, while they increase in private hospitals, underlining the economic divide in healthcare access. The study underscores the challenges faced by lower-income groups in accessing quality maternity care and the dual nature of India’s healthcare system, where private hospitals cater primarily to those who can afford them, while public hospitals struggle to meet the needs of economically disadvantaged populations.