A recent study published in TheLancet Regional Health-Southeast Asiareveals a notable correlation between income levels and the probability of undergoing cesarean section (C-section) deliveries in India. The data from theNational Family Health Survey-5(2019-21) highlights that women from high-income quintiles are more likely to opt for C-sections, even in government hospitals.

What Are Wealth Quintiles and How Do They Impact C-Section Rates?

Wealth quintiles are statistical values that divide a population into five equally sized groups based on wealth. Each quintile represents 20% of the population. The study revealed that merely 6% of women in the lowest wealth quintile (the poorest) underwent C-section deliveries in public hospitals across India. In stark contrast, the incidence of C-sections is higher among the higher-income groups.

How Does Economic Status Influence Cesarean Section Rates in India?

The study indicates the percentage of women undergoing C-section delivery at public hospitals across various categories. The different categories, including poorer, middle, richer, and richest, stand at 11%, 18%, 21%, and 25%, respectively. The data reveals a clear pattern that women from higher-income groups are more likely to choose C-sections. It also highlights the disparity in medical practices influenced by economic status.

Why Do Poorer Women Have Limited Access to C-Sections?

Dr. Anita Gadgil, co-corresponding author of the study, highlighted that one major reason for the lower rate of C-section deliveries among the low-income is lack of awareness. Furthermore, poorer women often face challenges in reaching higher centers where C-section deliveries are available. They may lack the financial means to do so. The access issue significantly impacts their ability to choose C-sections when medically necessary.

What Explains Regional Variations in C-Section Rates Across India?

The study further highlights the regional disparities in C-section rates. Southern states such as Kerala, Tamil Nadu, and Andhra Pradesh have high C-section delivery rates, sometimes up to 60%. Conversely, states with predominantly poor populations like Bihar, Assam, and Chhattisgarh have much lower rates. The regional difference highlights the varying accessibility and acceptance of C-sections across different parts of India.

What Are the Risks of High and Low Cesarean Section Rates in India?

High C-section rates in wealthier groups suggest overuse without medical necessity, leading to adverse health outcomes, unnecessary expenditure, and strain on public health resources. Conversely, low rates in poorer populations indicate inadequate access to necessary medical procedures, potentially resulting in maternal and newborn mortality and morbidity. The dual issue of overuse and underuse highlights the need for a balanced approach to C-sections.

How Can India Ensure Equal Access to C-Section for All Women?

The study suggests that raising awareness about government schemes provides financial support for C-section. It also enhances access to healthcare facilities in rural and poorer areas helping address these disparities. By making these services more accessible and affordable, the government can ensure that all women, regardless of their income level, have equal access to necessary medical procedures.

By addressing these disparities, India can progress towards a more inclusive and effective healthcare system. Tackling both overuse in wealthier groups and underuse in poorer populations can lead to better health outcomes for mothers and their babies across the country.

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