Use of sections doubled in India between 2005 and 2015: Lancet

Caesarean Section is most done surgery on pregnant mothers for conduction of Delivery of new born by Obstetrician throughout the World as it is most needed to save the life of new born if the foetus is any stress inside womb or the process to get foetus delivered by other method of delivery may endanger life of baby or mother or mother life is risk due to unwanted complication of pregnancy .But our Government has issued circular that audit of caesarean section should be done in every Government and private setup as its percentage has increased .Government think Doctors adopt this operation for ease of doing delivery early without undergoing exhaustive procedure of normal vaginal or vaginal instumental delivery as these procedures some time need long hours of observations of foetus and mother during delivery,less risky for foetus and mother in these days of growing consumer,civil and criminal cases against Doctors beside earning excessive money in private sector.

                   The number of children born in India through Caesarean sections increased from 9% in 2005-6 to 18.5% 2015-16, according to a series of three papers published in The Lancet Journal, which also found that C section was used almost twice worldwide between 2000 and 2015.While the operation is still unavailable to many women and children in low-income countries and regions, the procedure has been overused in many medium and high-income settings, researchers said, including those from Ghent University in Belgium.

         In the 10 countries with the highest number of born in the period 2010-2015, there were large differences in cesarean sections or the use of C sections between regions. For example, differences between the provinces in China ranged from 4% to 62%, and the differences between the states in India ranged from 7% to 49%.Globally, the use of sections has increased by 3.7% each year between 2000 and 2015 – increased from 12% of live born (16 million to 131.9 million) in 2000 to 21% of live born (29.7 million) of 140.6 million) by 2015, researchers said. 

In India, the use of section increased from 9% of birth 2005-6 to 18.5% 2015-16, found the research.The C-section is a life-saving intervention for women and neonates when complications occur, such as bleeding, birth defects, hypertensive disease, and children in abnormal condition.But the surgery is not without risk to mother and child and is associated with complications in future birth, researchers said. It is estimated that 10-15% of the birth requires medical C-section due to complications, indicating that the average use of the C-section should be between these levels.

    In at least 15 countries, the C-section exceeds 40% of researchers said.The South Asia region has seen the fastest use increase (6.1% per annum), with the C-section underutilized in 2000 but over-exploited until 2015 (rising from 7.2% of birth through C-section to 18.1%)   .Improvements have been slow in sub-Saharan Africa (approximately 2% per annum), where the use of the C sector has been low, increasing from 3% to 4.1% of birth in West and Central Africa, and from 4.6% to 6.2% in Eastern and Southern Africa.

      "In view of the increasing use of the C-section, even when not needed medical, there is an important need to understand the health effects for women and children," says Professor Sand Sandall from King's College London.

           Simply for increasing caesarean sections even in Government setup,questioning of Doctors by Government is highly debatable as most of the time is need of hours as mother and relatives always want prompt and best safe method of delivery having no complication to mother and new born and in era of high legal suits and watching electronic and print media Doctors donot want to bear any chance of litigation of course the mentality of Doctors to give more time to Delivery for long exhaustive observation and regulation of Delivery of new born for conduction of Delivery by normal Vaginal procedures  has also decreased but such audit or punishment of Doctors may not yield any positive outcome as in this study conducted in many countries.