“From Care to Commerce: The Changing Face of Childbirth”

India’s steady improvement in maternal health outcomes is undeniable, with the maternal mortality ratio declining from 130 in 2000 to 93 today. Yet, this progress coexists with a troubling rise in caesarean section (C-section) deliveries, raising concerns about the medicalisation—and commercialisation—of childbirth.
The World Health Organization recommends that C-section rates remain around 15%, beyond which the benefits plateau and risks may outweigh gains. India’s national average has climbed to 27%, with private hospitals reporting rates as high as 47%, and states like Telangana nearing 60%. Such figures suggest that factors beyond medical necessity are at play.
The economics of childbirth offers one explanation. A C-section is a predictable, time-bound procedure, often completed within 1–1.5 hours, generating significantly higher revenue compared to a normal delivery that may take 12–16 hours with uncertain outcomes. Post-operative care further enhances hospital earnings, while quicker turnover of beds improves efficiency. Additionally, surgical deliveries are perceived to offer legal safety to practitioners.
However, supply-side incentives intersect with demand-side preferences. The desire for pain-free childbirth, scheduling convenience, and even selection of “auspicious” dates have normalised surgical births. This shift has also marginalised traditional midwifery practices, which once provided continuous emotional and social support to mothers.
The consequences are not trivial. Higher rates of C-sections are associated with increased risks of maternal complications, childhood obesity, respiratory issues, and other long-term health concerns.
Addressing this trend requires more than individual ethics. Strengthening regulatory audits, ensuring informed consent, reviving midwifery, and enhancing public awareness are essential steps. Childbirth must remain a healthcare service, not a business model.

by Shreeram