While the World Health Organization holds that Caesarean section (C-sec) is required at the most in 10-15% of all deliveries—beyond that, studies show, there are no significant gains in terms of reducing neonatal or maternal mortality—private sector hospitals in India, as per the National Family Health Survey data, witness record-high levels of C-sec deliveries. In Tripura, 87.1% of all deliveries in urban private-sector hospitals were C-sec ones (compared to 36.4% in government ones), while in Haryana, where such deliveries are the lowest, 25.3% of deliveries in urban private-sector hospitals were C-sec ones (compared to 10.7% in the government sector).
It is true that many women opt for C-sec of their own accord, but the fact is that the high rates stoke the perception that private sector healthcare prescribes these, perhaps, even due to considerations of revenue targets. There is increasing realisation in developed economies—where medical insurance penetration is higher—that unnecessary surgeries, apart from eating into available healthcare infrastructure, impose a significant economic burden. There is also presumably a human cost—a recent study shows that doctors (assuming they are better-informed than the average patient) are less likely to choose C-sec for their own deliveries. While bringing down the frequency of surgically-mediated deliveries depends on both creating an incentive structure for hospitals and on greater patient awareness, the government could also get involved—in the US, for instance, the Federal Department of Health and Human Services has set a goal of limiting C-sec deliveries to 23.9% of all low-risk delivery cases by 2020.