With the World Health Organisation (WHO) making it clear on Friday that the Caesarean section procedure for delivery should be performed only when there's a medical need, the focus is back on the rising number of Caesarean deliveries in India.
The Muhurat baby is facing criticism.
With the World Health Organisation (WHO) making it clear on Friday that the Caesarean section procedure for delivery should be performed only when there's a medical need, the focus is back on the rising number of Caesarean deliveries in India.
The Muhurat baby is cited as one reason.
According to WHO, since 1985, the international healthcare community has considered the "ideal rate" for C sections to be between 10 and 15%.
In Mumbai, one in four babies is delivered by C-section, Dr Ameet Patki, president, Mumbai Obstetrics and Gynaecology Society (MOGS), said.
"There has been a rise in C-section cases in the last 20 years. Patients themselves insist on C-section. Muhurat baby is one reason. Doctors shouldn't entertain such requests and go for it only when medically required," Patki said.
Brihanmumbai Municipal Corporation (BMC) data shows that, in 2013, Caesarian delivery rate in private hospitals was 37.81%. It was 19.77 % in civic hospitals.
Studies show that when C section procedures rise towards 10% across a population, the number of maternal and newborn deaths decreases. When it goes above 10%, there is no evidence that mortality rates improve.
Now, seeing the rise in cost and high rates of C sections in high and middle-income countries, WHO has asked gynaecologists to adopt the internationally accepted Robson classification system.
WHO feels C-section may be necessary when vaginal delivery might pose a risk to the mother or the baby like prolonged labour, foetal distress or if the baby is in an abnormal position.
Dr Abhay Shukla, national co-convener of the Jan Swasthya Abhiyan, said, "I agree with WHO. There is a rising trend in C-section deliveries across the country, mainly in urban areas. Private hospitals, doctors and patients are responsible for this. It's like a supplier- induced demand."
"For C-section procedures, hospitals get more money and doctors spend less time per patient. That's why it's becoming popular," he said.
"For normal delivery, doctors have to sometimes spend 12-15 hours at a stretch, whereas C section can be finished in an hour. Also, in urban areas patients don't want to tolerate labour pain," said Dr Shukla.
The government should introduce a standard treatment guideline on C-section procedures, he suggested.
Dr Bipin Pandit, joint secretary, Federation of Obstetrics and Gynaecology Society of India (FOGSI), says to prevent this trend, emphasis should be placed on normal delivery during seminars and workshops. "We have been discouraging Muhurat baby demands. Request of timing is granted only if doesn't compromise the health of the baby and the mother," he said.
FOGSI is an umbrella body of gynaecologists in India with more than 30,000 members. Like FOGSI, MOGS has also decided to forward the WHO statement to its 3,000 members.
Late marriages and increased infertility rate have also added to the rise in C-section procedures, says Dr Kiran Coelho, gynaecologist at Lilavati Hospital, Bandra.
Robson classification
Proposed in 2001, the Robson classification is an internationally accepted system that classifies women into 10 groups, based on their obstetric characteristics (parity, previous CS, gestational age, onset of labour, fetal presentation and the number of fetuses).This classification has become very popular in many countries.
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