More than one in four births in India now surgical, Health experts urge caution

India is experiencing a sharp rise in Caesarean section (C-section) births, prompting concern among health experts about the increasing dependence on surgical deliveries. Government data presented in Parliament shows that C-section procedures have grown more than four-fold over the past 16 years from about 12.03 lakh in 2008-09 to over 54.35 lakh in 2024-25 . In contrast, the total number of reported births has remained largely stable, increasing only marginally from 1.88 crore to 1.98 crore during the same period.

As a result, C-sections now account for approximately 27.46% of all deliveries , meaning more than one in four births in the country occurs through surgery. The proportion has climbed steadily, crossing 10% in 2012-13 , exceeding 20% in 2020-21 , and continuing to rise each year thereafter.

Experts attribute the surge to a mix of medical, demographic and systemic factors. Clinically, a growing number of pregnancies are considered high-risk due to advanced maternal age, multiple pregnancies, prior C-sections, fetal distress, prolonged labour and maternal complications . Improved prenatal screening and hospital-based care also lead to earlier detection of risks, often resulting in surgical intervention.

Social changes have further influenced the trend. Many women are delaying childbirth, especially in urban areas, increasing the likelihood of complications. Additionally, patient preferences including fear of labour pain and the appeal of planned deliveries are playing a role. Higher C-section rates in private hospitals suggest that institutional factors such as scheduling convenience and medico-legal concerns may also contribute.

Despite the rise in surgical births, maternal and infant health indicators have improved significantly, according to official government data. India’s Maternal Mortality Ratio (MMR) declined from 212 in 2007-09 to 88 in 2021-23 , as per the Sample Registration System (Registrar General of India). Meanwhile, the Infant Mortality Rate (IMR) fell from 57 in 2006 to 25 in 2023 , based on estimates from the Sample Registration System and the Ministry of Health and Family Welfare. However, experts caution that unnecessary C-sections carry risks including infections, longer recovery, higher costs, and complications in future pregnancies underscoring the need for careful monitoring and promotion of safe normal deliveries.