Caesarean Section Rates Going Up

Our Past President, Professor CN Purandare, spoke at the 61st All India Congress of Obstetrics and Gynaecology where he expressed his concern at the rising rates of caesarean sections.

In conversation with Dr Swati Naik, who refers to our President as the 'Father Figure of Obstetrics and Gynaecology' Professor Purandare highlights the controversy surrounding the numbers of caesarean sections being carried out when a normal delivery is necessary. He comments:

"People now feel that caesarean sections are safer than doing instrumental vaginal delivery, which is the wrong assumption"

In India, the annual rate is 17.2% overall and numbers vary from city to city.

Since 1985 the World Health Organisation (WHO) has recommended the ideal rate for caesarean sections to be between 10-15%, to reduce maternal mortality. Professor Purandare states that there needs to be an up to date figure.

He believes the landscape of obstetric care has “changed drastically from what the 1985 thinking was.” Women are now becoming pregnant later in life because of reasons such as work commitments and IVF treatment. Caesarean sections are therefore carried out for a variety of reasons.

He emphasises the need for training to "revive the art of obstetrics" and therefore bring the rates of caesarean sections down. Both women and obstetricians should be educated to combat this growing trend and ensure caesarean sections are only carried out for women who are in need.

"We need to introspect, from both sides to see whether women who are demanding caesarean sections need to be educated as well. The obstetricians really need to retrain themselves to make sure that they are able to reduce the caesarean section rate by doing various other procedures as well"

Professor Purandare believes there should be a focus on delivering "naturally and normally as far as possible". FIGO has published guidelines on how to bring about the change in caesarean section rates, and he emphasises that "FIGO’s recommendation is to make sure that the caesarean section rate is brought down".

View his full interview: