Research Highlight

Caesarean delivery numbers vary across India

Disparity more among poor women

doi:10.1038/nindia.2021.123 Published online 27 September 2021

The number of caesarean deliveries are more in private healthcare facilities in India than public ones1. This disparity, seen more among less-educated and poor women, has increased over the past 15 years.

A variation in caesarean delivery numbers is prominent across states and within various public facilities, researchers from the US-based Harvard University and the Banyan Academy of Leadership in Mental Health in Thiruvidandai, India have found. 

They analysed 136,985 births within 27,218 communities, 640 districts and 36 states. Of these, 19.3 per cent were born via caesarean delivery. Though most births took place in public facilities, caesarean deliveries occurred more frequently in private facilities.

India has seen a steady rise in caesarean deliveries, which have doubled between 2006 and 2016. 

The researchers, led by S. V. Subramanian, found that state-specific prevalence varied from a low of 10.7 per cent in Bihar to a high of 62.1 per cent in Telangana. Of the total geographic variation in caesarean delivery, 44 per cent was attributable to states, followed by communities (32%), and, lastly, districts (24%).

High caesarean prevalence observed in some states may be to some degree composed of medically unnecessary caesarean deliveries. “This may adversely affect the health of mothers and babies," says Subramanian. This also blocks resources that may be allocated to other important healthcare needs, he says.


1. Rodgers, J. et al. PaediatrPerinat. Epidemiol. (2021) Doi: