National Family Health Survey: ‘Nearly 50 per cent of deliveries in pvt facilities through C-section’

🔴. Overall, there has been a four-point rise in the number of C-sections in the last five years in the country. Against 17.2% C-section births (NFHS-4), the fifth round of NFHS pegs the figure at 21.5%.

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The rise in C-section births is not just limited to private healthcare facilities but shows a 3% rise in public health facilities as well. (Representational)

ALMOST HALF of the deliveries in private institutions in the country were through Caesarean section. The percentage at private facilities has gone up to 47.4, according to data from the fifth round of the National Family Health Survey (NFHS-5), up from 40.9 per cent in the last survey (2015-16).

Overall, there has been a four-point rise in the number of C-sections in the last five years in the country. As against 17.2 per cent of C-section births (NFHS-4 2015-16), the fifth round of NFHS survey now pegs the figure at 21.5 per cent.

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The rise in C-section births is not just limited to private health care facilities, but shows a 3 per cent rise in public health facilities as well. Across public health care facilities, the percentage of C-section births according to NFHS-5 data is 14.3 as against 11.9 per cent in the last survey.

The World Health Organisation (WHO) recommends that caesarean deliveries should not exceed 10-15 per cent of all deliveries in any country. The International Institute for Population Sciences, Mumbai, is the nodal agency of the survey. The fieldwork for NFHS-5 was done in two phases, from June 2019 till January 2020, and the second phase from January 2020 till April this year. Information was gathered from 6.36 lakh households, 7.24 lakh women and 1.01 lakh men.

According to NFHS-5 data, the overall percentage of C-section births in the last five years has shown a rise in Haryana (11.7 to 19.5 per cent), Jharkhand, (9.9 to 12.8per cent) Madhya Pradesh (8.6 to 12.1 per cent) and Odisha (13.8 to 21.6per cent), Punjab (24.6 to 38.5per cent) Tamil Nadu (34.1 to 44.9 per cent), Uttar Pradesh (9.4 to13.7per cent), Uttarakhand (13.1 to 20.4 per cent) Kerala (35.8 to 38.9 per cent), Maharashtra (20.1 to 25.4per cent) Goa (31.4 to 39.5 per cent), Gujarat (18.4 to 21 per cent) and Union territories like Chandigarh (22.6 to 31.3per cent).

Delhi has shown a slight dip from 26.7 to 23.6 per cent in C-section births. Mizoram has shown a reduction from 12.7 per cent in 2015-16 (NFHS-4) to10.8 per cent in the fifth round of the NFHS survey. Nagaland also shows a slight decrease in C-section births at 5.8 per cent (NFHS 2015-16) and 5.2 per cent in the latest round.

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Dr K S James, Director of the International Institute of Population Sciences told The Indian Express that the ideal rate for caesarean sections should be between 10 per cent and 15 per cent. According to experts, the situation has become grim and the physician-induced demand can be controlled. “The rise in C-section deliveries in the government sector could also be due to complicated cases being referred to the public health facilities during the last stages,” Dr James said.

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Dr Sanjay Gupte, former President of Federation of Obstetric and Gynaecological Societies of India (FOGSI) attributed this rising trend to various reasons, including late pregnancies, increasing use of reproductive techniques, more obesity and lifestyle changes and overall demand by patients to avoid complications.

“A crucial factor is neither the patient nor the doctor wants to take any risk as fear of complications can lead to legalities. According to guidelines in Western countries, for instance, even if there is an unfortunate death of the infant, then the doctor is legally protected. However, in our country there is a need for such authentic guidelines so that the government and judiciary can agree for protection towards the doctor in the event of medico legalities,” Dr Gupte told The Indian Express.

Dr Gupte also challenged set notions that the doctor earns more for performing a C-section vis-a-vis a normal delivery. “The cost varies according to the facility. The doctor does not stand to earn more for a C section, other charges are taken into consideration,” he pointed out. Usually, at a good facility, the cost of a C-section is between Rs 90-95,000, while a normal delivery is in the range of Rs 60-65,000.

A majority of states C-section births have indicated a significant rise in both private and public health care facilities. In states like Arunachal Pradesh C-section births have risen from 8.9 per cent to 14.8 per cent. At private healthcare facilities, 47.3 per cent of Caesarean births took place as against 37.5 per cent in the last survey. In the public healthcare facilities too, there is a five-point rise from 12.5 to 17 per cent.

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Chhattisgarh also shows a similar trend with a rise in such births from 9.9 per cent to 15.2 per cent. In the private sector too, there has shown 57 per cent C-section births as against 46.4 per cent in the last survey at private healthcare facilities. In the public facilities, the rise is from 5.7 per cent to 8.9 per cent.

Across private facilities in Jharkhand, the percentage of C-section births was 39.5 per cent in the last survey, which went up to 46.7 per cent. Similarly in Madhya Pradesh, the rise is from 40.8 to 52.3 per cent in the private healthcare facilities, while the percentage of Caesarean births in Odisha has risen from 53.7 per cent to 70.7 per cent. Punjab saw 55.5 per cent C-section births up from 39.7 per cent in the private healthcare facilities while Tamil Nadu saw a rise from 51.3 per cent to 63.8 per cent in the private healthcare facilities.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More

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