GOVERNMENT OF INDIA

MINISTRY OF HEALTH AND FAMILY WELFARE

DEPARTMENT OF HEALTH AND FAMILY WELFARE
LOK SABHA
UNSTARRED QUESTION NO. 2218
TO BE ANSWERED ON 23RD SEPTEMBER, 2020

GUIDELINES FOR CAESAREAN DELIVERIES

2218. SHRI UPENDRA SINGH RAWAT:
DR. SUBHASH RAMRAO BHAMRE:
DR. DNV SENTHILKUMAR S.:
DR. AMOL RAMSING KOLHE:
SHRI KULDEEP RAI SHARMA:
SHRI MANICKAM TAGORE B.:
SHRIMATI SUPRIYA SULE:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the rate of caesarean deliveries across the country is higher than the developed
countries, if so, the details thereof indicating the number of such deliveries performed during the
last three years and the current year, State/UT-wise including Barabanki, Uttar Pradesh and the
reasons therefor;
(b) the details of the standards declared by WHO for caesarean deliveries;
(c) whether Government has put in place any guidelines and rules for cesarean deliveries and if
so, the present status of compliance thereof by Government and private hospitals and if not, the
corrective steps taken in this regard;
(d) whether the Government and private hospitals and Nursing Homes are forcing the women
patients and their family members to undergo caesarean operation even when it is not necessary;
(e) if so, the details thereof and the action taken against erring Government, private hospitals,
nursing homes in this regard; and
(f) the other steps taken by the Government to bring down C-section deliveries as per the WHO
standards?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)

(a) As per NFHS-4 (2015-16), the rate of caesarean deliveries in the country is 17.2% which is
lower than the developed countries viz. Latin America and the Caribbean countries (40.5%),
North America (32.3%), Oceania (31.1%), Europe (25%), Asia (19.2%) as per the WHO 2018
report.
 The details of the C-section deliveries performed during the last three years and current
year, State/UT-wise including Barabanki, Uttar Pradesh is given in Annexure as per HMIS.

(b) The standards declared by WHO for Caesarean deliveries state that at population level,
caesarean section rates higher than 10% were not associated with reductions in rates of maternal
and newborn mortality. It recommended the adoption of the Robson classification system, which
facilitates comparison and analysis of caesarean rates within and between different facilities, and
across countries and regions.

(c) & (f) Health is a State subject. However, MoHFW has taken the following steps to curb the
rise in C-section;

 Conveyed the WHO Statement to all States/UTs urging them to share the same with all
Obstetricians and Gynaecologists working in public health facilities in their respective
States/UTs.
 Collaborated with Federation of Obstetrician and Gynaecologists in India (FOGSI) to
share the WHO statement on C-section among all members.
 Under “LaQshya”- Labour room & maternity OT Quality Improvement Initiative,
Caesarean section audit has been implemented in all LaQshya certified public health
facilities to ensure that Caesarean sections are undertaken judiciously in only those cases
requiring such surgical interventions
 All CGHS empanelled hospitals are directed to display the information regarding ratio of
deliveries by caesarean section.

(d) & (e) No such information is available with the Government.

(f) As above.
 Annexure

Number of C-section deliveries conducted at public Number of C-section deliveries conducted at

Sr. No States/UTs
facilities private facilities

Apr20-June20 Apr20-
2017-18 2018-19 2019-20 2017-18 2018-19 2019-20
June20
AllIndia 1,756,951 1,897,546 1,860,189 365161 1,831,636 2,051,481 2,032,486 383437
1 A&NIslands 922 1,030 785 104 0 0 0 0
2 AndhraPradesh 89,514 94,202 92,261 20997 148,128 176,474 141,190 29942
3 ArunachalPradesh 2,640 2,027 2,430 354 773 998 1,062 259
4 Assam 62,993 68,092 67,707 11869 50,094 52,808 56,975 11116
5 Bihar 24,710 29,316 29,930 4979 15,964 16,531 17,476 1347
6 Chandigarh 9,413 9,595 9,218 1193 0 0 0 0
7 Chhattisgarh 19,374 20,179 21,597 5899 55,912 55,222 51,288 9633
8 Dadra&NagarHaveli 2,141 2,356 2,443 419 446 496 583 142
9 Daman&Diu 763 1,045 1,044 260 182 144 179 51
10 Delhi 52,544 55,204 53,475 9491 23,393 29,457 28,566 4300
11 Goa 3,589 3,430 3,234 902 4,133 4,313 4,618 1014
12 Gujarat 55,252 55,694 60,973 10791 132,062 131,979 142,580 19647
13 Haryana 31,665 35,919 36,889 7112 52,023 52,045 50,718 10877
14 HimachalPradesh 11,330 12,769 11,753 2848 5,801 5,722 5,894 1789
15 Jammu&Kashmir 57,863 62,388 63,889 14895 12,850 15,014 14,062 3915
16 Jharkhand 16,810 19,788 20,759 3308 36,954 36,400 32,014 3123
17 Karnataka 123,144 137,244 143,549 31605 133,139 142,641 144,780 31904
18 Kerala 56,563 57,853 55,033 13385 128,429 139,843 127,853 27407
19 Lakshadweep 323 353 327 109 0 0 0 0
20 MadhyaPradesh 71,622 81,073 78,713 17023 58,521 53,623 55,731 7854
21 Maharashtra 161,836 175,366 183,711 35865 188,963 225,528 236,823 49458
22 Manipur 4,200 4,626 6,582 1050 3,012 3,339 3,691 1001
23 Meghalaya 2,437 2,465 2,744 682 4,155 4,767 5,420 1122
24 Mizoram 1,858 1,976 1,906 360 1,262 1,295 462 308
25 Nagaland 1,612 1,412 1,588 94 1,242 1,442 1,441 385
26 Odisha 68,306 75,679 71,283 16058 26,042 60,104 50,804 10577
27 Puducherry 9,132 8,940 8,367 1591 4,950 5,100 1,122 200
28 Punjab 51,298 50,712 51,278 9604 77,192 84,361 86,914 18820
29 Rajasthan 89,504 98,754 95,358 17518 57,990 53,941 55,994 14045
30 Sikkim 1,472 1,293 1,702 453 691 1,194 1,038 376
31 TamilNadu 201,158 209,781 175,524 42482 211,022 223,019 173,399 36500
32 Telangana 129,273 142,477 126,840 30560 138,508 165,307 158,114 36101
33 Tripura 8,474 8,768 8,500 1973 2,699 2,348 4,476 1069
34 UttarPradesh 97,282 98,407 112,089 16181 55,733 91,358 188,779 29199
35 Uttarakhand 9,804 10,683 11,540 2068 7,138 9,527 6,640 1641
36 WestBengal 226,130 256,650 245,168 31079 192,233 205,141 181,800 18315

Number of C-section deliveries conducted Number of C-section deliveries conducted

Sr. No State-District
at public facilities at private facilities

Apr 20 - Apr 20 -
2017-18 2018-19 2019-20
June 20
2017-18 2018-19 2019-20
June 20

1 UP-Barabanki 2887 2786 3419 420 1497 1980 2297 32

Source: HMIS