Janmejaya Samal: Addressing Rising C-Section Rates in India
Janmejaya Samal, Associate Professor at SRM Institute of Science and Technology, shared a post on LinkedIn about a paper published in BMC Pregnancy and Childbirth:
“New Publication Alert!
Perspectives of Obstetricians and Midwives on the Preference for Caesarean Deliveries in Andhra Pradesh, India
Published in BMC Pregnancy and Childbirth
I’m pleased to share our latest qualitative study exploring one of India’s most pressing maternal health concerns – the rapidly rising rates of caesarean section (C-section) deliveries, particularly in Andhra Pradesh, where rates have reached 42.4%, far exceeding WHO’s recommended 10–15%.
What we explored:
- Through in-depth interviews with obstetricians and midwives across four districts, our study sought to understand why C-sections are increasingly preferred – even when not medically indicated.
Key insights from the study:
- Sociocultural and psychological factors such as fear of labour pain (tokophobia), family pressure, and beliefs around auspicious birth timings strongly influence decision-making.
- Maternal and lifestyle determinants including sedentary behaviour, convenience, and previous negative birth experiences play a major role.
- Health system challenges – medico-legal fears, staffing shortages, limited 24/7 OT facilities, and declining confidence among junior obstetricians – push providers toward surgical deliveries.
- Medical indications remain important, but a considerable proportion of C-sections arise from non-clinical factors.
Why this matters:
Understanding provider perspectives is crucial for formulating strategies that reduce unnecessary C-sections while ensuring maternal and neonatal safety. The findings call for:
- Strong regulatory frameworks
- Standardized clinical protocols
- Routine audits
- Enhanced maternal education
- Training and support for birth attendants
- Culturally sensitive communication strategies
Read the full article here.
A big thank you to all co-authors, participating clinicians, and the institutions that supported this research. Together, we hope this work contributes meaningfully to improving maternal health outcomes in India.”
Title: Perspectives of obstetricians and midwives on the preference for caesarean deliveries: a qualitative exploration in Andhra Pradesh, India
Author: Nagendra Babu Gavvala, Benson Thomas M, Anuj Kumar Pandey, Janmejaya Samal
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