Better late than never! The J&K administration’s acceptance of the need to curb the rising practice of caesarean section (C- Section) in private hospitals is timely. C-section deliveries are increasingly becoming a public health issue in modern-day India and the National Health Mission’s initiative to conduct a review of maternal and child death surveillance (MCDS) and carry out an audit on C-Sections in Jammu and Kashmir must be welcomed.

It is an alarming statistic that in J&K alone, over 82 percent child births are C-section deliveries, suggesting that this procedure is becoming the norm rather than the exception, even when it is well known that neither mother nor infant actually benefit positively from it.
Building maternal health literacy and awareness among women and the community is the need of the hour to minimise the use of C-Section. Formulating a mandate and implementing it through the National Health Mission (NHM) in states like J&K is, therefore, crucial.
Community health workers and primary care providers have a huge responsibility to stop this worrisome trend that potentially has negative health consequences for both mother and infant, especially when the World Health Organisation (WHO) recommends that C-Section threshold for child birth should be restricted to only ten or fifteen percent.
That a Caesarean delivery takes less time and effort, and pays more than the normal vaginal delivery is not in doubt. Private sector health institutions promote C-Section delivery to earn unregulated revenues.
Doctors and the private hospital managements, therefore, need to set aside their motivations to make that extra buck by performing “needless surgical deliveries.”Viewed from a global perspective, studies show that whether it is a developed country or a developing one, both have consistently high rates of C-section even when there is a shift from lower to higher Human Development Index (HDI).
Currently, as per reports published in the public domain, there is no internationally accepted classification system for the C-section “to allow for meaningful and relevant comparisons across different regions, cities, or facilities.”
In recent years, the 10-group classification (a.k.a. the Robson Classification) has been widely used in many countries. Being a diverse country, it is but natural for India to have differences on whether doing C-Section deliveries is right or wrong. Factors like different geographies and religions, the caste system’s do’s and don'ts, besides other socio-economic parameters such as women’s education, literacy, livelihood and health, eventually do play a part.