Need to focus on the small maternity homes from towns in India to reduce caesarean section rates in the private sector

Authors

  • Kishore B. Atnurkar Department of Obstetrics and Gynaecology, Dass Clinic, Tilak Nagar, Nanded, Maharashtra, India https://orcid.org/0000-0002-8269-9630
  • Pooja B. Toshniwal Toshniwal Hospital, Doctors’ Lane, Nanded, Maharashtra, India
  • Sujata A. Patil Sumeha Hospital, Manik Nagar, Nanded, Maharashtra, India
  • Rachita N. Bidwai Bidwai Hospital, Doctors’ Lane, Nanded, Maharashtra, India
  • Yogini V. Karlekar Janani Hospital, Chatrapati Chowk, Nanded, Maharashtra, India
  • Shadmani Shakil Al-Hayat Hospital, Degloor Naka, Nanded, Maharashtra, India
  • Supriya Pedgaonkar Sai Matruseva hospital, Z P Colony, Malegaon Road, Nanded, Maharashtra, India
  • Sangita S. Masare Vinayak Hospital, Wadiya Area, Nanded, Maharashtra, India
  • Sunita Burande Burande Hospital, Borban Area, Nanded, Maharashtra, India
  • Chanda C. Videkar Videkar Hospital Ganesh Nagar, Nanded, Maharashtra,
  • Rajshree Narod Mangal Murty Hospital, Doctors’ Lane, Nanded, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243455

Keywords:

CS rates, Small maternity homes, Private sector, Robson classification, Lady obstetricians

Abstract

Background: In India, the maternity services in the private sector are mainly provided by numerous small maternity homes, majority of them run by lady obstetricians, single handed. The purpose of the study is to classify the caesarean section (CS) rates at such maternity homes by applying Ten group Robson classification system (RTGS).

Methods: This study is based on the data collected from 10 randomly selected small maternity homes. The data includes the total number of vaginal births and CS done in each maternity home over a period of one year. The data was analysed by applying Robson classification, CS rate of each maternity home calculated and compared with Robson guidelines and MCS reference population.

Results: The average CS rate of the 10 small maternity homes was 55.09%. More percentage of CS were done in nulliparous women before labour than in spontaneous labour and after failed induction. The percentage of repeat CS was very high.

Conclusions: The CS rates in small maternity homes in the private sector, run by lady obstetricians single handed, in our study were very high especially in nulliparous and cases of previous CS. In the efforts to reduce CS rates in the private sector, we need to focus on the CS data from small maternity homes.

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References

World Health Organization. Appropriate technology for birth. Lancet. 1985;2(8452):436-7.

Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM; WHO Working Group on Caesarean Section. WHO Statement on Caesarean Section Rates. BJOG. 2016;123(5):667-70.

Pandey AK, Raushan MR, Gautam D, Neogi SB. Alarming Trends of Caesarean Section-Time to Rethink: Evidence From a Large-Scale Cross-sectional Sample Survey in India. J Med Internet Res. 2023;25:e41892.

Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021;6(6):e005671.

Neethi Mohan V, Shirisha P, Vaidyanathan G, Muraleedharan VR. Variations in the prevalence of caesarean section deliveries in India between 2016 and 2021 - an analysis of Tamil Nadu and Chhattisgarh. BMC Pregnancy Childbirth. 2023;23(1):622.

Singh P, Hashmi G, Swain PK. High prevalence of caesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health. 2018;18(1):613.

Sk R. Does delivery in private hospitals contribute largely to Caesarean Section births? A path analysis using generalised structural equation modelling. PLoS One. 2020;15(10):e0239649.

Peel A, Bhartia A, Spicer N, Gautham M. 'If I do 10-15 normal deliveries in a month I hardly ever sleep at home.' A qualitative study of health providers' reasons for high rates of caesarean deliveries in private sector maternity care in Delhi, India. BMC Pregnancy Childbirth. 2018;18(1):470.

Neuman M, Alcock G, Azad K, Kuddus A, Osrin D, More NS, et al Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal. BMJ Open. 2014;4:e005982.

Bhatia M, Dwivedi LK, Banerjee K, Dixit P. An epidemic of avoidable caesarean deliveries in the private sector in India: Is physician-induced demand at play? Soc Sci Med. 2020;265:113511.

Tripathy B, Jena A, Pandey AK, Mishra SS, Mishra C. Caesarean Section Delivery in India: A Comparative Assessment of Geographical Variability Using Nationally Representative Survey Factsheet Data. Natl J Community Med. 2023;14(4):260-6.

Begum T, Nababan H, Rahman A, Islam MR, Adams A, Anwar I. Monitoring caesarean births using the Robson ten group classification system: A cross-sectional survey of private for-profit facilities in urban Bangladesh. PLoS One. 2019;14(8).

Assefa EM, Janbo A, Ghiwot Y. Comparative analysis of cesarean section using the Robson's Ten-Group Classification System (RTCGS) in private and public hospitals, Addis Ababa, Ethiopia. Clin J Obstet Gynecol. 2021;4:81-91.

Tailor KS, Goswami KD. Analysis of Caesarean Section according to Robson’s Ten Group Classification System at a Tertiary Care Center Rajkot. Int J Pharm Clin Res. 2024;16(3):1613-7.

Dogra K, Arora N, Sharma B, Tanwar M. Analysis of caesarean section rate according to modified Robson’s classification at tertiary care centre in Uttarakhand, India. Int J Reprod Contracept Obstet Gynecol. 2019;8:1288-93.

World Health Organization. Robson Classification: Implementation Manual, Geneva. 2017. Available at: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/robson-classification/en/. Accessed on 16 October 2024.

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Published

2024-11-21

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Original Research Articles