REDRESSAL OF RISE IN CAESAREAN SECTION RATES IN PUBLIC HOSPITALS

Abstract

The study aims to know and compare the impact of change in health care facility on Caesarean Section (CS) rate within public and private sector. It is a retrospective observational study. This pilot study is based on the one year data collected from 10 different health care facilities. The data includes CS carried out in 2 public institutes and 8 maternity homes from private sector. In the present study the caesarean section rate was more than the WHO recommendations in all the 10 institutes which include both public and private hospitals. The worrisome observation in our study is that the CS rate of public hospitals is no way close to the percentage recommended by WHO. The CS rate in private sector was between 50 to 60 percent. Along with the medical indications, the factor like the obstetricians' environment has got the impact on the decision making in favor of CS. The majority of the maternity homes are run by lady obstetrician single handed with untrained staff. They need to work in a situation where monitoring of labor for vaginal birth leads to uncertainty in respect of the safety of the baby to be born and the time duration required. This fear of uncertainty, accountability makes the obstetricians CS friendly. The CS rates in public hospitals are on rise despite having better infrastructure. It is necessary to examine the obstetricians' environment in both public and private sector hospitals providing maternity services. It may be easier to begin the protocol to restrict the CS rate from public hospitals as there is some hierarchy in the department associated with trained staff. Subsequently, protocol can be designed for private sector.