Jammu and Kashmir Private Hospitals Lead India with 90% C-Section Rate
New data from the National Family Health Survey-6 (NFHS-6) reveals that private hospitals in Jammu and Kashmir have the highest Caesarean section (C-section) rate in India, with nine out of every ten babies delivered surgically. This rate far exceeds the national private-sector average of 54.1%. West Bengal follows at 87.7% and Telangana at 83.9%.
Medical experts attribute the rise in C-sections to several factors, including increased institutional deliveries, better detection of high-risk pregnancies, rising maternal age, greater use of assisted reproductive technologies, and previous C-sections. In the private sector, scheduled deliveries, convenience, financial incentives, and maternal preference may also play a role.
Dr. Sami Jan, a faculty member in the Department of Gynaecology and Obstetrics at SKIMS Medical College and Hospital in Srinagar, noted that no single study conclusively explains why C-sections are more common in Jammu and Kashmir. She suggested that the tertiary referral system receives a high proportion of high-risk pregnancies from district hospitals, which naturally increases the number of women requiring C-sections. Other contributing factors include delayed referrals, advanced technology for detecting fetal distress, geographic and weather challenges, and infertility treatments.
According to NFHS-6 (2023-24), 27.2% of all births in India are now by C-section, up from 21.5% in NFHS-5 (2019-21). The increase is driven largely by the private healthcare sector, where the C-section rate rose from 47.4% to 54.1%. In contrast, the public sector rate increased modestly from 14.3% to 16.9%. While institutional deliveries have risen from 88.6% to 90.6%, the growth in C-sections has outpaced this, widening the gap between private and public facilities and raising concerns about potential overuse of medically unnecessary C-sections.
The World Health Organisation (WHO) states that C-sections should only be performed when medically necessary. At the population level, rates above approximately 10% are not associated with further reductions in maternal or newborn mortality. WHO no longer recommends a specific national target rate.
Dr. Nikhil Gupta, an integrative psychiatrist at Wellness Clinic Jammu, pointed out that fear of labour pain, anxiety about the baby's safety, past experiences, misinformation, and cultural beliefs can influence decisions. Emerging biomedical evidence suggests that C-sections may affect early gut microbial colonisation in infants, and some studies have reported a modest association with neurodevelopmental conditions such as autism, though causality remains unproven. He emphasised that informed consent requires balanced counselling about both vaginal and surgical delivery, and integrating psychological support throughout pregnancy can promote informed decision-making.
The data underscore the need for policies that ensure every woman who needs a C-section receives one, while avoiding unnecessary surgical interventions. Experts call for improved counselling, better referral systems, and monitoring of C-section rates in private hospitals to align with medical necessity.
