This was published in ‘The Better India’ on May 6 2017. Here is the link, and below is an excerpt.
New research from Harvard Medical School in the US, where too the ‘profit motive’ gets disproportionately blamed, emphasizes what could be called system factors: limited resources, high workload, limited motivation, and limited accountability. These put pressure on doctors to prefer C-sections, which are more convenient and much quicker, over normal birth.
Such factors are at work in India too. In a 2000 article, Madhukar Pai had outlined similar reasons behind unnecessary caesarean deliveries in Indian cities (yes, our C-section problem had been recognized long ago by public health experts). For example, some pertinent reasons he mentioned were: lack of round-the-clock patient monitoring facilities, lack of trained nurses, heavy workload on obstetricians, and lack of regulation of our private health sector. Besides, in many parts of the country, pregnant women and families often ‘request’ C-sections so that the baby can be born at a supposedly auspicious time. It is an embarrassing fact about India that decisions about thousands of C-sections are taken not by doctors, but by astrologers.