Midwifery in India: Balancing C-Section Trends

Paper: GS – II, Subject: Social Justice, Topic: Issues of Women, Issue: Role of Midwives in Safe Childbirth.

Context:

The article discusses the rising trend of caesarean (C-section) deliveries in India and highlights the neglected role of midwives in ensuring safe natural births. It argues that midwifery in India is the missing link in maternal healthcare system.

Key Takeaways:

1. THE PROBLEM:

The WHO recommends that C-section rates should be 10–15% of total births.
C-section rates in India have increased sharply from about 13% (2014) to 23% (2019–21).\
In some estimates, the rate has reached 27% in 2024–25, far above WHO norms.
India has made progress in reducing maternal mortality, but over-medicalisation of childbirth INCLUDING overuse of surgical delivery is emerging as a concern.
The absence of a strong midwifery system is pushing childbirth toward unnecessary surgical intervention.
Private hospitals show extremely high C-section rates (up to 70–80% in small facilities).
Financial incentives and convenience often influence the decision toward surgery.
Many women, especially in urban areas, prefer scheduled deliveries for comfort and predictability.
Childbirth is increasingly treated as a medical event rather than a natural process.
This leads to unnecessary interventions even in low-risk pregnancies.

2. ROLE OF MIDWIVES (THE SOLUTION):

Midwives are trained professionals who assist women during pregnancy, labour, and postnatal care, especially in normal (non-complicated) deliveries.
Midwives support women through natural childbirth, identifying when medical intervention is truly required. They provide continuous care, emotional support, and personalised guidance.
They help reduce unnecessary C-sections by promoting normal deliveries. They ensure safer births in low-risk pregnancies without over-medicalisation.
They improve maternal experience and outcomes.

3. Global vs India Scenario:

In many countries, midwives are central to maternal care systems.
India has only about 1,500 trained midwives, whereas nearly 9 lakh are needed.

4. Rural–Urban Need:

In rural areas, midwives provide accessible and safe delivery care.
In urban areas, they act as guides who know when intervention is necessary and when it is not.

CORE TAKEAWAY

India’s maternal health success is now challenged by excessive C-sections and over-medicalisation.
Strengthening midwifery services is essential to restore balance between natural and surgical childbirth.
The goal should be safe, evidence-based, and need-driven care—not profit-driven or convenience-driven intervention.

Source: (The Indian Express)

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