With the uterus scam setting example of medical doctors indulging in criminal acts, there is an equally serious pattern of rising caesarean sections having become a money making racket. From being emergency life saving procedures, doctors are peddling C-sections as a pain-free and convenient option that can be scheduled on a special day and at an auspicious time without revealing the risks like excessive blood loss, blood clots, heart attacks, difficulty in breastfeeding and increasing chances of repeat C-section births.
C-section rates are higher in private sector hospitals, nursing homes and clinics. Private practitioners defend caesarean births maintaining that they have to respect the wishes of the patients who increasingly demand it. This raises the question whether a patient is a consumer demanding a particular line of treatment even if it is not medically appropriate. Obstetricians in the private sector use the convenient excuse of patient demand and couch it as a woman’s right to choose issue to push a procedure that is more remunerative for them. Obstetricians rarely talk about their own personal preference for C-sections as it takes less time and can be scheduled to their convenience. According to official sources in the Union Ministry of Health and Family Welfare, a C-section birth costs anything between Rs.40,000 and over Rs.1.5 lakh in the private sector, depending upon solvency and the gullibility of such patients.
It is officially learnt that C-section rate in India was 8.5 percent till 2010, which the latest round of the National Family Health Survey (2015-16) showed to have jumped to 17.2 per cent. The rate in the private sector is 41 per cent and 12 per cent in the public health facilities. In some states like West Bengal, C-section rates are 71 per cent and in Telengana, 75 per cent. As per the United Nations World Health Organisation (WHO), 10-15 per cent C-section births are considered normal. This leads to incontrovertible evidence of higher caesarian rates being pushed by the profit motive rather than patient demand. Studies have shown obstetricians receiving financial incentives to go more and more for caesarian births in hospitals with financial incentives for such operations.
Alarmed by higher rates than the official norms prescribed for C-section rates by WHO, the Union Minister of Woman and Child Development Ms. Maneka Gandhi ‘s advice to make it mandatory for hospitals to display publicly the number of C-sections and normal deliveries carried out, in order to help patients make a well informed choice of hospitals and doctors, was met with stiff protests from the medical fraternity claiming that ‘it would develop mistrust between patients and doctors’ and ‘could result in refusal of surgery even when required’. This is how scalpel-happy doctors are claiming C-section births are going up because of the insistence of patients, thus making a bonfire of transparency and openness for informed choices of patients.
It is evident now that the consumer protection law that has been extended to cover patients and hospitals has been of little use to the women whose wombs have been removed. The health regulator Medical Council of India’s (MCI) code of medical ethics has been of little or nil use in stopping obstetricians from pushing unnecessary C-sections to the detriment of patients. The Clinical Establishment Act has also failed to prevent hospitals from overcharging patients and is a dismal failure in penalising hospitals doing so with impunity. It seems that a culture of impunity has overtaken the medical profession, which needs to be tackled with an iron hand lest the people of India continue to be exploited without any perceptible remedial measures!