THIRUVANANTHAPURAM: Every second birth in public hospitals in the districts of Ernakulam, Kollam and Pathanamthitta, happens under the knife, through Caesarean sections. The three districts show a shockingly high rate of C-sections, as per the data available from the Directorate of Health Services (DHS).Ernakulam tops the list for the period from January to September this year, with a whopping 3,568 C-sections out of a total 5,560, amounting to more than 64 percent of all births in public hospitals.There was a brief lull in the rate of C-sections after the controversial mass Caesarean issue in Cherthala, moving down from 67.4 percent in February to 58.7 percent in July. However, in August and September, the situation had gone back to square one with a C-section rate of 64.6 percent.“Generally the accepted rate for C-sections, as per the limits set by the World Health Organisation is 15 percent, it can go up to 20 percent or so, 50 percent or more is way too above the acceptable levels,” said Dr Vijayakumar, head of the Department of Community Medicine, Thiruvananthapuram Medical College.More than half of the births are through C-sections in public hospitals of Pathanamthitta and Kollam too, where the average hovers around 58 percent and 55 percent respectively. Kannur and Thrissur are close on the heels.“The level of income, rate of literacy, the number of children per couple, more number of doctors and better anaesthesia facilities are factors that could contribute to the high rate of C-sections in the three districts. We have now launched a vaginal birth delivery promotion programme in the state, concentrating especially on Ernakulam and the other two districts,” said Director of Health Services Dr P K Jameela.While the total number of deliveries in public hospitals in Pathanamthitta is half or less than half of Ernakulam, there is no dip in the number of C-sections. According to the figures provided by the DHS, of the 220 deliveries in June this year, as many as 154 were C-sections.In Kollam too, there was a small dip following the Cherthala controversy and the issuance of guidelines for conducting C-sections. However, in August and September, the rate had once again shot up above the 50-percent mark.Unfortunately, reliable figures regarding C-sections in private hospitals are not available. Also unavailable are the details regarding the rate of primary C-sections, that is C-section in the first delivery, that would actually show the trend.
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