Andhra Pradesh has recorded a 56.12 per cent caesarean section (C-section) rate in the financial year 2024–25, an increase of 14 per cent from the already concerning 42.4 per cent recorded during the 2019–21 National Family Health Survey-5 (NFHS-5).
The latest alarming figures, released by the State Health Department on Tuesday, show that more than half of all deliveries in Andhra Pradesh now involve surgical intervention, marking the state’s C-section rate at nearly four times the World Health Organisation’s recommended maximum of 15 per cent.
Most caesarean births are recorded in private healthcare facilities, where 67.71 per cent of deliveries are now conducted via C-section, compared to 41.40 per cent in government hospitals.
This 26-percentage point gap has raised concerns about possible over-medicalisation of childbirth and profit-driven clinical decisions in the private sector.
By comparison, neighbouring Telangana reported a 60.7 per cent C-section rate in NFHS-5 — the highest at the time — while other Indian states maintained rates below 50 per cent.
During the NFHS-5 period, Andhra Pradesh’s C-section rate was already flagged as problematic, with 27.7 per cent planned surgeries and 14.7 per cent emergency interventions. Despite awareness and scrutiny, the continued rise has further alarmed public health experts.
The Health Department attributed the high rate of surgical deliveries to gaps in clinical training and governance, especially in public healthcare facilities.
Currently, staff nurses in government hospitals provide obstetric services during childbirth.
"Due to their lack of proper knowledge and training on various issues, caesarean deliveries are becoming more common,” the department stated, suggesting a growing dependence on doctors for interventions that may otherwise be avoidable.
To address the issue, Health Minister Satyakumar Yadav has launched a statewide initiative to encourage natural deliveries by strengthening maternal care through trained midwives.
Under the new scheme, 1,264 midwives will be trained and deployed in 86 government hospitals, each handling between 600 to 6,000 deliveries annually.
The 18-month training programme, costing ₹2.5 lakh per nurse including stipend, will focus on all stages of maternity care — from pre-pregnancy counselling and nutritional support to labour pain management, complication detection, and postnatal care such as breastfeeding assistance and maternal–infant bonding.
“The lack of clinical competency in existing staff nurses has led to an increased role for doctors during deliveries,” the Health Department noted. “As a result, C-sections are becoming more frequent.”
The minister has directed that the scheme be expanded to tribal and rural areas, ensuring that every primary health centre in the state is equipped with well-trained midwives.
Healthcare experts say Andhra Pradesh stands at a critical juncture.
“With rising healthcare costs, long-term maternal risks associated with unnecessary surgeries, and mounting pressure on public hospitals, the midwifery initiative could play a vital role in correcting the state’s childbirth practices,” said a child and women’s health expert.
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