C-section deliveries exceed safe limits

The discovery of caesarean deliveries, or C-sections, was a major medical breakthrough that helped prevent countless maternal and fetal deaths. However, global health standards recommend that the procedure be performed only when medically necessary. Yet, in Pakistan, where accountability gaps plague the healthcare system, it is often difficult to determine whether a caesarean is carried out to save the lives of the mother and child or to serve the birthing business.

Beyond cases required for medical reasons, many doctors now favour C-sections over natural deliveries, seeing them as more predictable and convenient since the procedure is quicker and involves fewer complications for the medical staff. However, C-sections carry increased health risks for both the mother and her newborn and may lead to complications in future pregnancies. Experts emphasize that a natural delivery remains the healthier option for both maternal and infant health.

Bashira Rani, a new mother from Lahore, shared that high blood pressure and the risk for potential labour complications led her towards a C-section. However, Naila, a new grandmother, revealed that a private hospital demanded Rs200,000 for her daughter's C-section, "Eventually my daughter had a natural birth at a public hospital after we paid a bribe. The Health Department lacks a system to regulate private hospitals, allowing financial exploitation," claimed Naila.

Sajida Bibi, a new mother from Peshawar, revealed that she was still experiencing complications after her C-section. While the doctors' side of the story remains unknown, Sajida believes she was pressured into surgery. "I kept crying and requested the doctor not to perform the C-section, but because of their greed for earning more money, they went ahead. Now I suffer from severe back pain and other complications," shared Sajida, whose story reflects a wider trend of medical malpractice hidden behind unnecessary C-sections.

Although backaches are often a classic postpartum complaint among women regardless of the mode of delivery, Dr Erum Majid, Associate Professor at Jinnah Hospital's Gynecology Department, revealed that C-sections were associated with a greater risk of complications including bleeding, infection, and anesthesia risks. "C-section requires careful monitoring, anesthesiologist clearance, and highly skilled female doctors. Sadly, no central data exists across the country to monitor their statistics," noted Dr Majid.

In Sindh, the rising rate of surgical deliveries places a financial burden on public hospitals, as patients require IV drips and other supplies. In 2025, Jinnah Hospital Karachi reported 12,549 deliveries, of which 6,438 were C-sections. When The Express Tribune contacted the Civil Hospital Karachi for data, they claimed that no records were available.

In Punjab too, C-section rates are rising. Medical experts warn that presenting C-sections as an "easy and safe option" contradicts medical principles and is influenced by financial and administrative factors. After the introduction of the health card, the trend shifted toward C-sections. Data from private hospitals shows that 525,619 C-sections were recorded from 2017-2024, which rose to 668,238 after 2024.

Most births now occur via C-section in private hospitals. Between 2016 and 2024, Rs16.36 billion was paid in claims for C-sections. Public hospital normal deliveries cost a few hundred rupees, while private C-section packages range from Rs100,000 to Rs400,000. Doctors justify C-sections by citing reduced pain and labour time.

Sources from the Punjab Health Department cited a shortage of trained midwives and experienced nurses, increased hospital loads, and migration of staff abroad as other factors contributing to C-sections. Doctors often coerce women psychologically for C-sections, but due to lack of checks and balances, no significant action has been taken against them.

Dr Sunila Khan, a gynecologist, noted that some women and their husbands scheduled elective C-sections to avoid pain and deliver on a specific date. "While private hospitals are often accused of profiting, doctors assess patients via examinations and ultrasounds to determine whether a C-section is appropriate. These surgeries also occur in public hospitals but due to their heavy patient load, women often leave a day or two after surgery," said Dr Khan.

Pakistan Medical Association President Dr Shershah Syed warned that unnecessary C-sections in Pakistan were a human rights concern and a serious risk to maternal and newborn health. "Despite WHO guidelines limiting C-sections to 15 per cent, rates in some hospitals reach 50-70 per cent, especially in private facilities, which are often profit-driven," noted Dr Syed, who urged stronger government oversight, evidence-based medical decisions, and improved training.

Dr Khalid Sheikh, Chairman of the Sindh Healthcare Commission, claimed that only postgraduate gynecology specialists could perform C-sections. "The Pakistan Medical and Dental Council (PMDC) monitors medical education but is not directly involved in overseeing C-section practices," said Dr Sheikh.