TL;DR C-section deliveries in India have risen to over 1 in 4 births, up from 1 in 5 in five years. The increase is widespread across states and districts, with several regions reporting very high rates. The trend points to a mix of overuse in some areas and under-access in others, shaped by access to institutional healthcare and socio-economic factors.

Context

Caesarean section (C-section) is a vital surgical procedure intended to save the lives of mothers and newborns when complications make vaginal delivery unsafe, such as obstructed labour, fetal distress, or abnormal positioning. Yet, its use has risen sharply in recent decades, including in India, extending beyond clear medical need. A range of factors drives this trend, including fear of labour pain, the convenience of scheduling births, and perceptions that C-sections are safer or less traumatic for the baby. In some settings, cultural preferences, such as choosing an auspicious birth date, also play a role, alongside concerns about preserving pelvic health and avoiding complications associated with vaginal delivery.

At the same time, systemic factors are equally important. Fear of litigation can push healthcare providers toward more defensive practices, while in certain contexts, financial incentives in private healthcare have raised concerns about profit-driven overuse. The World Health Organization has indicated that population-level C-section rates above 10–15% are unlikely to improve maternal or newborn outcomes, underscoring the need to balance access with appropriate use. In this context, we explore trends and patterns in C-section deliveries across India.

Who compiles this data?
The data is compiled by the Ministry of Health and Family Welfare (MoHFW) based on information reported by States and Union Territories. Since health is a State subject, detailed hospital-level data is maintained by respective State/UT health departments, while the Centre aggregates and publishes data at broader levels such as states and districts.

Where can I download clean & structured data related to this?

Clean, standardised, structured, and ready-to-use dataset on Year, State and District-wise Total Number of Deliveries and Caesarean (C-Section) Deliveries Reported is exclusively available on Dataful. The data was accessed through RTI. A collection of datasets from NFHS is also available on Dataful, which covers information such as institutional deliveries, family planning, child birth, population, etc.

Key Insights

• Despite a decline in total reported deliveries, C-section volumes continued to rise, pushing their share from 20% to over 27% between 2020–21 and 2024–25. In short, more than 1 in 4 births in India are now via C-section, up from 1 in 5 just five years ago.

• Almost every single state and union territory recorded a higher C-section rate in 2024-25 compared to 2020-21, indicating a systemic shift in maternal healthcare delivery nationwide. Sikkim recorded the highest national rate at 62.8%, following a 22.2 percentage point increase over five years.

• Southern states such as Telangana, Tamil Nadu, Andhra Pradesh, and Karnataka have consistently reported high C-section rates, often exceeding 40–50% over the years. Kerala and Punjab also fall in this category, with persistently elevated shares.

• Several states have witnessed a steep increase in C-section rates over the past five years. Maharashtra, West Bengal, and Odisha show particularly sharp rises, with increases of over 10–15 percentage points. Similarly, Assam and Ladakh have recorded rapid upward trends.

• In contrast, states like Bihar, Jharkhand, and Uttar Pradesh continue to report low C-section rates, well below the national average. Madhya Pradesh and Rajasthan, although showing gradual increases, still remain on the lower end. These 5 states alone accounted for nearly 47% of the institutional deliveries reported during the 5 years.

• In 2024-25, 146 of 775 districts reporting deliveries had C-section rates above 50%, up from 61 of 735 such districts in 2020-21. The highest share was recorded in Mahe at over 80%. In Telangana, 23 of 33 districts exceeded 50% (including 6 above 70%), while in Tamil Nadu, 25 of 38 districts crossed the 50% mark.

Why does it matter?
Data shows a strong correlation between high C-section rates and access to institutional & private health & maternal care. The rates are significantly higher in private hospitals, especially in urban areas, raising concerns about financial incentives and provider practices, while poorer states and populations continue to report low rates, suggesting under-access to essential surgical care.

Nationally, C-section births in private facilities increased from 27.7% in NFHS-3 to 40.9% in NFHS-4 and to 47.4% in NFHS-5. In comparison, public facilities reported a much lower 11.9% in NFHS-5, up from 9.3% in NFHS-4. State-level data reveal that in states like West Bengal (82.7%), Jammu & Kashmir (82.1%), and Telangana (81.5%), over 80% of all deliveries in private hospitals are surgical, suggesting institutional and systemic drivers beyond clinical necessity.

According to a Lancet study published in December 2024, C-section rates are closely linked to income and wealth, with richer women far more likely to undergo the procedure, pointing to inequities in both access and overuse. The study also noted that the average overall out-of-pocket expenditure for C-section is eight times higher than for normal vaginal deliveries, underscoring both financial and equity concerns.

Key Numbers

• C-section share: 20.1% → 27.5% (2020–21 to 2024–25)

• Districts >50%: 61 in 2020-21 → 146 in 2024-25

• Total C-sections: 41 lakh in 2020-21 → 54 lakh in 2024-25

• Highest state (2024-25): Sikkim – 62.8%

• Lowest states: Bihar (~5.5%), Jharkhand (~10.4%)

• Highest district: Mahe – 80%+

• Private vs public (2019-21): 47.4% vs 11.9%