Need to focus on the small maternity homes from towns in India to reduce caesarean section rates in the private sector

Background: In India, the maternity services in the private sector are mainly provided by numerous small maternity homes, majority of them run by lady obstetricians, single handed. The purpose of the study is to classify the caesarean section (CS) rates at such maternity homes by applying Ten group Robson classification system (RTGS). Methods: This study is based on the data collected from 10 randomly selected small maternity homes. The data includes the total number of vaginal births and CS done in each maternity home over a period of one year. The data was analysed by applying Robson classification, CS rate of each maternity home calculated and compared with Robson guidelines and MCS reference population. Results: The average CS rate of the 10 small maternity homes was 55.09%. More percentage of CS were done in nulliparous women before labour than in spontaneous labour and after failed induction. The percentage of repeat CS was very high. Conclusions: The CS rates in small maternity homes in the private sector, run by lady obstetricians single handed, in our study were very high especially in nulliparous and cases of previous CS. In the efforts to reduce CS rates in the private sector, we need to focus on the CS data from small maternity homes.