Trends, Geographic patterns and Determinants of Caesarean sections in Karnataka: Insights from the National Family Health Survey

Background: The rising Caesarean section (C-section) rates in India, including Karnataka, raise concerns about over-medicalization. C-sections, when medically indicated, can be lifesaving; however, their unnecessary use poses risks to both mothers and infants. This study aims to investigate the trends, geographic patterns, and determinants of C-section deliveries in Karnataka, utilizing data from NFHS. Material &methods: This study utilized NFHS-5 data on women who delivered in the past five years, along with earlier rounds (NFHS-1 to NFHS-4) to assess trends. Descriptive statistics were used to show trends and geographic distribution, while inferential statistics including logistic regression were used to identify determinants of C-sections. Key variables included maternal age, education, wealth, residence, and healthcare facility type. Results: The study found a significant rise in C-section rates across Karnataka, from 3 % in NFHS-1 to 31.5 % in NFHS-5 with higher rates in southern districts. Key determinants include higher maternal age, education, economic status, and private health facilities, where odds of C-section were 3.7 times higher (OR = 3.77; 95 % CI: 3.14–4.17) than in public facilities. Women with pregnancy complications (OR = 0.5017; 95 % CI: 0.44–0.56) were less likely to have C-sections than those without complications. Conclusion: The study underscores the growing trend of C-sections, especially in private healthcare settings. Efforts are needed to ensure that C-sections are performed based on medical necessity rather than convenience or economic incentives, to safeguard maternal and infant health in Karnataka.