Mumbai, November 9, 2026: Concerned over the rising number of Caesarean-section deliveries, the Maharashtra government has directed all public health institutions to conduct mandatory audits of every C-section to ensure that surgical deliveries are performed only when medically necessary.
According to the Health Management Information System (HMIS), up to September 2026, C-sections accounted for 37% of institutional deliveries in government hospitals and 59% in private hospitals. The public sector recorded 1,89,152 Caesarean deliveries out of 3,18,683 births, while private hospitals reported 1,18,036 C-sections out of 3,23,245 deliveries.
The government has cited the increasing proportion of surgical births over successive National Family Health Surveys (NFHS) as a reason for strengthening monitoring. The C-section rate in government institutions increased from 18.3% under NFHS-4 to 23.8% under NFHS-6, while the private-sector rate rose from 39.1% under NFHS-5 to 48.5% under NFHS-6.
Mandatory Audit Of Every Caesarean Delivery
Through an order issued on November 3 by the State Family Welfare Office, Pune, civil surgeons, municipal health officers and deans of government medical colleges have been instructed to implement the audit mechanism. Every Caesarean delivery, including primary and repeat procedures, will be scrutinised, and the operating doctor must complete an audit form on the same day, recording the medical reasons for surgery.
Hospitals must submit monthly audit reports to district authorities by the fifth of every month, while district officers will forward consolidated reports to the state by the 10th. The findings will also be reviewed during monthly Reproductive and Child Health meetings and LaQshya Quality Assurance Committee meetings.
C-Section Rates Across Mumbai Metropolitan Region
In the Mumbai Metropolitan Region, Mumbai recorded 12,654 C-section deliveries out of 25,002 institutional births, accounting for 51%, the highest among the three civic bodies. Navi Mumbai reported 2,071 Caesarean deliveries out of 4,766 births (43%), while Thane recorded 2,665 C-sections out of 6,918 deliveries (39%).
The government has also directed the BMC's Executive Health Officer, civil surgeons and other municipal health officers to counsel private practitioners to undertake similar audits.
Medical indications for C-sections include previous Caesarean delivery, premature birth, breech or transverse presentation, twin pregnancy, antepartum haemorrhage and cephalopelvic disproportion.
Doctors Cite Multiple Reasons For Rising C-Sections
A senior doctor from a state-run hospital in Mumbai said several factors contribute to the rise in Caesarean deliveries, including lack of physical fitness among women, delayed hospital visits after complications develop, and the high number of high-risk pregnancies and emergency referrals handled by public hospitals.
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In Numbers
Public Hospital:
Number of institutional deliveries conducted (including C-sections): 323245
Total number of C-section deliveries performed: 118036 (37%)
Mumbai:
Total deliveries: 25002
C-section: 12654 (51%)
Navi Mumbai (Municipal Corporation):
Total deliveries: 4766
C-sections: 2071 (43%)
Thane:
Total deliveries: 6918
C-sections: 2665 (39%)
Maximum In Public Hospitals:
Bhandara – Total deliveries: 3385
C-sections: 2174 (64%)
In Private Hospitals:
Total deliveries: 318683
C-sections: 189152 (59%)
Mumbai – Total deliveries: 24740
C-sections: 14606 (59%)
Navi Mumbai (MC) – Total deliveries: 4794
C-sections: 2643 (55%)
Thane – Total deliveries: 2015
C-sections: 1177 (58%)
Maximum In Private Hospitals:
Bhandara – Total deliveries: 2812
C-sections: 2420 (86%)
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