At Ludhiana hospitals, shift-end rush causing C-section spike

Manav Mander

Ludhiana, June 14

In sub-divisional hospitals at Khanna and Samrala in Ludhiana district, pregnant women often have to go under the knife for a Caesarean section (C-section) procedure not on medical grounds but due to a peculiar reason — the impatience among doctors and staff to leave hospital at the end of their shift at 3 pm.

Curious case of ‘3 pm caesareans’

• Pregnant women often undergo C-section delivery in Khanna & Samrala due to impatience among doctors, staff to leave hospitals at end of shift at 3 pm
• Although doctors are ‘on call’ duty after 3 pm, they prefer to refer women to other hospitals
• The Ludhiana Civil Surgeon has sent notices to 2 govt hospitals, seeking an explanation for high number of C-section procedures

All C-section procedures at these hospitals are conducted before 3 pm, none after that. Although doctors are ‘on call’ duty after 3 pm, they prefer to refer the expecting mothers to other hospitals.

According to reliable sources in the Health Department, it is the hurry to return home after completing the day’s shift that causes doctors and staff to put expectant mothers on the surgery table.

Ludhiana Civil Surgeon Dr Jasbir Singh Aulakh has sent notices to two government hospitals and a few private ones, seeking an explanation for the high number of C-section procedures conducted by them. The notice issued to government hospitals in Khanna and Samrala notes that no C-section procedure is being done there after 3 pm and most cases requiring this procedure are referred to other hospitals. The staff at these hospitals has been asked to give an explanation on the same.

“Private hospitals have been asked to submit their record of C-section cases so that a medical audit can be done by the Civil Surgeon’s office. Government hospitals have also been asked to submit their records and give appropriate reasons for high number of C-section deliveries, and why no C-section delivery was done in these hospitals after 3 pm,” said a source.

While the World Health Organisation (WHO) recommends that the percentage of C-section deliveries should not exceed 10-15 per cent in any area, it’s very high in the Ludhiana hospitals — 45.20 per cent at the Khanna Civil Hospital and 51.42 per cent at the Samrala Civil Hospital in the last one year.

The situation is much worse in private hospitals: between March 2023 and March 2024, records of 191 private hospitals and nursing homes reveal that five of them did not conduct even one normal delivery in this duration; in 52 of them the C-section delivery rate is 70-96 per cent. It is an open secret that private hospitals use the C-section procedure as a source of minting money, but such high numbers for government hospitals — where no fees are charged — have been raising eyebrows.

Dr Sunil Katyal, state chief of Indian Medical Association (IMA), said medical indicators should be the only criteria for C-section procedures. “C-sections are performed for various reasons and some doctors are criticised for advising C-sections with financial incentives in mind,” he said. “The increasing number of C-sections has raised concerns about unnecessary medicalisation of childbirth.”