Third Child Seen as High-Risk Amid Rising C-Sections

Kurnool:Medical experts have cautioned that the Andhra Pradesh government’s push encouraging families to have three or four children may face challenges because of the rising number of cesarean deliveries and declining fertility rates.

The state government has announced incentives and financial support for nutrition and education to encourage larger families. Chief Minister N. Chandrababu Naidu has also promised support to families opting for more children.

Doctors, however, said the increasing dependence on Cesarean sections was discouraging many women from considering a third child.

Anantapur-based gynaecologist Dr Nissi Vinutna said repeated cesarean deliveries carried higher medical risks.

“When a woman has to undergo two or three Cesarean deliveries, there is a higher risk of heavy bleeding, infections and delayed recovery. Such pregnancies are generally categorised as high-risk, and require close monitoring until delivery,” she said.

Health experts said the financial burden was also a factor, with each cesarean delivery in private hospitals costing up to Rs 1 lakh.

In several cases doctors encourage surgical deliveries.

Dr N. Vamsidhar said delayed marriages, late pregnancies and increasing dependence on cesarean deliveries were affecting fertility trends. “Many gynaecologists consider normal delivery to be risky and prefer to avoid it, which is indirectly impacting reproductive decisions,” he said.

According to World Health Organisation guidelines, Cesarean sections should not exceed 15 per cent of total deliveries. However, private hospitals in the state crossed this level more than two decades ago and the numbers have continue to rise.

Senior gynaecologist Dr A. Anil Kumar said nearly 80 per cent of deliveries at the government hospital where he worked were normal deliveries.

“A woman who has a normal delivery the first time is more likely to have a smoother second delivery. But when the first and second deliveries are Cesareans, the body undergoes certain adverse physical changes,” he said.

Doctors also expressed concern over teenage pregnancies in the state -- which account for 8.8 per cent of pregnancies among girls below 18 years.

Health experts said early marriages and pregnancies in rural areas often weakened young mothers and affected future reproductive health.

According to official data, Andhra Pradesh records around 6.10 lakh deliveries annually, with institutional deliveries accounting for 99.2 per cent. The fertility rate stands at 1.5, while cesarean deliveries in private hospitals account for 67.8 per cent.

The government has set targets to reduce the family planning adoption rate from 70 per cent to 50 per cent, lower cesarean deliveries to 40 per cent and bring down teenage pregnancies to 3 per cent.

* Key statistics - Andhra Pradesh

- Annual deliveries 6.10 lakh

- Institutional deliveries 99.2 per cent

- Fertility rate 1.5

- Deliveries in private hospitals around 4 lakh

 C section rate in private hospitals 67.8 per cent

- Family planning adoption 70 per cent

- Teenage pregnancies 8.8 percent

* Government targets:

- Reduce family planning rate to 50 per cent

- Reduce C sections to 40 per cent

- Reduce teenage pregnancies to 3 per cent