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The National Family Health Survey (NFHS-6), conducted in 2023-24 and released in May 2026, has revealed a troubling paradox in India’s maternal healthcare story. While institutional deliveries have risen dramatically and maternal healthcare access has improved, the country is witnessing a sharp increase in Caesarean section (C-section) births – many of which may not be medically necessary.

Twenty-two-year-old Suman (name changed) from a village near Rajasthan’s Dholpur delivered her first child at a private hospital earlier this year. She returned home with a healthy newborn, but also with a debt of nearly Rs 80,000 – equivalent to several months of her family’s income. Her husband, a daily-wage worker, borrowed money from relatives and local lenders to pay hospital bills. For the family, childbirth became not only a medical event but an economic crisis.

Months later, the loan remains unpaid. Suman’s story raises a question that statistics alone cannot answer: when did surgery become such a common part of childbirth, and at what cost to women and their families?

NFHS-6 shows that India’s C-section rate has risen from 21.5% in NFHS-5 (2019-21) to 27.2%. In private health facilities, the figure has reached 54%, meaning that more than one in every two deliveries is now surgical. Urban India has crossed 40%.

Rajasthan mirrors this trend. The state’s overall C-section rate stands at 35%, while urban private hospitals report a rate of 49.4%, nearly one in every two births. The survey also points to a widening urban-rural divide, suggesting that districts with a stronger private healthcare presence are witnessing significantly higher rates than less urbanised regions.

The World Health Organisation has long maintained that population-level C-section rates above 10-15% do not necessarily improve maternal or neonatal outcomes. While every pregnancy is different and many C-sections are lifesaving, rates far above this threshold raise concerns........

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