Childbirth | Rising cost of motherhood-Pregnancy care. Pregnancy care is now more institutionalised and monetised in India than ever before, leading to ill-advised C-sections, non-essential tests that hog hospital resources and luxury maternity services for the affluent and anxious.
Childbirth | Rising cost of motherhood. At the outpatient department of a private hospital in Delhi, a young, eight-month pregnant woman (name withheld) is in tears, pleading with her gynaecologist to perform a Caesarean section. There is no medical emergency, nor is the baby ready. It’s just that she wants her child to share a birthday with her late father.
Talk to the experts and they will tell you that such requests are no longer unusual. Many an urban couple now approaches their doctor with elaborate birth plans, demanding additional scans despite normal reports, non-essential genetic tests, elective inductions and planned Caesareans to fit auspicious dates, family events or work schedules. “Urban parents,” says Dr P.M. Gopinath, director of reproductive medicine at Kauvery Hospital in Chennai, “have Instagram, YouTube, parenting apps and conflicting advice from everywhere. The brain is doing risk assessment 24 x 7.”
According to findings of the sixth round of National Family Health Survey (NFHS-6), conducted in 2023-24 and released in May 2026, pregnancy is becoming more intensively managed than ever before. Of all births in India, 90.6 per cent of births now take place in health institutions. While that’s good news, what’s not so encouraging is that 27.2 per cent of births now take place through C-section. The percentage is far higher in urban India at 40.5 per cent, and goes up to 54.1 per cent in private hospitals. This is far above the World Health Organization’s recommended rate of 10-15 per cent of births in a population delivered by C-section, above which maternal or newborn survival has not been shown to improve. The WHO has long maintained that rates beyond this threshold cannot be justified as essential medical need.
Symptomatic of this increased medicalisation is the rise of premium maternity care in the country, transforming childbirth into a highly curated experience for affluent urban families. Hospitals now market pregnancy packages that promise hotel-like comfort alongside medical care. At Apollo Cradle Royale in Delhi, mothers can opt for personalised birthing packages that include luxury labour-delivery-recovery suites, multi-cuisine meals, antenatal classes and lactation consultations. Other premium providers, including Cloudnine Hospitals, offer apartment-style suites, dietitians, physiotherapists and concierge-style maternity packages, which can range from Rs 1.5 lakh to over Rs 5 lakh.
TIRED AND TEEMING WITH TESTS
Doctors find nothing wrong with making maternity care more comfortable. Better facilities can improve the birth experience. The concern begins when it starts influencing decisions that should be guided primarily by medical need.
A C-section, for example, is a life-saving operation when medically indicated, but it remains a major abdominal surgery. Compared with a vaginal birth, it carries a higher risk of infection, blood loss, blood clots, longer recovery and complications in future pregnancies, including placenta accreta, a condition in which the placenta becomes attached to the uterine wall and cannot separate after delivery, increasing the risk of life-threatening bleeding. Researchers are also studying possible long-term effects on children. A 2024 population-based cohort study published in the Journal of the Formosan Medical Association found that children born through C-section had higher risks of respiratory tract infections, asthma, allergic rhinitis, atopic dermatitis and childhood obesity than those born vaginally, although the authors stressed these were associations and not proof of cause and effect. “We are seeing more pregnancies at an advanced maternal age, a higher prevalence of gestational diabetes and hypertension, and more pregnancies conceived through assisted reproductive techniques. These situations often make Caesarean delivery the safer option,” says Dr Sharma. “Obstetricians point out that even younger women are increasingly presenting with high blood pressure and diabetes during pregnancy, contributing to the rise in medically indicated Caesarean births,” says Dr Anita Gupta, senior director of gynaecology at Fortis La Femme, Delhi. The bottom line, cautions Dr Sharma, is that “the decision to perform a Caesarean should always be guided by clinical indications and individual patient needs rather than convenience or preference alone”.