The changing paradigm of labour and childbirth in Indian cities: an enquiry into increasing rates of caesarean deliveries

Newborn baby delivered by caesarean section with his mother. Emergency tray arranged in a labour room at a community health centre. Aide-memoire outlining when to refer the mother or the newborn to a higher centre in the labour room of community health centre in Uttar Pradesh, India. Entrance to the blood bank at a district hospital in Uttar Pradesh, India. Labour room at a private hospital. A national ambulance services driver poses outside his ambulance. Public information notice displayed at a district hospital reads “offering or receiving bribes is a punishable offence”. Poor quality and unhygienic environment at a postnatal care ward. A pregnant women waits her turn to be called for her antenatal consultation. Scenes outside a district hospital after discharge of recently delivered woman. Scenes at a postnatal care clinic/ immunization centre at a busy district hospital. Many women seek care in private hospitals, as they believe that they offer a cleaner and more comfortable environment, provide better quality services and adhere to more respectful care practices.12Many doctors prefer CS in order to save time, ease scheduling, increase earnings and to avoid litigation and harassment.13 In addition, medical education is prohibitively expensive in India, with fees of approximately US$800,000 leading many specialists to focus on cost recovery and profit motives. A roadside fortune teller reads a client’s palm. Conflict of interest: None declared.