Publication:

A one year study on evaluation of pattern of caesarean section and its outcome before and after introduction of Janani Suraksha Yojna and maternal ambulances services

Background The steady rise in caesarean section rates is an emerging area of concern in mother-child healthcare and a matter of international attention. During last decade Janani Suraksha Program and maternal ambulances services have brought many significant changes in maternal and perinatal outcomes in India, one of which is significantly increased number of institutional deliveries, this may have brought a difference in pattern of cesarean sections as well. Present study has analyzed caesarean section trend before and after introduction of Janani Suraksha Yojna (JSY) and maternal ambulance services at our institute.

Methods A structured proforma was filled up for every case and results were recorded on excel sheet. All the cases included in study were further divided in group 1 (deliveries done in year 2004-2005), group 2 (deliveries done in year 2014-2015) before and after introduction of JSY and maternal ambulance services respectively. Comparative analysis between study group1 and group 2 was done using Pearson Chi square test.

Results In group1, total deliveries during study period were 6050, out of which 562 (9.28%) were caesarean deliveries. In group 2, total deliveries was 8674, out of which 1182(13.62%) were caesarean deliveries. The most common indication for which the rise in caesarean section rate is seen in our study was repeat caesarean section, in group 1 was 21.7% and in group 2 was 32.2%, followed by failed medical induction.

Conclusions The rate of caesarean section has increased after introduction of JSY and maternal ambulance services which may be a direct consequence of increase in institutional deliveries.