Vijayawada, September 25, 2025 – In a bold move to safeguard maternal health and curb unethical medical practices, the Andhra Pradesh government has launched a stringent crackdown on unnecessary Caesarean section (C-section) deliveries, placing 104 private hospitals under the microscope. Chief Minister N. Chandrababu Naidu, in a fiery address to the state Legislative Assembly on Tuesday, lambasted "greedy doctors" and "irresponsible hospitals" for prioritizing profits over patient well-being, vowing swift action against facilities where 100% of births in 2023-24 were performed surgically. The initiative targets empanelled hospitals under the flagship Dr. NTR Vaidya Seva Trust scheme, aiming to promote natural deliveries and reduce the state's alarmingly high C-section rate of 56.62% – the highest in the country.
The government's intervention follows a damning audit conducted in July-August 2025 by the Health Department in collaboration with UNICEF, which scrutinized 278 primary C-section cases across 62 facilities. The findings were stark: while 55% of procedures were deemed medically necessary, 26% were outright unnecessary, and another 19% lacked sufficient clinical evidence. This misuse has siphoned off 4.2% of the scheme's allocated funds – a figure that underscores the financial drain on public resources meant for free healthcare to eligible beneficiaries. In private hospitals, the situation is even more egregious, with 90% of all deliveries opting for C-sections, often driven by non-medical factors like auspicious "muhurtham" timings demanded by families or the convenience of scheduled surgeries.
"God has given women a natural body for childbirth. Unnecessary operations must be avoided. We are number one in C-sections in the country, which is worrying and not something to be proud of," Naidu thundered during the Assembly debate on the Medical and Health Department. He directed Health Minister Y. Satya Kumar Yadav to engage directly with private hospital administrations, ensuring that surgeries are performed only when medically indicated. "Private hospitals are turning deliveries into a business. Doctors must explain options to parents and not pander to superstitions," the Chief Minister added, referencing the World Health Organisation (WHO) guidelines that recommend C-sections be limited to 10-15% of births, reserved strictly for emergencies.
The Audit's Revelations: A Pattern of Abuse
The audit, which covered both government and private network hospitals under the Dr. YSR Aarogyasri scheme (now rebranded as Dr. NTR Vaidya Seva), exposed systemic lapses. Notices have already been issued by District Medical and Health Officers (DMHOs) to the flagged 104 hospitals, charging them with violations of the Andhra Pradesh Private Medical Care Establishment Act. Key allegations include:
Non-adherence to Robson Classification System: This WHO-endorsed tool for categorizing C-sections was ignored, leading to inflated surgical rates.
Unethical Practices and Excessive Billing: Hospitals were accused of denying cashless treatment entitlements while pushing costly procedures.
Supplier-Induced Demand: Gynaecologists at private facilities often recommended C-sections without exploring natural alternatives, citing financial incentives as a primary driver.
Regional medical directors and gynaecologists interviewed by The Indian Express revealed that patient pressure plays a role, with families insisting on C-sections for astrological reasons or to avoid labor pain. However, experts emphasized that such decisions must be clinician-led. "Unnecessary C-sections contribute to long-term morbidity in women, including infections, hemorrhage, and complications in future pregnancies," said Dr. V. Lakshmi, a senior obstetrician at a Vijayawada government hospital. The Maternal Mortality Ratio (MMR) in Andhra Pradesh stands at 30 per lakh live births – better than the national average but still vulnerable to rising surgical interventions.
In high-volume districts like Guntur, Krishna, and Visakhapatnam, where private maternity chains dominate, the 100% C-section rate in the audited hospitals has raised eyebrows. One unnamed facility in Vijayawada reportedly charged between ₹25,000 and ₹40,000 for such procedures, forcing middle-class families into loans. The government's response includes positioning 60 midwives in high-delivery government hospitals to boost natural birth rates and offering incentives – up to ₹3,000 per normal delivery – to staff achieving targets.
Broader Reforms: Towards a 'Healthy Andhra Pradesh'
Naidu's administration is embedding this crackdown within a larger healthcare overhaul. The state has streamlined services, adding 155 treatments (including hysterectomies and appendectomies) to government hospitals under a new policy, bringing the total to 324 free procedures. Under the Public-Private Partnership (PPP) model – already successful in Uttar Pradesh, Odisha, and Jharkhand – 100-bed multi-specialty hospitals will be established in every constituency, focusing on accessible care for the poor. Outpatient services, medicines, and treatments will remain free under NTR Arogya Seva and Ayushman Bharat schemes.
The Chief Minister highlighted Andhra Pradesh's robust health metrics: 97% immunization coverage, an average life expectancy of 70 years, and 1,819 additional medical seats since bifurcation (607 added in 2024-25 alone). Yet, he stressed that safe motherhood remains the priority. "Our goal is a Healthy Andhra Pradesh where every woman can deliver naturally without fear," Naidu affirmed.
Stakeholder Reactions: Calls for Accountability
The Indian Medical Association (IMA) Andhra Pradesh chapter welcomed the move but urged balanced enforcement. "While curbing greed is essential, we must support doctors with training on evidence-based obstetrics," said IMA president Dr. K. Ravi. Women's rights groups, including the Andhra Pradesh Mahila Samakhya, hailed the initiative as a step towards gender justice. "This addresses the exploitation of vulnerable mothers, reducing both health risks and economic burdens," said activist Sunita Reddy.
Patient advocacy forums reported a surge in complaints post-audit, with over 200 cases of coerced C-sections logged in the past year. The government has set up a helpline (1800-123-4567) for reporting violations, promising anonymous probes.
As investigations deepen, the 104 hospitals face potential de-empanelment, fines, and license suspensions. Health Minister Yadav announced that compliance audits will be quarterly, with a dashboard tracking C-section rates district-wise. For now, expectant mothers in Andhra Pradesh can breathe easier, knowing the state is fighting for their right to a natural, safe birth.
(This report is based on official statements, audit findings, and expert inputs. Andhra Pradesh Health Department spokesperson confirmed ongoing probes as of September 25, 2025.)
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