Without medical regulations encouraging for-profit practices, new mothers and babies are at risk of complications.
LAHORE/KARACHI/PESHAWAR:
The discovery of cesarean deliveries, or C-sections, was a major medical breakthrough that helped prevent countless maternal and fetal deaths. However, global health standards recommend that this procedure be performed only when medically necessary. Yet in Pakistan, where accountability gaps plague the health system, it is often difficult to determine whether a cesarean section is performed to save the lives of the mother and child or to serve the birthing industry.
Beyond cases required for medical reasons, many doctors now favor C-sections over natural births, viewing them as more predictable and convenient because the procedure is quicker and involves fewer complications for medical personnel. However, C-sections carry increased health risks for the mother and her newborn and can lead to complications in future pregnancies. Experts emphasize that a natural birth remains the healthiest option for maternal and child health.
Bashira Rani, a new mother from Lahore, shared that high blood pressure and the risk of potential complications during labor led her to undergo a cesarean section. However, Naila, a new grandmother, revealed that a private hospital demanded Rs 200,000 for her daughter’s C-section. “Eventually, my daughter gave birth naturally in a public hospital after we paid a bribe. The Ministry of Health does not have a system to regulate private hospitals, which allows financial exploitation,” Naila claimed.
Sajida Bibi, a new mother from Peshawar, revealed that she was still suffering from complications after her cesarean section. Although the doctors’ version remains unknown, Sajida believes she was pressured to have the operation. “I kept crying and asked the doctor not to perform a C-section, but because of their greed to make more money, they continued. Now I am suffering from severe back pain and other complications,” shared Sajida, whose story reflects a larger trend of medical malpractice hidden behind unnecessary C-sections.
Although back pain is often a classic postpartum complaint among women, regardless of the mode of delivery, Dr Erum Majid, associate professor at the Department of Gynecology at Jinnah Hospital, revealed that C-sections were associated with a higher risk of complications, including bleeding, infection and anesthesia. “Caesarean section requires careful monitoring, clearance from an anesthesiologist and highly trained female doctors. Unfortunately, there is no central data across the country to track the statistics,” Dr Majid noted.
In Sindh, the increasing rate of surgical deliveries places a financial burden on public hospitals as patients require intravenous drips and other supplies. In 2025, Jinnah Hospital in Karachi reported 12,549 deliveries, including 6,438 by cesarean section. When The Express PK Press Club contacted Karachi Civil Hospital for data, they claimed that no records were available.
In Punjab too, C-section rates are increasing. Medical experts warn that presenting C-sections as an “easy and safe option” contradicts medical principles and is influenced by financial and administrative factors. After the introduction of the health card, the trend shifted towards cesarean sections. Data from private hospitals shows that 525,619 cesarean sections were recorded between 2017 and 2024, with this figure increasing to 668,238 after 2024.
Most deliveries now take place by cesarean section in private hospitals. Between 2016 and 2024, Rs 16.36 billion was paid in C-section claims. Normal deliveries in government hospitals cost a few hundred rupees, while private C-section packages range from 100,000 to 400,000 rupees. Doctors justify C-sections by citing a reduction in pain and length of labor.
Sources in the Punjab Health Department cited shortage of qualified midwives and experienced nurses, increased workload in hospitals and migration of staff abroad as other factors contributing to C-sections. Doctors often psychologically coerce women into having a cesarean section, but due to the lack of checks and balances, no meaningful action has been taken against them.
Dr. Sunila Khan, a gynecologist, noted that some women and their husbands schedule elective C-sections to avoid pain and deliver on a specific date. “While private hospitals are often accused of profiteering, doctors assess patients through scans and ultrasounds to determine whether a cesarean section is appropriate. These operations also take place in government hospitals, but due to the large number of patients, women often leave a day or two after the operation,” said Dr Khan.
Pakistan Medical Association President Dr Shershah Syed has warned that unnecessary cesarean sections in Pakistan are a human rights concern and a serious risk to maternal and newborn health. “Despite WHO guidelines limiting C-sections to 15 percent, rates in some hospitals reach 50 to 70 percent, especially in private facilities, which are often profit-driven,” noted Dr Syed, who urged the government to strengthen surveillance, make evidence-based medical decisions and improve training.
Dr Khalid Sheikh, chairman of the Sindh Health Care Commission, said only postgraduate specialists in gynecology could perform cesarean sections. “The Pakistan Medical and Dental Council (PMDC) monitors medical training but is not directly involved in supervising C-section practices,” Dr Sheikh said.
