Karnataka plans labour pain-relief options to reduce C-section deliveries

Bengaluru: The Karnataka health department is planning to introduce labour analgesia options in government hospitals to curb the rising C-section delivery rates, which currently account for nearly 47 per cent of institutional deliveries, officials said.

The initiative aims to reduce fear of pain during childbirth, encouraging more women to opt for natural deliveries and lowering the risks associated with surgical births, including maternal mortality. The proposed pain-management options include epidural injections and nitrous oxide.

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Medical Dialogues had previously reported that amid the growing rate of cesarean deliveries, which now account for 46% of births and are overshadowing normal deliveries, the Karnataka government has formulated a special program that will be introduced next month to control and reduce unnecessary cesarean deliveries in the state.

An epidural, a regional anaesthesia injected into the lower back, numbs contractions while keeping the mother awake. Nitrous oxide, a mix of gas and oxygen, provides mild pain relief and reduces anxiety during labour, allowing mothers to remain mobile and alert.

The initiative follows a pilot study conducted in Tumakuru, which found that C-section rates significantly exceed recommended levels. Fear of labour pain was identified as a major factor discouraging natural childbirth. Harsh Gupta, principal secretary of the health department, said that the study, which analysed a few hundred cases, showed that C-section rates are higher than they should be. He added that the new pain management techniques are expected to help alleviate mothers’ fear of pain.

Gupta noted that implementing epidurals will require additional expert anaesthetists, and the hospital is currently figuring out how to allocate human resources for that. He mentioned that, on the other hand, nitrous oxide can be self-administered during contractions.

The department is also consulting experts on birthing positions and plans to expand interventions such as water births, music therapy, and aromatherapy, currently available at Vani Vilas Hospital, across other government facilities.

In Karnataka, 47% of institutional deliveries in 2024–25 were C-sections. The govt views this as a major contributor to maternal mortality. "Higher C-section rates also increase the risk of complications such as sepsis, oxygen deprivation to the baby, and ultimately, maternal mortality rates. Some experts have informed us that mothers often choose elective C-sections for perceived safety. Studies indicate that immunity levels are lower in babies born by C-section compared to those born via natural delivery. We are adding this information to the surgery consent form so mothers can make informed decisions," Gupta explained, reports TOI.

The pilot study’s findings have also led to training programs for medical staff to promote vaginal deliveries, including for mothers with previous C-sections. Nurses and midwives will be trained to encourage a healthy diet, exercise, and yoga during pregnancy.

Dr. Pranathi Aravind, senior consultant in the Department of Obstetrics and Gynaecology at Gleneagles BGS Hospital, said that stories about labour pain heard from mothers and grandmothers, along with fear of pain during labour, often lead women to opt for C-sections. She explained that the duration of labour can be anywhere between 14–15 hours for a first birth and about half that for subsequent births. Labour analgesia, she added, can not only relieve women of pain but also encourage younger mothers to consider natural delivery.

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