By Noor ul ain Ali
When Sara, a 29-year-old schoolteacher from Lahore, went into labor, she was told by her private hospital that her baby’s heartbeat was dropping and an emergency C-section was the only option.
Panicked and unprepared, Sara consented.
But a week later, while talking to a friend who’s a gynecologist, she found out that in many such cases, “fetal distress” is often loosely interpreted and sometimes exaggerated in private hospitals to justify a cesarean delivery.
Sara’s story isn’t unique. It’s part of a growing trend in Pakistan where cesarean sections (C-sections), once considered a last resort, are increasingly being pushed as routine.
According to UNICEF, Pakistan’s C-section rate has soared to over 40% in urban areas, far exceeding the World Health Organization’s recommended rate of 10-15%. In many private hospitals, doctors admit off the record, that more than half of their deliveries are now conducted surgically.
So, what changed?
“Natural births take time. You can’t schedule them. But a C-section? It’s fast, predictable, and more profitable,” said a mid-level administrator from a leading hospital chain in Karachi, requesting anonymity.
For hospitals, a C-section can cost between Rs. 120,000 to Rs. 300,000, often double the fee of a vaginal delivery. Add charges for anesthesiologists, post-op stays, medicines, and the bill climbs even higher.
“I’ve been pressured to convince patients for surgery when it wasn’t needed,” confessed a junior gynecologist at a private maternity center in Islamabad. “The administration doesn’t say it directly, but there’s a clear preference for faster turnover.”
She explains that hospitals subtly reward doctors who perform more C-sections, either through bonuses, better shifts, or patient referrals.
Meanwhile, patients are often left confused and cornered, trusting that their doctors are acting in their best interest, unaware of the business model behind the curtain.
C-sections are major abdominal surgeries. They carry higher risks of infection, longer recovery times, increased chances of complications in future pregnancies, and emotional trauma.
“I couldn’t walk properly for weeks,” said Areeba, a new mother from Multan. “I kept asking myself, was this really necessary?”
In rural areas, women face even harsher consequences. Lack of post-op care, unaffordable medicines, and physical strain from household responsibilities lead to life-threatening complications after surgery. Oversight, No Accountability
Despite the rising numbers, there’s no formal regulatory body in Pakistan that audits or investigates hospital delivery trends. The Pakistan Medical & Dental Council (PMDC) offers ethical guidelines, but enforcement is lax.
“It’s a blind spot in our healthcare governance,” says Dr. Mehreen, a women’s health activist. “Hospitals are run like businesses. Patients are not clients, they’re patients in need of help.”
Experts say the solution isn’t just regulation it’s informed consent. Women must be educated about their birthing rights, alternative options, and the difference between necessity and convenience.
Some maternity clinics in the country are now offering midwife-assisted births, birthing classes, and VBAC (vaginal birth after cesarean) options, but these remain rare and mostly in elite circles.
Until then, women like Sara will keep wondering: Was I really at risk — or just a line item on someone’s financial target sheet?
Names have been changed to protect privacy.