Bengaluru: More women in Karnataka are giving birth via caesarean section (C-section) than before, with state health data showing a 20% increase in such deliveries over the past three years.In 2024-25 alone, of over 8.3 lakh institutional births, 3.9 lakh — nearly 47% — were C-sections, according to the health and family welfare department.Bengaluru Urban has emerged as a significant contributor to this trend, accounting for one in every five C-sections in the state. Of over 1.4 lakh deliveries in the district this year, 72,014 were surgical — pushing the C-section rate close to 50%. The city’s rates have been climbing steadily, from about 43.3% in 2022-23 to 44.3% in 2023-24.Other districts showing higher-than-average C-section figures include Belagavi (35,903), Tumakuru (18,999), Kalaburagi (17,202), and Vijayapura (16,440). By contrast, Chamarajanagar and Kodagu have reported notably lower rates, with 4,447 and 1,948 C-section births respectively since April 2024.Doctors cite a combination of clinical, cultural, and legal factors behind this increase. “There’s a clear surge in high-risk pregnancies, often driven by lifestyle-related disorders like diabetes, hypertension, and obesity,” said Dr Savitha C, medical superintendent at Vani Vilas Hospital. “Women are also delaying childbirth more frequently and turning to fertility treatments such as IVF, increasing the likelihood of surgical deliveries. For some, it’s also about fear of labour or the decision to have only one child,” she added.While medical advancements have enabled safer pregnancies for women with complex health conditions, Savitha said natural delivery, when feasible, remains preferable. “A vaginal birth allows faster recovery. A C-section is major surgery with associated risks — ranging from infection and haemorrhage to delayed mobility and, rarely, maternal death.”Dr Sapna Raina, senior consultant at Narayana Health City, said a primary C-section often leads to repeats, as a scarred uterus increases the risk of rupture. “In cities like Bengaluru, many women are older, who have undergone fertility treatment. They view their pregnancies as ‘precious’ and wouldn’t want to take any chance for complications for babies. This emotional context sometimes tips the decision towards surgery, even when not strictly necessary,” she said.Elective C-sections have also become more common. Dr Priya S P Patil of Altius Hospital noted an increase in families requesting deliveries at specific times for spiritual or astrological reasons. “Cultural beliefs about auspicious timings are playing a bigger role than before,” she said.Legal pressure adds another layer. In cases of prolonged labour, where outcomes are uncertain, many doctors opt for surgery to avoid the risk of litigation, Dr Patil said, adding: “Taken together — repeat procedures, maternal age, lifestyle factors, cultural preferences, and medico-legal fears — the rise in surgical births becomes more understandable.”C-section complications:■ Intraoperative haemorrhage■ Placenta accreta (rupture) in repeat procedures■ Risk of hysterectomy or maternal death■ Prolonged hospital stay■ Limited mobility post-surgery——— BOX: 5 districts with highest number of C-sectionDistrict2022-232023-242024-25Bengaluru Urban66,93271,73472,014Belagavi26,40332,45435,903Tumkuru17,17318,68118,999Kalaburgi11,12914,42817,202Vijayapura11,45414,67916,440 BOX: Rising cases of C-sections in Karnataka YearNumber of C-sectionsTotal number of deliveries2022-233.2 lakh7.4 lakh2023-243.8 lakh8.4 lakh2024-253.9 lakh 8.3 lakhSource: Health department | Figures in lakh rounded off