 bill no 199 of  2017 the protection of women from unnecessary caesarean section deliveries bill, 2017 by shri maheish girri, mp a billto protect women from unnecessary and arbitrary caesarean section deliveries through the regulation and financial disincentivizing of private and public hospitals and for matters connected therewith or incidental theretobe it enacted by parliament in the sixty-eighth year of the republic of india as follows:—short title and commencement1 (1) this act may be called the protection of women from unnecessary caesareansection deliveries act, 20175(2) it shall come into force on such date as the central government may, by notificationin the official gazette, appointdefinition2 in this act, unless the context otherwise requires:(a) ''abnormally high rate of caesarean section deliveries" refers to a rate, in the given locality of the public or private hospital, doctor, paramedic, medical practitioner and other institution or persons carrying out deliveries on a regular basis, of more than fifteen per cent of the local population;(b) ''appropriate government" means in the case of a state, the government of that state and in all other cases, the central government;5(c) ''board'' means the caesarean section deliveries control board constituted under section 6;10(d) "caesarean section deliveries" or "c-section deliveries" refers to a surgical procedure in which incisions are made through a woman's abdomen and uterus when vaginal delivery is not possible or wherein the vaginal  delivery is likely to put the health of the mother or the baby at risk;102 of 1956(e) "medical practitioner" means any person holding medical qualification recognized under the indian medical council act, 1956 and enrolled as such by the appropriate authority;(f) "ordinary delivery" refers to the vaginal delivery;15(g) "prescribed" means prescribed by rules made under this act; and (h) "private hospital" includes hospitals, private nursing homes, medical institutions and clinics being run by a medical practitioner or a group of medical practitioners of a trust or society203 (1) the appropriate government shall, by notification in the official gazette, shall put a cap on the price charged by both private and public hospitals for caesarean section deliveriesproportionate capping of cost of caesarean section deliveries(2) the cap on the price charged for caesarean section deliveries shall be proportionate to the price charged for ordinary deliveries, and shall not exceed twenty per cent of the total cost of the ordinary delivery in a hospital25(3) the appropriate government shall ensure that every public and private hospital under their jurisdiction comply with the provisions of this sectionmandatory declaration by doctors and hospitals304 (1) it shall be the duty of every public and private hospital, doctor, paramedic, medical practitioner or person carrying out deliveries on a regular basis to declare the percentage of caesarean section deliveries being carried out by them on a monthly basis in such manner as may be prescribed(2) every declaration made under sub-section (1), shall be shown to the prospective women seeking delivery, and shall, at the end of every month, be forwarded to the appropriate government in such manner as may be prescribed355  any public or private hospital, doctors, paramedics, medical practitioner and other institutions or persons carrying out delivery on regular basis, who fails to make declaration under section 4, shall be punished with imprisonment for a term which may extend upto two years or with a fine which may extend upto rupees ten lakh or with bothpunishment for failure to make mandatory declaration406 (1) the appropriate government shall, by notification in the official gazette, constitute a board under their jurisdiction to be known as the caesarean section delivery control board for carrying out the purposes of this act(2) the composition of the board shall be such as may be prescribedconstitution of caesarean section delivery control board7 (1) the board shall—functions of the board45(a) conduct enquiries against public or private hospitals, doctors, paramedics, medical practitioner and other institutions or persons carrying out deliveries on a regular basis, having an abnormally high rate of caesarean section deliveries; and(b) undertake such other functions as may be assigned to it, from time to time, by the appropriate government for carrying out the purposes of this act58 if any public or private hospital, doctor, paramedic and other institution or personcarrying out deliveries on a regular basis, having an abnormally high rate of caesarean section deliveries, after an enquiry made under sub-section (1) of section 7, is found to beperforming unnecessary or arbitrary caesarean section deliveries the head of the hospital or person responsible for carrying such deliveries, shall be punished with imprisonment for a term which may extend upto seven years or with fine which may extend up to rupees twenty lakh or with bothpunishment for doctors and hospitals with abnormally high rate of caesarean section deliveries10power to make rules9 (1) the appropriate government may, by notification in the official gazette, makerules for carrying out the purposes of this act15 20(2) every rule made under this act by the central government shall be laid, as soon as may be after it is made, before each house of parliament, while it is in session, for a total period of thirty days which may be comprised in one session or in two or more successive sessions, and if, before the expiry of the session immediately following the session or the successive sessions aforesaid, both houses agree in making any modification in the rule or both the houses agree that the rule should not be made, the rule shall thereafter have effect only in such modified form or be of no effect, as the case may be; so, however, that any such modification or annulment shall be without prejudice to the validity of anything previously done under that rule(3) every rule made by the state government under this act shall be laid, as soon as may be after it is made, before the state legislature statement of objects and reasonsour country has witnessed a steep rise in unnecessary and arbitrary caesarean section deliveries being carried out across all states over the past few years according to the world health organization, a figure below five per cent of the total population implies that a substantial proportion of women do not have access to surgical obstetric care on the other hand a rate higher that fifteen per cent of the total population indicates over-utilization of the procedure for reasons other than life saving reasons in india, from under ten per cent in 2010 as per the district level household and facility survey (dlhs-3) and the national family health survey, the rate of caesarean section deliveries has steeply risen in few states and the country as a whole given the presence of a substantial inter-state variation of caesarean section deliveries, few large states (population of ten million and above) such as kerala, haryana, andhra pradesh and tamil nadu have undergone a significant increase in the number of caesarean section deliveries moreover, certain districts have reported a rate of caesarean section deliveries of more than eighty per cent the rising rate of caesarean section deliveries makes it evident that the rise is unnatural, unnecessary and arbitrary and is done for financial gains that arise on account of the higher prices in caesarean section deliveries as opposed to ordinary deliveries taking note of the rising rate of caesarean section deliveries and the harmful effects on mothers and children born out of the same, the need is to regulate and financially disincentivize the caesarean section deliveries in the countrythe bill, therefore, seeks to provide for a basic regulatory mechanism to safeguard the interests of women who are victims of unnecessary and arbitrary caesarean section deliveries by providing a cap on the price charged for caesarean section deliveries in as much as it will not be more than twenty per cent of what is charged in case of ordinary deliveries it also seeks to provide for mandatory declarations to be made by doctors, hospitals or any person carrying out deliveries on a regular basis in relation to the rate of caesarean section deliveries, as well as a mechanism of enquiring into the same in addition, the bill also provides for the punishment for the failure to make mandatory declaration and for unjustified abnormally high rates of caesarean section deliverieshence this billnew delhi;maheish girriaugust 4, 2017 financial memorandumclause 6 of the bill provides for constitution of caesarean section delivery control board the bill, therefore, if enacted will involve expenditure from the consolidated fund of india it is estimated that a sum of about rupees ten crore will be involved as recurring expenditure per annuma non-recurring expenditure of rupees five crore is also likely to be involved memorandum regarding delegated legislationclause 9 of the bill empowers the appropriate government to make rules for carrying out the purposes of the bill as the rules will relate to matters of detail only, the delegation of legislative power is of a normal character lok  sabha———— a billto protect women from unnecessary and arbitrary caesarean section deliveries through theregulation and financial disincentivizing of private and public hospitals and for mattersconnected therewith or incidental thereto————(shri maheish girri, mp)gmgipmrnd—2232ls(s3)—03112017