by Rana Islamiah Zahroh, Ana Pilar Betrán, Alya Hazfiarini, Marc Cheong, Fitriana Murriya Ekawati, Ova Emilia, Caroline Homer, Meghan A Bohren
BMJ Global Health, Volume 11, Issue 10, Commentary. 1 October 2026. Open access. 10.1136/bmjgh-2026-023873
Summary Box
Caesarean section (CS) is a life-saving intervention but CS rates are rising globally beyond clinical need. Enhanced Recovery After Caesarean Section (ERACS), originally an evidence-based peri-operative approach, is increasingly commercialised and marketed as a premium CS option.
- In Indonesia, ERACS promotion emphasises comfort, painless birth and rapid recovery, contributes to misinformation, disinformation and an infodemic shaping women’s perceptions of birth, downplays the risks of CS and may encourage women to choose CS more readily.
- Commercial framing of ERACS reinforces inequities, as access is largely limited to wealthier women in private hospitals and is not routinely covered by national insurance. This model risks increasing unnecessary CS use and placing additional strain on surgical capacity and essential health system resources.
- Stronger regulation, clear evidence-based guidelines and equitable financing are urgently needed to protect women’s rights to safe, informed and equitable maternity care.