Egypt ranks third globally in the number of cesarean deliveries, a trend fuelled by the convenience of scheduling births for both mothers and doctors, as well as the higher profits compared to natural deliveries. This financial incentive often encourages doctors and hospitals to opt for cesarean sections, even when not medically required.
In response, the Ministry of Health and Population issued a package of binding regulatory measures this week for all private medical facilities. The aim is to promote safe natural childbirth and reduce the rate of medically unnecessary cesarean sections.
The step aligns with international standards and the guidelines issued by the Egyptian Health Council, ensuring the provision of high-quality healthcare services for mothers and newborns, and reinforcing the commitment to improving health service quality.
Hossam Abdel-Ghaffar, the ministry’s spokesperson, stated that the measures represent a pivotal step in raising the standard of obstaetrics and gynaecology services provided by private sector facilities. According to Abdel-Ghaffar, the initiative is in line with the presidential campaign “Golden 1,000 Days” for the Egyptian family, launched under the umbrella of the 100 Million Health Campaign.
The initiative targets the first 1,000 days of a child’s life, including part of the pregnancy and the first two years after birth. This phase is considered critical, as 85 per cent of a child’s mental, physical, and psychological development occurs during these early stages.
Abdel-Ghaffar explained that the ministry seeks to enhance the safety of mothers and newborns by ensuring the application of best medical practices through close monitoring of periodic statistical reports from medical institutions.
Private medical facilities are now required to submit detailed monthly reports that include the total number of births, the percentage of cesarean deliveries classified according to the Robson Classification, and an analysis of the reasons for performing cesarean operations. The classification system organises deliveries into groups based on routinely collected obstetric data such as gestational age, previous cesarean history, fetal presentation, number of foetuses, and the onset of labour.
Submission of these reports began at the end of August, with a continuous commitment to regular reporting. To ensure effective implementation, the ministry has tasked health directorates in every governorate with monitoring compliance and evaluating the performance of medical facilities.
According to official reports from the Ministry of Health and Population, Egypt has one of the highest cesarean rates in the world. Abla Al-Alfi, deputy minister for population affairs and family development, stated that Egypt ranked first globally in cesarean delivery rates, reaching 72 per cent in 2021. She described this as a troubling indicator of the medical system’s approach to childbirth.
Al-Alfi emphasised that natural birth is the medically preferred method, while cesarean delivery, being a surgical procedure, should globally account for only around 10 per cent of births. In 2000, Egypt had a much lower rate compared to neighbouring countries, but the percentage gradually increased, reaching 28 per cent by 2008 at a time when the United States recorded 33 per cent. By 2014, Egypt’s cesarean rate had doubled to 52 per cent, making it the third highest globally.
Many women opt for cesarean delivery to avoid the pain and struggle of natural birth, often unaware of the risks and consequences. According to official statistics, a significant number of cesarean deliveries in Egypt are performed without medical necessity, exposing women to a wide range of complications.
Obstaetrician and gynaecologist Maha Mosaad noted that pregnant women often choose cesarean births to escape labour pain. She stressed that cesarean sections carry the same risks as any major surgery and should only be performed when medically indicated, such as in cases of heart disease, high blood pressure, diabetes or twin pregnancies where natural delivery poses a risk.
Mosaad added that while natural childbirth also carries risks, those associated with cesarean sections are generally more severe. These include postoperative bleeding, a higher risk of blood clots, and potential wound infections.
The World Health Organisation has described the global rise in cesarean deliveries as an “epidemic”, noting that “the maternal mortality rate among women who undergo cesarean sections is four to 10 times higher than among women who deliver vaginally.”
* A version of this article appears in print in the 4 September, 2025 edition of Al-Ahram Weekly
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