Seeking to curb the surge in unnecessary caesarean sections and boost natural birth rates in the public sector, Egypt’s health minister Khaled Abdel‑Ghaffar has ordered public and central hospitals to provide a woman’s first vaginal delivery free of charge.
The move is part of a wider Health Ministry campaign to bring Egypt’s exceptionally high C-section rate closer to global norms. By targeting first births and private hospitals, where unnecessary procedures are concentrated, the ministry is trying to push doctors toward evidence-based decisions and bring delivery practices in line with medical guidelines.
According to a letter circulated to health affairs directorates, obtained by Al Manassa, the decision was based on the Higher Committee to Reduce Cesarean Sections’ recommendation to treat first vaginal births in hospitals as emergency cases. This classification brings them under Prime Ministerial Decree No. 1063 of 2014 , which obliges all medical facilities to provide accident and emergency care free of charge for 48 hours.
The committee recommended the measure to encourage safe vaginal deliveries and curb unjustified caesarean sections, arguing it would strengthen maternal and child health indicators. The health minister approved the proposal and circulated it to health directorates.
Deputy Health Minister for Population and Family Development Abla Al‑Alfy said the decision applies only to public and central hospitals under the health affairs directorates. It excludes private hospitals and those affiliated with the Specialized Medical Centers Secretariat, while university hospitals and the Curative Care Organization already provide the service free of charge.
Al‑Alfy told Al Manassa the focus on a woman’s first birth reflects its influence on future deliveries. A first vaginal delivery increases the likelihood of subsequent natural births, reducing reliance on caesarean sections and the health complications associated with them.
She noted that C-section rates in Egypt remain high, with some procedures performed without medical justification. Contributing factors, she said, include mothers’ fear of labor pain and inadequate physical and psychological preparation for vaginal delivery during pregnancy.
C-section rates in Egypt reached 80% in 2025 before falling to 63% in the first quarter of 2026, with about 93% of these births taking place in private-sector hospitals, according to an April Health Ministry statement.
The Health Ministry’s department overseeing private medical facilities announced Monday that obstetrics and gynecology operations at Dar Al‑Fouad Hospital in 6 October City will be suspended for one month, except in emergencies.
The move followed findings that the hospital had violated September 2025 guidelines aimed at reducing medically unnecessary cesarean sections, according to a health ministry statement. Officials said the suspension is part of stricter oversight of C‑section practices in the private sector.
The ministry said doctors must adhere to scientific standards when deciding whether to perform a caesarean, notably by using the birth monitoring chart, or partogram, to track labor progress. They must also apply the Robson classification to assess the medical justification for surgical intervention. Proper documentation of these procedures, it added, ensures the soundness of medical decisions and protects service providers.
On private sector oversight, Deputy Minister Abla AlAlfy said her department is coordinating with the Health Ministry’s unit supervising private medical facilities to monitor cesarean rates and compliance with clinical standards. She stressed that any violations identified are subject to review and accountability.
The decision was welcomed by the Egyptian Initiative for Personal Rights, which recommended that the Health Ministry intensify oversight efforts and punitive administrative measures against private medical facilities that ignore medical guidelines aimed at reducing unnecessary C-sections.
