Egypt’s health and population minister Khaled Abdel-Ghaffar said his decision issued last week to make first-time vaginal births free at public and central hospitals aims to “restore citizens’ confidence in normal childbirth services at state hospitals,” adding that overcoming existing stigmas “requires time.”
Births at Ministry of Health facilities and university hospitals account for just 35% of total deliveries in Egypt, he told Al Manassa, with the private sector handling 65% to 70%. The minister argued that the imbalance has fueled medically unjustified C-sections driven by the profit motives of some private providers.
Abdel-Ghaffar’s decision classifies “primipara births” (a woman’s first vaginal delivery) as emergency cases under Prime Ministerial Decree No. 1063 of 2014, which mandates all medical facilities to provide emergency treatment free of charge for the first 48 hours. Abdel-Ghaffar attributed the move to a sharp drop in deliveries at state facilities and a corresponding surge in private-sector cesarean sections.
Cesarean section rates in Egypt reached 80% in 2025 before declining to 63% in the first quarter of 2026. Approximately 93% of those births occurred at private sector hospitals, according to a ministry statement from last April.
A circular letter addressed to health affairs directorates obtained by Al Manassa revealed the decision followed a recommendation from the Supreme Committee for Reducing Cesarean Sections. By legally classifying initial vaginal births as emergency cases, the committee ensured they fell under the 2014 decree’s mandate for free emergency care.
Abdel-Ghaffar told Al Manassa that the state will bear the financial cost of his decision, contending that the real return lies in improving maternal and child health in the long term and reducing rates of medically unjustified surgical intervention.
While the cost of a natural birth currently stands at around 1,500 Egyptian pounds ($29) at public hospitals, medical teams receive 50% of the medical service fee as an incentive, according to ministry spokesperson Hossam Abdel Ghaffar. This is stipulated by Decree No. 75 of 2024, which regulates health facilities under local administration.
To improve the quality of healthcare, Abdel Ghaffar told Al Manassa, the ministry is also establishing incentives for physicians, implementing specialized training programs, and providing advanced fetal monitoring devices—specifically cardiotocography (CTG) machines—for use during the final months of pregnancy and labor.
The health ministry previously confirmed it was tightening its oversight of the private sector to ensure compliance with clinical guidelines. It vowed to impose the harshest penalties on non-compliant facilities, citing recent action taken against Dar Al Fouad Hospital in 6th of October City.
Last week, the Free Treatment Administration suspended obstetrics and gynecology operations at the hospital for one month—excluding emergency cases—after the facility violated clinical guidelines issued in September 2025, announced a health ministry statement.
The decision was welcomed by the Egyptian Initiative for Personal Rights, which called on the Free Treatment Administration to intensify its oversight efforts and punitive administrative measures against private medical facilities that disregard protocols aimed at reducing unnecessary C-sections.
