Most women in Cyprus choose a cesarean section rather than a vaginal birth, placing our country near the top of European rankings and often in first place.
In recent years, Cyprus’s rate has hovered around 60%, while the average in the European Union ranges from 27% to 30%. For example, in 2024 the cesarean section rate rose to 62%, in 2025 to 61%, and so far this year, the rate stands at nearly 58%.
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“This rate remains significantly higher than projected, though there are signs of very slight improvement.”
Monica Kyriakou – Director of the Health Services Department, OAY
Along with Cyprus, Greece, Romania, Bulgaria, and Poland rank among the top countries in terms of cesarean section rates (40%–62%). Italy, Hungary, Germany, and Slovakia are close to the European average (25%–38%), while the lowest rates are found in two Scandinavian countries (Finland, Sweden), the Netherlands, Slovenia, and France (15% to 20%).
“Let’s figure out the deeper reasons behind this. Is it because a C-section is now a safe procedure? Painless? Is it a matter of culture, as we say? Do young women prefer it among themselves to avoid discomfort?”
Aphrodite Elissaiou – President of the Society of Gynecology and Obstetrics
Cyprus’s high rate caused an uproar, leading the parties involved to coordinate a national strategy that was implemented in 2024. At the same time, the organization implemented clinical guidelines within the healthcare system regarding the indications for cesarean section.
“We require that these be documented in the system, which is also a very important factor, and the third step we have taken is to implement a procedure whereby the doctor is required to fully inform the pregnant womanthe time of delivery regarding the pros and cons of a cesarean section and vaginal delivery.”
Monica Kyriakou
According to data from the Hellenic Medical Association (OAY), 25 obstetricians and gynecologists perform more than 70% of deliveries via cesarean section, and 5 of them perform more than 90%.
“I’m not going to get into whether these cesarean sections are justified or not. Some of them may be. I’m simply referring to the big picture, which obviously accounts for Cyprus’s very high rates.”
Monica Kyriakou
“We can’t say that there are colleagues who actually push for C-sections just because they want to. There must certainly be a medical reason for a doctor to say that a woman should have a cesarean.”
Aphrodite Elissaiou
Is it ultimately a financial issue or a cultural one? Quite often, the impression prevails that a gynecologist recommends a cesarean section because of the higher fee they receive.
Data from the Organization show that the average cost of a cesarean section is 3,700 euros, compared to 2,700 euros for a vaginal delivery.
These amounts, however, are paid as reimbursement to the hospitals.
“Since a cesarean section is a surgical procedure, it involves operating room conditions, supplies, equipment, and staff; obviously, from the organization’s perspective, hospitals receive higher compensation for a cesarean section compared to a vaginal delivery. So yes, the organization reimburses hospitals about 1,000 euros more for a cesarean section.”
Monica Kyriakou
“Now, with GESY, we’re talking about a 100-euro difference. So the issue of compensation doesn’t even come up. The difference in terms of payment is negligible. So it’s not a matter of payment.”
Aphrodite Elissaiou
Despite efforts to lower the rate, a woman’s choice to proceed with a cesarean section remains.
“We uphold a woman’s right to choose, but there needs to be more education. So that natural childbirth is once again viewed as a normal process.”
Monica Kyriakou
“If, despite all the discussions she has had with her obstetrician, she insists that she does not want to proceed with a vaginal birth, then she signs a form stating that, even though there is no medical indication, she wishes to proceed.”
Aphrodite Elissaiou
A percentage that, as they admit, they do not expect to decrease overnight, but over time.
Watch the report by Nasia Ioannou:
