The perception that it is less painful, its promotion by doctors, and the right to choose

Most women in Cyprus choose a cesarean section over vaginal delivery, placing the country near the top of European rankings and often in first place. Cyprus’s

trend

In recent years, Cyprus’s cesarean rate has hovered around 60%, while the European Union average 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%.

Speaking to “alpha on Sunday,” Monica Kyriakou, director of the Health Services Department at the OAY, admits that this rate remains significantly higher than expected, though there are signs of very slight improvement.

What is the situation in Europe?

Along with Cyprus, Greece, Romania, Bulgaria, and Poland rank among the top countries for cesarean section rates. These countries have rates ranging from 40% to 62%. Italy, Hungary, Germany, and Slovakia are close to the European average, with rates ranging from 25% to 38%. The lowest rates are found in two Scandinavian countries—Finland and Sweden—as well as the Netherlands, Slovenia, and France.

The big question, of course, is why cesarean sections are performed at such a high rate in Cyprus. According to the President of the Society of Gynecology and Obstetrics, Aphrodite Elissaiou, the underlying causes of this choice need to be analyzed.

“Is it because a cesarean section is now a safe method? Painless? Is it a matter of culture, as we say? Do young women simply prefer it to avoid discomfort?” Ms. Elissaiou notes.  

Cyprus’s high rate alarmed all relevant authorities, who, in addition to identifying the causes, moved forward with the coordination of a national strategy that was implemented in 2024. All relevant authorities acknowledge that this high rate will not decrease overnight. 

Clinical Practice Guideline

Given these facts, the OAU implemented clinical guidelines within the healthcare system regarding the indications for cesarean section, requiring that these be documented in the system as well. The OAU asks obstetricians and gynecologists to inform pregnant women, before the time of delivery, about the pros and cons of cesarean section and vaginal delivery.
  
However, according to OAU data, 25 obstetricians and gynecologists perform more than 70% of deliveries via cesarean section, and 5 perform more than 90%.

These

figures did not go unnoticed by the president of the gynecological society. “We cannot say that there are colleagues who actually promote cesarean sections simply because they want to. There is certainly a medical reason why a doctor would say that a woman needs to have a cesarean section.”

This is precisely where the question arises as to whether the issue is financial or a matter of culture. There is often the impression that a gynecologist promotes cesarean sections because of the higher fee they receive.

The organization’s data show that the average cost of a cesarean section is 3,700 euros, compared to 2,700 euros for a vaginal delivery. However, these amounts are paid as reimbursement to hospitals, and gynecologists refute the argument that they receive higher fees for performing cesarean sections, since, based on the figures they provide,, the difference compared to a natural birth amounts to approximately 100 euros.  

The Right to Choose

Despite efforts to reduce the rate, all sides emphasize that 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 now viewed as a normal process,” Ms. Kyriakou told “Alpha on Sunday.”

If, after receiving information and discussing the matter with her obstetrician, the pregnant woman wishes to proceed with a cesarean section, then she signs a document stating that, although there is no medical indication, she wishes to proceed with a cesarean section.