Cypriot gynaecologists express their support for the use of incentives and financial rewards to promote natural childbirth while opposing penalties for high caesarean rates, provided they do not exceed medically acceptable limits.
The doctors acknowledge that the rate of caesarean sections in Cyprus is significantly higher than the European average and welcome the efforts of the Ministry of Health and the Health Insurance Organisation (HIO) to promote natural births.
However, they suggest that, as a first step, it would be more prudent to refrain from imposing any penalties on doctors who perform a large number of C-sections.
Instead, they advocate for a comprehensive information campaign targeting expectant mothers, as a significant number of them, according to the doctors, request caesareans without medical necessity.
It is important to recall that, per the design of the HIO, which aligns with the Ministry of Health’s national strategy to promote natural childbirth, gynaecologists will be incentivised financially when they maintain caesarean rates within limits that are in line with the EU average. Conversely, they will face reduced reimbursements if they exceed these limits.
Cyprus’ caesarean section rate reached a staggering 62.31% in 2023, far exceeding the European Union average of below 30%, according to data from the Health Ministry’s Monitoring Unit and the General Healthcare System (GHS).
This upward trend follows previous years, with 59% and 60% of births in 2021 and 2022 respectively delivered via C-section.
The Health Insurance Organisation (HIO) is reportedly considering a dual approach of incentives and disincentives to tackle the issue, as revealed by philenews on Wednesday.
Dr. Dinos Mavromoustakis, a board member of the Gynaecological Company, acknowledged the need to address the high caesarean rate but cautioned against a one-sided approach.
“Multiple factors contribute to this phenomenon,” Dr. Mavromoustakis said. “We are witnessing a rise in IVF treatments, leading to more twin pregnancies and potential C-section deliveries. Additionally, there are more women choosing to have children at an older age, which inherently carries higher risks.”
He also noted a growing trend of women requesting elective C-sections. “A significant number of women express a preference for C-sections upfront,” he explained.
“Before implementing disincentives, a comprehensive public awareness campaign is crucial to shift childbirth perceptions. Educating expectant mothers can happen alongside promoting natural birth through incentives”, he noted.
The Gynaecological Company has proposed measures to encourage natural deliveries. “We suggested increasing reimbursement rates for natural childbirth, which often requires more time and effort from doctors,” Dr. Mavromoustakis said, adding “we also propose incentives apply for successful vaginal births after previous C-sections.”
“Gynaecologists strive to educate and persuade women who request C-sections without medical indication to consider the benefits of natural childbirth. We provide them with information and explain that, in the absence of medical reasons, surgery is not recommended.”
It is worth noting that the HIO’s plan, which includes both incentives and disincentives, is currently in the consultation phase with relevant stakeholders, including the Gynaecological Company. The deadline for completing this dialogue and finalising the plan is the end of July.
