Turkey begins punishing doctors for high Caesarean section rates

One of the sharpest medical conflicts in recent years is unfolding in Turkey. The country’s Ministry of Health has begun taking disciplinary measures against obstetrician-gynaecologists whose Caesarean section rates exceeded established benchmarks. According to Turkish media and international news agencies, the sanctions have already affected more than 100 specialists, while inspections are continuing.

The story of six obstetrician-gynaecologists who were subjected to disciplinary measures sparked public debate. Depending on the specific case, the doctors received warnings, were temporarily suspended from practice, sent for mandatory additional training, and lost part of their salaries and professional rights for the duration of the sanctions. At the same time, the Ministry of Health is reviewing the cases of more than 100 other specialists across the country.

Why the authorities launched the campaign

The reason for such harsh measures is Turkey’s record-high Caesarean section rate. According to the latest available OECD data for 2023, around 61.5% of all births in the country were delivered by Caesarean section — the highest rate among the organisation’s member states.

Recep Tayyip Erdoğan’s government has been trying for several years to reduce the number of operations performed without strict medical indications. The campaign is part of a broader demographic policy aimed at increasing the birth rate. As early as 2025, Turkey banned planned Caesarean sections without medical indications in a number of private medical centres.

Why doctors are opposed

The Turkish Medical Association has sharply criticised the authorities’ approach. According to the organisation’s representatives, the problem is systemic rather than individual.

Medical professionals point to several factors:

overcrowded obstetric departments;

staff shortages;

insufficient time for prolonged monitoring of natural labour;

the high risk of lawsuits in the event of complications during vaginal births;

organisational features of maternity hospitals.

In doctors’ view, punishing individual specialists will not eliminate the causes of the high Caesarean section rate, but will only increase pressure on obstetricians.

Possible risks for patients

This is the aspect causing the greatest concern within the professional community.

Experts warn that if a doctor fears disciplinary punishment for a “too high percentage” of operations, they may delay the decision to perform a Caesarean section for longer in borderline clinical situations. In obstetrics, such delays can lead to serious complications for both the mother and the baby.

The Federation of Women’s Associations of Turkey has also opposed administrative intervention in the choice of delivery method. The organisation believes that the decision should be made solely on the basis of medical indications, the woman’s condition and the professional assessment of the treating doctor, rather than statistical indicators or government standards.

Expert view

The goal of reducing unnecessary Caesarean sections is itself consistent with the recommendations of international medical organisations. However, most specialists emphasise that the number of operations should be reduced not by punishing doctors, but by improving antenatal care, raising the quality of natural birth management, expanding medical staff and informing expectant mothers.

That is why what is happening in Turkey is already being described not simply as a reform of obstetric care, but as a serious test of the balance between the state’s demographic policy, doctors’ professional independence and women’s right to a safe medical decision.