Türkiye’s Ministry of Health has introduced sweeping new regulations aimed at reducing the rate of medically unnecessary cesarean sections and promoting natural births, as part of its nationwide “Healthy Türkiye Century” initiative.

The measures were formally published in the Official Gazette this week and mark a significant shift in the country’s maternal health policy.

Under the revised framework, planned cesarean deliveries without medical necessity will be banned at medical centers, with new structural and procedural requirements imposed on facilities that offer childbirth services.

The regulation mandates that only facilities with fully equipped birth units and operating rooms will be authorized to carry out deliveries. Birth rooms must meet specific architectural criteria—each measuring at least 16 square meters—with controlled entry and exit systems, isolated from high-traffic areas, and positioned for immediate access to surgical intervention if needed.

New Standards for Medical Centers and Clinics

The updated law affects private health institutions, including medical centers, polyclinics, and private practices. Medical centers with at least 10 specialist physicians offering 24/7 services will now be allowed to establish emergency and surgical intervention units, but only for procedures that do not require complex follow-up surgeries. All such centers must obtain proper certification.

The regulations also allow the merger of two or more polyclinics to form a medical center, while reinforcing that private practices must strictly adhere to current scientific and medical standards. Electronic medical records and reporting will now be mandatory across all private healthcare facilities to improve oversight and compliance.

The Ministry of Health stated it will intensify audits and monitoring efforts to ensure medical procedures—especially surgeries like C-sections—are performed only with valid clinical indications.

Addressing Alarming Trends in Cesarean Rates

The policy shift comes in response to Türkiye’s rising C-section rates, which have climbed by 30% over the past decade, with 61 out of every 100 births now occurring via cesarean section. Health officials argue this figure far exceeds international recommendations and increases health risks for both mothers and newborns.

Despite the overall national increase, the ministry reported success in some regions, noting that cesarean births have declined in 51 provinces due to targeted interventions and educational campaigns.

Public Backlash and Political Endorsement

The Health Ministry’s campaign recently stirred public debate after the Sivasspor football team displayed a ministry-sponsored banner at a televised match on April 13. The banner read: “What’s normal is natural birth — cesarean section is not natural unless medically necessary.” The message, perceived by many as a form of pressure on women’s reproductive choices, sparked criticism on social media and from women's rights groups.

President Recep Tayyip Erdoğan defended the campaign, calling the initiative “a matter of national survival” tied to Türkiye’s rapidly declining birth rates. At the inauguration of the Bağcılar Women’s and Children’s Hospital in Istanbul, Erdoğan highlighted that the government has built 391 hospitals in the last two decades, raising the total number of hospitals nationwide to 1,547.

“This is not about ideology—it’s about the future of our nation,” Erdoğan stated, aligning the campaign with broader demographic and healthcare goals.

As the country grapples with both a declining fertility rate and increasing public discourse on women’s bodily autonomy, the latest regulations mark a significant moment in Türkiye’s ongoing debate over health policy, state intervention, and reproductive rights. (ILKHA)