Embu County recorded the highest rate of caesarean section (CS) deliveries in Kenya, with more than four in every ten births in the county delivered by surgery, an indication of the high cost of child births in the devolved unit.
A newly published healthcare survey for 2025/26 by the Kenya National Bureau of Statistics shows that C-Section births accounted for 43 percent of deliveries in Embu-more than double the national average of 20.3 percent and almost three times the World Health Organization’s recommended upper limit of 15 percent.
A caesarean section is a surgical procedure in which a baby is delivered through an incision made in the mother’s abdomen and uterus. It is performed when complications during pregnancy or labour make a vaginal delivery unsafe for the mother or baby.
‘The internationally recommended optimal CS rate is between 10 percent and 15 percent. Rates below five percent may indicate inadequate access to emergency obstetric care, while rates above 15 percent suggest possible overuse for non-medical reasons,’ the survey read.
‘Evidence indicates that a CS rate of up to around 10 percent is associated with reductions in maternal and neonatal mortality, but a rate beyond this threshold provides no additional health benefits.’
C-Section births are more expensive compared to normal deliveries. For example, private hospitals charge between Sh220,900 and Sh360,000 for the C-section procedure, compared to between Sh80,000 and Sh100,000 for a normal delivery.
In public and county health facilities, the cost of C-Section delivery is standardised under the Social Health Authority (SHA) framework. For patients who are registered SHA members, a C-Section delivery package is fully covered up to between Sh30,000 and Sh32,600.
Experts attribute the national increase in the number of procedures to greater access to surgical facilities in urban and private hospitals, as well as to doctors’ fear of lawsuits, which can encourage earlier intervention. Repeat operations are also contributing to the increase, with a previous CS often influencing the mode of delivery in a subsequent pregnancy.
‘Over the past three decades, CS rates have increased globally, raising public health concerns due to associated maternal and neonatal risks, inequities in access and cost implications’, the survey said.
The survey also recorded high rates in other counties, including Kiambu (38.6 percent), Kirinyaga (37.5 percent), Nyeri (36.9 percent) and Murang’a (35.6 percent). Tharaka-Nithi recorded 33.7 percent, Makueni 30.2 percent, and Meru 24.8 percent.
Nationally, the percentage of births delivered via CS has increased five-fold since 2003, from four percent in 2003 to 17 percent in 2022, before rising to 20.3 percent in the latest survey.
A higher rate of caesarean sections was reported in private hospitals than in public facilities. Surgical deliveries accounted for 33.1 percent of births in private non-governmental facilities, compared with 18.2 percent in public facilities.