Medical greed or indulgence. Caesarean section scalpels deliver newborns to incubators

Country/area: Egypt

Organisation: Arij- cairo 24

Organisation size: Small

Publication date: 10/12/2021

Credit: The investigation conducted with the support of Arij


I am Sara Gamal, an Egyptian journalist. I obtained a BA in media from Cairo University, and specialized in journalism in 2009.

During 12 years of work, I practiced most of the journalistic arts, such as writing reports, in-depth stories, features and investigations, and supervised the development of content for a number of press organizations.

In 2020, I obtained a diploma in data journalism with the support of the International Center for Journalists and the ARIJ Foundation, and worked on a number of investigations and in-depth stories based or supported by data.

I work on various files, such as workers’ and children’s rights, but I have a special interest in working on issues of women’s rights and the right to health.

Project description:

 I prepared a data-driven investigation about caeserean section in Egypt to prove the relationship between the responsibility of medically unexplained caesarean deliveries in increasing the need for newborns to enter incubators and exposing them and their mothers to health risks and unnecessarily financial costs. Egypt stopped issuing official data on caesarean section rates in 2014, so I prepared a database of 6,500 mothers who gave birth during the period from 2014 to 2020 to provide the necessary data to detect the escalation of caesarean section rates during those years, in addition to using official and international data and medical studies. 

Impact reached:

The investigation resulted in emphasizing the doctors’ responsibility in increasing the caesarean section rates and that they lead the decision-making regarding the caesarean section, contrary to what is being promoted that women are the ones who request a caesarean section. 

A number of women MPs in the People’s Assembly submitted parliamentary requests to question the Minister of Health regarding the escalation of caesarean sections and endangering mothers and newborns, The Parliament’s Health Committee discussed some of these requests and decided to assign some women representatives to prepare proposals to solve this problem.

Discussion about the risks of cesarean delivery was sparked through the media, and through social media platforms, and a group of male and female students at Beni Suef University launched a campaign to raise awareness of the risks of cesarean deliveries.

 The most important impact, in my opinion, was the reaction of mothers who were alerted to the danger of an unjustified caesarean section for them and their newborns, which doctors do not tell them, according to the official data and the data of the questionnaire that I prepared as well. It was also necessary to activate the right of women to know the risks that they may be exposed to with their newborns, as half of the newborns are exposed to complications and one out of every 5 caesarean births needs incubators that are found with difficulty and at a high cost. This should not happen without mothers realizing that they can avoid it and also protect themselves from complications Caesarean section by avoiding unexplained caesarean sections, which is what the investigation aimed and focused on.

Techniques/technologies used:

I used Google Form to set up the survey, and after I had collected 6,500 mothers’ submissions.

I later pulled the survey results into Excel, and there I cleaned and analyzed the data to get the data I used in the investigation.

I used specialized tools to help me translate reports and studies related to the subject matter of the investigation.
I used an audio recorder to record the testimonies of participants and sources in the investigation.

I used Google Drive to save all the materials I collected, drafts, surveys, studies, reports, everything.

What was the hardest part of this project?

The absence of updated data and information was the biggest challenge to prove the investigation hypothesis.

The latest official data on caesarean section rates were issued in 2014, so it was necessary to produce data that revealed the extent of the phenomenon in the years following 2014, in addition to obtaining data that disclosed the cost of cesarean delivery.

The financial gain represented an incentive to increase these surgeries, the percentage of newborns exposed to complications and the percentage placed in incubators, the difficulty and cost faced by families in providing these incubators, the complications faced by mothers, and whether doctors tell mothers about the possibility of their and their newborns being exposed to complications, in addition to revealing the owner of Cesarean decision.

All of this data was revealed through a questionnaire that included 6,500 Egyptian mothers who gave birth from 2014 to 2020, and the questionnaire data was used to prepare a database, and the analysis of the data provided a lot of information that proved the hypothesis of the investigation and confirmed beyond doubt the continued exacerbation of cesarean deliveries and their effects.

The problem of unexplained caesarean sections, despite its serious impact on mothers and newborns, does not receive official, medical, or even real societal attention.

Therefore, I faced great difficulty in communicating with official sources, and medical sources were content with emphasizing their lack of responsibility for the escalation of caesarean section rates and accusing women of being the ones who decide on caesarean sections.

I translated dozens of medical papers, most of them contained accurate medical terminology, and this forced me to contact more than one doctor to verify the accuracy of the information I was getting.

The last and most minor difficulty was the visualization and the distribution of graphs, maps and data.

What can others learn from this project?

I think that the most important thing in my investigation, which I hope will be useful to others, is not to give in to the absence of data and information even if we have to create it!.

Taking numbers and static data for a human context makes stories and investigations more impactful.

Attention to data analysis to obtain detailed and new information often achieves new and important additions.

Attention to the visual representation of data and the diversity in the use of expressive visual models achieves a smooth reading of data and information.

Project links: