Maternal care in the Dominican Republic: The high rate of cesarean sections raises alarms
A recent report from the National Multi-Purpose Household Survey (ENHOGAR-MICS 2025), conducted by the National Statistics Office, has brought to light a concerning reality in the Dominican health system: 68.2% of births in the country occur via cesarean section, while only 31.8% correspond to vaginal births.
This trend is notably more pronounced in the private sector, where the figure reaches an alarming 89%, compared to the 52.8% recorded in public health centers. These statistics position the country well above global and regional averages, exceeding the Latin American and Caribbean average by approximately 25 percentage points.
The impact of unnecessary interventions
From a public health perspective, it is recognized that a cesarean section is a vital procedure when there is a real clinical justification. However, as it is major surgery, it carries significant risks for the mother, such as hemorrhages, infections, and more extensive recovery processes. For newborns, the intervention without medical necessity can lead to respiratory difficulties, especially if performed before the pregnancy is full-term.
The Dominican Republic has shown that it is possible to expand access to prenatal care. Now, the challenge is to ensure that every pregnancy and every birth receives quality care, respectful of women’s rights and based on the best scientific evidence.
Anyoli Sanabria, UNICEF Deputy Representative in the country.
Progress and pending challenges
Despite the figures surrounding cesarean sections, the report highlights significant progress in maternal health. Currently, 97.6% of Dominican women receive prenatal care from qualified personnel, with high compliance percentages in essential tests such as blood pressure checks and laboratory analyses.
However, inequality persists in the postnatal stage. According to the data collected:
- 84.7% of women in the lowest income quintile access postnatal check-ups within two days of giving birth.
- This figure rises to 97% in the highest income quintile, highlighting a gap that requires immediate attention.
To correct the course, it is suggested to implement tools such as the Robson Classification, which allows for the precise identification of the obstetric groups where the highest number of cesarean sections are concentrated. The goal of health authorities should focus on strengthening clinical protocols, ensuring that each intervention is backed by a real need and that the process is, above all, safe, dignified, and respectful for mothers and their children.
