Evidence map›Paper›PMID 36366970›Full record

ArticleWomen's health (London, England)

Cesarean delivery on maternal request in Israel: Maternity department policies and obstetricians' perspectives.

Galit Hirsh-Yechezkel, Saralee Glasser, Adel Farhi, Gila Levitan, Yael Shachar, Inna Zaslavsky-Paltiel, Valentina Boyko, Yossef Ezra, Liat Lerner-Geva

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in Women's health (London, England). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Galit Hirsh-YechezkelWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.
Saralee GlasserWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.ORCID 0000-0003-0084-2710
Adel FarhiWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.
Gila LevitanWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.
Yael ShacharWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.
Inna Zaslavsky-PaltielWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.
Valentina BoykoWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.
Yossef EzraDepartment of Obstetrics and Gynaecology, Hadassah University Hospital, Jerusalem, Israel.
Liat Lerner-GevaWomen and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel.
Tel Aviv University · ILHadassah Academic College · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to describe Israeli maternity departments' policies regarding cesarean delivery on maternal request, and factors associated with obstetricians' support for cesarean delivery on maternal request in specific scenarios.

methodsThis multicenter cross-sectional study included 22 maternity department directors and 222 obstetricians from the majority of Israeli hospitals. Directors were interviewed and completed a questionnaire about their department's cesarean delivery on maternal request policy, and obstetricians responded to a survey presenting case scenarios in which women requested cesarean delivery on maternal request. The scenarios represented profiles referring to the following factors: maternal age, poor obstetric history, pregnancy complications, and psychological problems. The survey also included the obstetricians' socio-demographic information and questions about other issues associated with cesarean delivery on maternal request. The main outcome measures were department policies regarding cesarean delivery on maternal request and obstetricians' support for cesarean delivery on maternal request in specific cases.

resultsPolicies were divided between allowing and prohibiting cesarean delivery on maternal request (n = 10 and 12, respectively), and varied regarding issues such as informed consent and pre-surgery consultation. Most of the obstetricians (96.5%) did not support cesarean delivery on maternal request in the "reference scenario" describing a young woman with no obstetric complications. Additional factors increased the rate of support. Support was greater among obstetricians aged > 45 (odds ratio = 2.11; 95% confidence intervals 1.33-3.36) and lower among females (odds ratio = 0.58; 95% confidence intervals 0.39-0.86). Obstetricians whose department policy was less likely to allow cesarean delivery on maternal request reported lower rates of support for cesarean delivery on maternal request in most cases.

conclusionPolicies and obstetricians' support for cesarean delivery on maternal request vary broadly depending on clinical profiles and physician characteristics. Department policy has an impact on obstetricians' support for cesarean delivery on maternal request. Health policy will benefit from a framework in which the organizations, physicians, and patients are consulted.

Indexed as

ObstetricsPhysiciansAttitude of Health PersonnelCross-Sectional StudiesFemaleHumansIsraelPolicyPractice Patterns, Physicians'Pregnancycesarean deliveryinterviewmaternal requestmaternity departmentsobstetricianssurvey

Identifiers

PMID36366970
PMCPMC9661554
OpenAlexW4309246423

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.