{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:34:54Z","timestamp":1777944894192,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003976","name":"Israel National Institute for Health Policy Research","doi-asserted-by":"publisher","award":["2009\/53"],"award-info":[{"award-number":["2009\/53"]}],"id":[{"id":"10.13039\/501100003976","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to describe Israeli maternity departments\u2019 policies regarding cesarean delivery on maternal request, and factors associated with obstetricians\u2019 support for cesarean delivery on maternal request in specific scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This 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\u2019s 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\u2019 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\u2019 support for cesarean delivery on maternal request in specific cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Policies were divided between allowing and prohibiting cesarean delivery on maternal request (n\u2009=\u200910 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 \u201creference scenario\u201d describing a young woman with no obstetric complications. Additional factors increased the rate of support. Support was greater among obstetricians aged\u2009&gt;\u200945 (odds ratio\u2009=\u20092.11; 95% confidence intervals 1.33\u20133.36) and lower among females (odds ratio\u2009=\u20090.58; 95% confidence intervals 0.39\u20130.86). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Policies and obstetricians\u2019 support for cesarean delivery on maternal request vary broadly depending on clinical profiles and physician characteristics. Department policy has an impact on obstetricians\u2019 support for cesarean delivery on maternal request. Health policy will benefit from a framework in which the organizations, physicians, and patients are consulted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057221125366","type":"journal-article","created":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T03:44:09Z","timestamp":1668138249000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Cesarean delivery on maternal request in Israel: Maternity department policies and obstetricians\u2019 perspectives"],"prefix":"10.1177","volume":"18","author":[{"given":"Galit","family":"Hirsh-Yechezkel","sequence":"first","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0084-2710","authenticated-orcid":false,"given":"Saralee","family":"Glasser","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel","family":"Farhi","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gila","family":"Levitan","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Shachar","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inna","family":"Zaslavsky-Paltiel","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Boyko","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yossef","family":"Ezra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Hadassah University Hospital, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liat","family":"Lerner-Geva","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center affiliated with Tel Aviv University, Ramat Gan, Israel"},{"name":"School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"key":"bibr1-17455057221125366","unstructured":"National Institutes of Health. 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Health at a glance 2015-OECD indicators: caesarean sections. Paris: OECD Publishing, 2015."},{"key":"bibr26-17455057221125366","doi-asserted-by":"crossref","unstructured":"OECD. Health at a glance health at a glance 2019-OECD indicators: cesarean sections, https:\/\/doi.org\/10.1787\/4dd50c09-en (2019, accessed 28 June 2022).","DOI":"10.1787\/4dd50c09-en"},{"key":"bibr27-17455057221125366","unstructured":"OECD. Caesarean sections (indicator), https:\/\/data.oecd.org\/healthcare\/caesarean-sections.htm (2022, accessed 28 June 2022)."},{"key":"bibr28-17455057221125366","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2012.09.006"},{"key":"bibr29-17455057221125366","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003006"},{"key":"bibr30-17455057221125366","unstructured":"The Royal Australian and New Zealand College of Obstetricians Gynaecologists. 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Caesarean birth: NICE guideline [NG192] 2021, https:\/\/www.nice.org.uk\/guidance\/ng192\/chapter\/Recommendations (2021, accessed 14 September, 2022)."},{"key":"bibr32-17455057221125366","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31927-5"},{"key":"bibr33-17455057221125366","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0203274"},{"key":"bibr34-17455057221125366","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.3816"}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057221125366","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17455057221125366","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057221125366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:25:20Z","timestamp":1777710320000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17455057221125366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":34,"alternative-id":["10.1177\/17455057221125366"],"URL":"https:\/\/doi.org\/10.1177\/17455057221125366","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"article-number":"17455057221125366"}}