Caesarean delivery rates, determinants and indications in Makassed Hospital, Jerusalem 1993 and 2002

East Mediterr Health J. Jul-Aug 2009;15(4):868-79.


This study investigated the rising rate of caesarean section (CS) deliveries between 1993 and 2002 (9.4% to 14.4%) and associated factors, including indications for CS and sociodemographic and clinical characteristics based on the register of a major Palestinian teaching hospital. Instrumental deliveries declined from 12.6% to 4.4%. Fetal distress decreased as an indication for CS, while previous CS and breech presentations contributed to the increase. Decision-making for CS needs to frame the benefits and risks of the intervention within the context of women's entire reproductive life-cycle and existing standards of care, avoiding unnecessary and costly CS deliveries to reduce iatrogenic complications and conserve resources.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Breech Presentation / surgery
  • Cesarean Section / trends*
  • Chi-Square Distribution
  • Female
  • Fetal Distress / surgery
  • Health Services Research
  • Hospitals, Teaching*
  • Humans
  • Hypertension, Pregnancy-Induced / surgery
  • Logistic Models
  • Medical Audit
  • Middle East
  • Parity
  • Patient Selection*
  • Practice Patterns, Physicians' / trends*
  • Pregnancy
  • Socioeconomic Factors
  • Unnecessary Procedures / trends