title: A case-control study of caesarean delivery on maternal request: who and why?
abstract: OBJECTIVE
  The current study aimed to evaluate the profile of women who are most likely to undergo caesarean delivery on maternal request (CDMR) and clarify their reasons for this decision.
  
  
  METHODS
  For this multicentre case-control study, data were collected from 429 women who underwent CDMR and 429 matched controls who delivered vaginally from June, 2008 through February, 2009. Participants were interviewed by telephone regarding sociodemographic variables, health and lifestyle.
  
  
  RESULTS
  CDMR predictors were as follows: increasing age (OR = 1.09/year; 95%CI: 1.05-1.14), family status (unmarried without a steady partner versus married - OR = 3.60; 95%CI: 1.08-11.97), decreasing level of religiosity (secular versus ultra-orthodox - OR = 11.82; 95%CI: 3.75-37.21), and never having engaged, or ceasing sports activity during pregnancy (OR = 1.79; 95%CI: 1.09-2.91 and 2.38; 95%CI: 1.28-4.43, respectively). Above average income reduced the probability of CDMR (OR = 0.56; 95%CI: 0.33-0.94). The most frequent reasons for choosing CDMR were concern for pain (21.9%), concern for their own or baby's health (20.4% and 16.5%, respectively) and emotional aspects (10.0%).
  
  
  CONCLUSIONS
  Older, unmarried and/or secular women had increased probability of CDMR. Addressing specific concerns regarding vaginal delivery may provide the basis for a patient-oriented intervention for preventing unnecessary surgery.
authors.affiliation: a Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd , Tel Hashomer , Israel .|b School of Public Health, Sackler Faculty of Medicine, Tel Aviv University , Israel .
authors.forename: Liat
authors.initials: L
authors.lastname: Lerner-Geva
authors.affiliation: a Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd , Tel Hashomer , Israel .
authors.forename: Saralee
authors.initials: S
authors.lastname: Glasser
authors.affiliation: a Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd , Tel Hashomer , Israel .
authors.forename: Gila
authors.initials: G
authors.lastname: Levitan
authors.affiliation: a Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd , Tel Hashomer , Israel .
authors.forename: Valentina
authors.initials: V
authors.lastname: Boyko
authors.affiliation: b School of Public Health, Sackler Faculty of Medicine, Tel Aviv University , Israel .|c Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel .
authors.forename: Abraham
authors.initials: A
authors.lastname: Golan
authors.affiliation: d Department of Obstetrics and Gynecology , Rambam Medical Center , Haifa , Israel .
authors.forename: Ron
authors.initials: R
authors.lastname: Beloosesky
authors.affiliation: e Department of Obstetrics and Gynecology , Soroka Medical Center , Beer Sheba , Israel .
authors.forename: Eitan
authors.initials: E
authors.lastname: Lunenfeld
authors.affiliation: b School of Public Health, Sackler Faculty of Medicine, Tel Aviv University , Israel .|f Maternity Department, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel .
authors.forename: Ariel
authors.initials: A
authors.lastname: Many
authors.affiliation: g Maternity Department and Pregnancy Complications Unit, Shaare Zedek Medical Center , Jerusalem , Israel .
authors.forename: Arnon
authors.initials: A
authors.lastname: Samueloff
authors.affiliation: b School of Public Health, Sackler Faculty of Medicine, Tel Aviv University , Israel .|h Department of Obstetrics and Gynecology , Chaim Sheba Medical Center , Tel Hashomer , Israel .
authors.forename: Eyal
authors.initials: E
authors.lastname: Schiff
authors.affiliation: h Department of Obstetrics and Gynecology , Chaim Sheba Medical Center , Tel Hashomer , Israel .
authors.forename: Ann
authors.initials: A
authors.lastname: Shoham
authors.affiliation: i Department of Medicine in the Galil , Safed Campus, Bar Ilan University , Safed , Israel.
authors.forename: Menachem
authors.initials: M
authors.lastname: Fisher
authors.affiliation: a Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd , Tel Hashomer , Israel .
authors.forename: Galit
authors.initials: G
authors.lastname: Hirsh-Yechezkel
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000523:psychology* / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D011247:Pregnancy; D055815:Young Adult
keywords: Caesarean section; maternal request; mode of delivery