Israel Medical Association Journal

Cesarean section has undergone a transformation that has radically changed the prognosis of both the pregnant woman and her unborn child. The attributed mortality rate of Cesarean section during the 19th century was over 50% worldwide. Today, mortality from Cesarean delivery is rare. However, the technique of transversely incising the uterus in its lower uterine segment, although less than a century old, is passed on from instructor to apprentice, often without either of them being aware of its noble history. In this brief review, we discuss the reported history regarding this incision and the significant role played by John Munro Kerr.

We present an overview of the current sexual behavior of adolescents in Israel, including the related social and moral issues, and compare it to that in Western countries. An important factor is the existence of liberal versus conservative views regarding the use of contraception and termination of pregnancy in these young subjects. We describe the current situation where in most cases the medical providers do not provide adequate contraceptive advice to adolescent girls, resulting ultimately in a high rate of unintended pregnancy. In our opinion, it is essential to make effective contraception more accessible to this vulnerable group.

Background: Domestic violence is considered a major risk factor in pregnancy.

Objectives: To assess the prevalence of different kinds of abuse (physical, psychological, sexual) of pregnant as compared to non-pregnant women, and to identify demographic risk factors for physical abuse that characterize the woman and her partner.

Methods: A cross-sectional survey was conducted in 270 women seeking gynecologic care at women health centers in northern Israel. Information was collected by means of a standardized questionnaire administered via phone, and addressed demographic data, interaction with the partner, and reporting of physical abuse. All information was obtained from the respondents (including information about her partner).

Results: Four abuse scores were computed: severe physical attack, minor physical attack, psychological abuse, and sexual coercion. Psychological abuse was found to be the most prevalent (24%), followed by minor and severe physical attack (17% and 8.1%, respectively), and sexual coercion (5.6%). Physical attacks related to pregnancy (directed at the abdomen) occurred in 5.4% of the pregnant women. There was no significant difference in the prevalence of the different types of abuse between pregnant and non-pregnant women. Physical attack was associated with socioeconomic status, work status, and degree of religiosity.

Conclusion: Pregnant women were at a similar risk for abuse as non-pregnant women in all abuse categories. Predictors for abuse – socioeconomic status and religiosity – are reviewed primarily in a cultural context.