Defence: Mohammed Zimmo

MD Mohammed W.Y. Zimmo at Institute of Clinical Medicine will be defending the thesis "Exploring caesarean section in Palestine" for the degree of PhD.

Foto: Øystein Horgmo

Trial Lecture - time and place

See Trial Lecture.

Adjudication committee

  • 1st opponent: Professor Jos van Roosmalen, University of Leiden, Athena Institute VU University Amsterdam
  • 2nd opponent: Professor Nils-Halvdan Morken, University of Bergen
  • Committee Chair: Professor Johanne Sundby, University of Oslo

Chair of the Defence

Professor Johan Ræder

Principal Supervisor

 Dr. Åse Vikanes


Caesarean section is one of the most common surgical procedures worldwide. It may have negative impact on both mothers and children, short as well as long term. Caesarean section rates vary between countries and even between hospitals within countries. In order to curb the alarming trend of rising caesarean section rates globally, understanding which groups of women are at higher risk of caesarean section is essential.

The aims of this thesis were to assess differences in use of caesarean section between six Palestinian government hospitals, to explore the impact of mothers’ characteristics as well as given reasons for caesarean section and to identify the women at higher risk of giving birth by caesarean section. The data was collected from all women giving birth in six hospitals located in different areas across Palestine from March 1st 2015 until April 30th 2017. This study, including 75000 women, is the first large scale research collaboration between Gaza and West Bank in maternal-child health.

Clear variations in rates of cesarean section were found between study hospitals. Mothers’ attributes, such as previous birth by caesarean section or in vitro fertilization treatment, were associated with higher caesarean section rates. However, neither mothers’ characteristics nor given reasons for caesarean section could explain the variations in the rates of caesarean section between hospitals. Around 60% of the variation between study hospitals was explained by six clinical reasons for caesarean section. More than 40% of caesarean sections were done for women who had previously given birth by caesarean section, 12% for women with twin pregnancies and 8% for women with preterm labour (<37 weeks of pregnancy).

Efforts need to be directed towards increasing the proportion of normal births after caesarean section and by reducing the number of caesarean sections in twin pregnancies and preterm Labour.

Additional information

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Published Nov. 21, 2018 3:52 PM - Last modified Nov. 22, 2018 10:09 AM