June 26, 2026, has become a date many pregnant women find especially appealing, but doctors say a Caesarean section should never be scheduled just because a date looks good on paper. In Israel, Caesareans account for about 20% of all births, one of the lowest rates among OECD countries, and about 60% of those are emergency operations after labor begins. The remaining 40% are planned in advance for medical reasons.
Dr. Roni Chen, head of the delivery room, emergency unit and maternity wards in the women’s department at Beilinson Hospital, said the well-known saying “once a Caesarean, always a Caesarean” is no longer absolute. He said 35% to 40% of Caesareans are still done because of a prior Caesarean, due to concern about uterine rupture or adhesions, but the approach has changed. “Seventy percent of women who delivered by Caesarean in the past are candidates for vaginal birth, and 90% of them succeed,” he said, adding that vaginal birth after Caesarean is possible only after one prior Caesarean, while women with two prior Caesareans will usually have another surgical delivery.
The second most common reason is abnormal fetal presentation, responsible for about 35% of Caesareans. These include breech, brow, transverse, and other non-head-down positions. Chen said that for the past 20 years breech babies are not delivered vaginally in Israel by default, except in twin pregnancies when the first twin is head-down and the second is breech. Other reasons include maternal height, with a Ben-Gurion University and Soroka study finding women under 1.54 meters had a nearly 21% Caesarean rate versus 14% for taller women, and estimated fetal weight, which leads to 10% to 15% of Caesareans.
Chen said babies weighing more than 4.250 kilograms are generally delivered by Caesarean, though there are exceptions, including some pregnancies with diabetes or women who have already delivered similarly large babies vaginally. Another 5% of Caesareans are due to placenta complications, such as placenta previa, and about 5% more are caused by maternal illnesses such as heart or lung disease or uterine malformations. On special dates, hospitals can sometimes adjust scheduled medically necessary Caesareans by a few days if possible, but not by two weeks. He also recalled a patient who wanted to give birth on such a date and did, unexpectedly arriving in labor at 37 weeks.
