Based on the assumption that the construction of meaning in the process of policy-making is crucial if we wish to understand the gender outcomes of social policy, this article analyzes the parliamentary debates that preceded and accompanied the legislation of the Israeli Mono-Parental Families Act, 1992. It focuses on the enunciation of gender roles and relations in the discourses that framed and justified the Act as well as on how the capacity to establish and maintain autonomous households was constructed and legitimized. Two sets of discourses emerged during the deliberations over the Act, each of which endeavored to interpret the needs, identities, and capacities for action among lone-parent families. The article shows how a specific version of the capacity to establish and maintain autonomous households—that of caregivers who happen to be workers—was privileged in the policy paradigm underlying the Act. The alternative vision—that of workers with caregiving responsibilities—was marginalized and eventually disregarded in the final wording and implementation of the Act. The article concludes with an analysis of the socio-political processes that underlie the prioritization of the version, which was ultimately expressed in the implementation of the Act. It is suggested that a state-level collective identity project shaped by demographic concerns and geo-political factors and changes in the political economy combined to define the needs, identities, and capacities for action of lone-parent families in terms of a model of motherhood in which care-giving trumped paid work.

Background: Induction of labor (IOL) in nulliparas with premature rupture of membranes (PROM) and an unfavorable cervix at term poses challenges. Our study sought to investigate the impact of prostaglandin E2 (PGE2) compared to oxytocin on the duration of IOL in this specific group of parturients. Methods: This was retrospective matched-case study. All nulliparas with term PROM who underwent induction between January 2006 to April 2023 at Shaare Zedek Medical Center were identified. Cases induced by either PGE2 or oxytocin were matched by the following criteria: (1) time from PROM to IOL; (2) modified Bishop score prior to IOL ≤ 5; (3) newborn birthweight; and (4) vertex position. The primary outcome was time from IOL to delivery. Results: Ninety-five matched cases were identified. All had a modified Bishop score ≤ 5. Maternal age (26 ± 4.7 years old, p = 0.203) and gestational age at delivery (38.6 ± 0.6, p = 0.701) were similar between the groups. Matched factors including time from PROM to IOL (23.5 ± 19.2 versus 24.3 ± 21.4 p = 0.780), birth weight of the newborn (3111 g versus 3101 g, p = 0.842), and occiput anterior position (present on 98% in both groups p = 0.687) were similar. Time from IOL to delivery was significantly shorter by 3 h and 36 min in the group induced with oxytocin than in the group induced with PGE2 (p = 0.025). Within 24 h, 55 (58%) of those induced with PGE2 delivered, compared to 72 (76%) of those induced with oxytocin, (p = 0.033). The cesarean delivery rates [18 (19%) versus 17 (18%)], blood transfusion rates [2 (2%) versus 3 (3%)], and Apgar scores (8.8 versus 8.9) were similar between the groups (PGE2 versus oxytocin, respectively), p ≥ 0.387. Conclusions: Induction with oxytocin, among nulliparas with term PROM and an unfavorable cervix, was associated with a shorter time from IOL to delivery and a higher rate of vaginal delivery within 24 h, with no difference in short-term maternal or neonatal adverse outcomes.

(1) Background: We aimed to investigate whether second-stage cesarean delivery (SSCD) had a higher occurrence of low-segment uterine incision extensions compared with cesarean delivery (CD) at other stages of labor and to study the association of these extensions with preterm birth (PTB). (2) Methods: In this retrospective longitudinal follow-up cohort study, spanning from 2006 to 2019, all selected mothers who delivered by CD at first birth (P1) and returned for second birth (P2) were grouped by cesarean stage at P1: planned CD, first-stage CD, or SSCD. Mothers with a PTB at P1, multiple-gestation pregnancies in either P1 or P2 and those with prior abortions were excluded. (3) Results: The study included 1574 selected women who underwent a planned CD at P1 (n = 483 (30.7%)), first-stage CD (n = 878 (55.8%), and SSCD (n = 213 (13.5%)). There was a higher occurrence of low-segment uterine incision extensions among SSCD patients compared to first-stage CDs and planned CDs: 50/213 (23%), 56/878 (6.4%), and 5/483 (1%), respectively (p < 0.001). A multivariate logistic regression showed that women undergoing an SSCD are at risk for low-segment uterine incision extensions compared with women undergoing a planned CD, OR 28.8 (CI 11.2; 74.4). We observed no association between the occurrence of a low-segment uterine incisional extension at P1 and PTB ≤ 37 gestational weeks in the subsequent delivery, with rates of 6.3% (7/111) for those with an extension compared to 4.5% (67/1463) for those without an extension (p = 0.41). Notably, parturients experiencing a low-segment uterine incisional extension during their first childbirth were six times more likely to have a preterm delivery before 32 weeks of gestation compared to those without extensions, with two cases (1.8%) compared to four cases (0.3%), respectively. A similar trend was observed for preterm deliveries between 32 and 34 weeks of gestation, with those having extensions showing twice the prevalence of prematurity compared to those without, with a p-value of 0.047. (4) Conclusions: This study highlights that mothers undergoing SSCD experience higher prevalence of low uterine incision extensions compared to other CDs. To further ascertain whether the presence of these extensions is associated with preterm birth (PTB) in subsequent births, particularly early PTB before 34 weeks of gestation, larger-scale future studies are warranted.

Background/Objectives: The safety of trial of labor after cesarean (TOLAC) following prior preterm low-segment transverse cesarean delivery (pCD) was compared to that following term low-segment transverse cesarean delivery (tCD) in terms of the rate of uterine rupture (UR) and adverse maternal and neonatal outcomes. Methods: A multicenter retrospective cohort study evaluated the delivery outcomes among women with a prior primary pCD and those with a primary tCD. The primary outcome was UR, defined as a full-thickness uterine wall defect. The secondary outcomes included maternal and neonatal morbidities. Chi-square, Fisher’s exact test, and Mann–Whitney tests, with the results reported as means ± SDs or medians + interquartile ranges (IQRs), were employed. Results: The cohort comprised 5340 women, including 186 with a prior pCD and 5154 with a prior tCD. The median gestational age at pCD was 28 weeks, compared to 39 weeks for tCD. Women in the pCD group had higher rates of hypertensive disorders (20.4% vs. 2.5%; p < 0.001). No significant difference in UR incidence was observed at subsequent delivery (0% vs. 0.6%; p = 0.3). However, the pCD group had higher rates of subsequent preterm delivery (19.9% vs. 4.7%; p < 0.01) and vaginal birth after cesarean (VBAC) success (86.1% vs. 77.3%; p = 0.015). Adjusted analyses showed no significant association between pCD and composite adverse neonatal outcomes (OR = 0.796, 95% CI [0.487–1.301]; p = 0.363). Conclusions: This study underscores the safety of trial of labor after a primary preterm cesarean delivery, indicating no increased risk of uterine rupture compared to term cesarean deliveries. Care should be directed toward lowering subsequent preterm delivery and its associated risks.

Background: Underrepresentation of Asian Americans and Pacific Islanders (AAPIs) in research requires urgent attention. The Collaborative Approach for AAPIs Research and Education (CARE) registry aims to increase AAPIs’ representation in research. We report results from a multilingual discrete choice experiment (DCE), an innovative method to determine older AAPIs’ preferences for tailored recruitment strategies and messaging.Methods: Initial DCE recruitment strategy/messaging attributes and attribute levels were selected based on feedback from CARE focus groups. A pilot study (16 participants from 7 AAPI cultural groups) refined attribute wording and levels. The final DCE survey was translated into Simplified and Traditional Chinese, Korean, and Vietnamese. CARE academic and community partners recruited participants (AAPIs aged ≥50 years) for the survey, asking them to select their preference in each of 12 pairs of recruitment strategies (randomly selected from 48 different combinations) of three attributes: (1) from whom they would like to learn about CARE; (2) what would motivate them to join CARE; and (3) how they would prefer hearing about CARE. A custom Qualtrics survey displayed image pairs of randomly selected messaging combinations. Analyses utilized conditional logistic regression models to estimate odds ratios with 95% confidence intervals.Results: A total of 356 (mean age = 65.0; range: 50‐93) participants from 7 AAPI cultural groups (Asian Indian, Chinese, Filipino, Japanese, Korean, Samoan, and Vietnamese) completed the survey. Overall, participants had similar preferences for learning about CARE between community organizations and the healthcare community, however, participants preferred learning about CARE from the healthcare community (e.g., doctors, clinics) relative to community champions and faith‐based organizations. Participants were more motivated to join CARE to help advance research relative to sharing personal experiences; and preferred to hear about CARE via social media and instant messaging relative to a flyer or workshop/seminar. Importantly, preferences varied by age, cultural group, survey completion language, and whether the participant received assistance with the survey.Conclusions: To our knowledge, this is the first study using a DCE approach to elicit preferences for registry recruitment strategies among AAPIs. Findings will inform appropriate tailoring of recruitment strategies/messaging to successfully engage AAPI participants in a registry for ADRD research.aging after age 90.