Cesarean Health Overview

Principles

Definition

Cesarean health is a research field investigating the short-term and long-term health outcomes and experiences for both mothers and infants associated with cesarean birth, encompassing physical, psychological, and social dimensions. This domain examines the clinical, social, and systemic factors influencing these outcomes and their significance for clinical guidelines, public health policy, and patient care across the life course.

Ontological type

Maternal Outcomes

Infant and Child Outcomes

Epidemiology

Key developments

Key Figures

TOLAC and VBAC Promotion era

Andrew R. Willan [1] was affiliated with St. Boniface Hospital [3] and the University of Toronto [4] during this era. His key contributions in this era come from the paper Planned cesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial [5], which illuminated trade-offs between cesarean and vaginal birth for breech and helped shape guidelines aimed at reducing unnecessary repeat cesareans and guiding intrapartum decision-making. Mary E. Hannah [2] was affiliated with St. Boniface Hospital [3] and the University of Toronto [4] during this era. Her contributions, rooted in the same breech trial [5], helped translate results into clinical guidance that supported safer delivery choices and informed policy discussions during the era’s push to expand vaginal birth options while safeguarding maternal and perinatal outcomes.

VBAC Risk Profiling era

Mary D. Sammel [1] and affiliations at Stanford University [3] and the University of Pennsylvania [4] played a pivotal role in VBAC risk profiling during the VBAC Risk Profiling era (2001-2007). Her contributions include Maternal complications with vaginal birth after cesarean delivery: A multicenter study [5], The effect of birth weight on vaginal birth after cesarean delivery success rates [6], and Obstetric outcomes in women with two prior cesarean deliveries: Is vaginal birth after cesarean delivery a viable option? [7], which quantified risks and informed predictive modeling for era-specific decision-making. George A. Macones [2] and affiliations at Stanford University [3] and the University of Pennsylvania [4] emerged as leading voices in VBAC risk assessment through the same era. Across the VBAC Risk Profiling era, the three VBAC-focused papers [5][6][7] helped define safety thresholds and patient-centered risk-based guidelines for VBAC after cesarean, illustrating how prior obstetric history and fetal characteristics shaped clinical decisions.

Cesarean Rate Management era

Aaron B. Caughey [1], affiliated with Harvard University [3] and University of California, San Francisco [4], contributed to cesarean rate management in the 2008–2019 era. His work on Safe prevention of the primary cesarean delivery [7] and Delivery After Prior Cesarean: Maternal Morbidity and Mortality [8] informed evidence-based risk-benefit assessments and helped drive reductions in unnecessary primary cesareans while expanding safe VBAC access. Jeanne‑Marie Guise [2], associated with Duke University [5] and Oregon Health & Science University [6], helped shape the cesarean rate management agenda in this era. Her work on Safe prevention of the primary cesarean delivery [7] and Delivery After Prior Cesarean: Maternal Morbidity and Mortality [8] contributed to guideline revisions, patient counseling, and benchmarking of indications that supported safer TOLAC and reductions in primary cesarean rates.