In 1916 Edwin B. Cragin in the United States published Conservatism in Obstetrics in which he discussed medical practices and techniques to preserve the vitality of pregnant women and their fetuses. Cragin argued that women who give birth via cesarean section, the surgical act of making an incision through both the abdomen and uterus to remove the fetus from a pregnant woman's womb, must rely on that method for future births. That claim was later coined the Dictum of Cragin. In Conservatism in Obstetrics, Cragin described obstetric techniques to maintain healthy births for women and fetuses. Cragin's article outlined the best practices for obstetricians in the early twentieth century, and publicized the claim that if a woman delivers a newborn via cesarean section, she should deliver any future newborn via the same method, a theory that persisted throughout the century.

In 1986, Vern L. Katz, Deborah J. Dotters, and William Droegemueller published “Perimortem Cesarean Delivery,” an article in which they developed the Four Minute Rule for perimortem cesarean sections. The Four Minute Rule states that if a pregnant woman’s heart stops beating, physicians should begin an operation to deliver the fetus within four minutes and aim to have the fetus delivered within five minutes of cardiac arrest. Although cardiac arrest during pregnancy is uncommon, it can happen when pregnant women experience trauma, blood clots, infection, or have preexisting heart conditions. In the article, the authors emphasize how the Four Minute Rule increased maternal and fetal survival rates and decreased cases of severe fetal brain damage. The article “Perimortem Cesarean Delivery” was the first article to present the Four Minute Rule, which has influenced international guidelines and become the standard for maternal resuscitation and fetal survival in emergency medicine, operating rooms, and many other aspects of medical practice.

Horatio Robinson Storer was a surgeon and anti-abortion activist in the 1800s who worked in the field of women’s reproductive health and led the Physicians’ Crusade Against Abortion in the US. Historians credit Storer as being one of the first physicians to distinguish gynecology, the study of diseases affecting women and their reproductive health, as a separate subject from obstetrics, the study of pregnancy and childbirth. Storer was one of the first physicians to successfully perform a Caesarian section, or the removal of the fetus through a surgical incision, followed by the removal of the woman’s uterus, a procedure which would later be known as Porro’s operation. Storer was also an anti-abortion activist who believed that public attitudes toward abortion were too relaxed and that the laws did not effectively punish what he deemed to be the criminal act of abortion. Historians credit Storer with leading the Physicians’ Crusade Against Abortion, which they consider largely responsible for the increase in laws criminalizing abortion in the late 1800s.

Jane Eliot Sewell presented “Cesarean Section--A Brief History” in 1993 as a brochure in the National Library of Medicine’s exhibit on the history of cesarean sections, hereafter c-sections, in Bethesda, Maryland. A c-section is a surgical procedure that doctors use to deliver a fetus through an incision in a pregnant person’s abdomen. The National Library of Medicine’s exhibit included a collection of artwork and photographs that coincide with the historical account of the procedure, and the brochure presents that information in print form. Sewell describes the chronological advancements and evolution of the c-section as well as other medical technological improvements that helped increase surgical survival rates. The brochure and accompanying exhibit provide background and history of the procedure available to the American College of Obstetricians and Gynecologists, for whom it was published, and the general public. “Cesarean Section—A Brief History” provides a cohesive explanation of the chronological history and advancements of c-sections, a procedure that millions of people undergo to give birth each year.

Renate Blumenfeld-Kosinski published Not of Woman Born in 1990. The book is a historical account of the cesarean birth procedure, hereafter c-section, during the Renaissance in Europe. A c-section is a surgical procedure that medical professionals use to deliver a fetus through an incision in a pregnant person’s abdomen. During the medieval and Renaissance periods, midwives performed c-sections on pregnant women after they had died when there was a chance that the fetus was still alive. They did this so the midwife could get the baby baptized, enabling it to be buried in sacred ground after death. Not of Woman Born traces how the procedure evolved in the late fifteenth and sixteenth century to be more commonly performed by male surgeons, rather than midwives, to save both the mother and the fetus. Blumenfeld-Kosinski provides historical, religious, and cultural context for understanding how people viewed and practiced c-sections in Europe during medieval and Renaissance times, in contrast to how people view and rely on the widespread delivery procedure in modern times.

In 2021, Brooke Wilson and colleagues published “Oral Administration of Maternal Vaginal Microbes at Birth to Restore Gut Microbiome Development in Infants Born by Caesarean Section: A Pilot Randomised Placebo-controlled Trial,” hereafter “Oral Administration,” in eBiomedicine. Previous researchers had established that neonates born via caesarean section, or c-section, the surgical delivery of an infant through an incision made in the mother’s abdomen, have different gut microbiomes from neonates delivered vaginally. They further hypothesized that such a difference may be because infants born by c-section do not receive exposure to their mother’s vaginal microbiome during delivery. Thus, Wilson and colleagues investigate whether oral vaginal seeding, or the process of transferring vaginal microbes to a newborn’s mouth, can restore the gut microbiome of newborns born by c-section. “Oral Administration” was one of the first articles to demonstrate that oral vaginal seeding is ineffective in altering the gut microbiome of newborns delivered by c-section and prompted other researchers to explore alternative research routes to enhancing the gut microbiome of newborns born by c-section.

In 2010, Maria Dominguez-Bello, Elizabeth Costello, Monica Contreras, and colleagues published “Delivery Mode Shapes the Acquisition and Structure of the Initial Microbiota Across Multiple Body Habitats in Newborns,” hereafter “Delivery Mode” in the journal Proceedings of the National Academy of Sciences. The term microbiota, which the authors use interchangeably with the term microbiome, refers to the collection of microorganisms, including bacteria, fungi, and viruses, found in and on the human body. The development of the microbiome, which begins at birth when a newborn is first exposed to the mother’s microbiota, impacts the development of the immune system, and how a person’s body responds to disease. Though researchers in the early 2000s were aware of a connection between delivery mode and the neonatal gut microbiome, they knew little about how delivery mode affects a neonate’s microbiome beyond the gut. Dominguez-Bello and associates’ experiment was one of the first to show that a neonate’s microbial community is uniform across their body and elaborate on the differences in microbiomes across delivery methods, which can make neonates born via c-section more susceptible to conditions such as asthma.

Maria Regina Torloni and colleagues published “Classifications for Cesarean Section: A Systematic Review,” hereafter “Classifications for C-sections,” in 2011 in the journal PLOS One. A Cesarean section, or C-section, is a surgical birth through an incision in the pregnant person’s abdomen and uterus. Across the world, medical professionals use many different C-section classification systems to group the procedures according to particular features of the medical situation, such as the person undergoing the C-section or their specific medical needs. The authors of “Classifications for C-sections” systematically review the various available classification systems and evaluate them to identify their strengths and weaknesses. In “Classifications for C-sections,” the authors stress the need for a standardized classification system that experts can use to communicate internationally and address the health needs of pregnant people seeking C-sections.