Abstract
Thirty years ago seems like yesterday: a time of immense socioeconomic changes, explosion of an "Internet" computer concept, and identification of human immunodeficiency virus. Like all events of the past, transformations in obstetrics developed over time. Cesarean birth can be better understood in a broader context when one considers how the art of obstetric practice has evolved. Cesarean birth progressed from delivering a fetus perimortem or postmortem to a time of operative births that simultaneously juggle a woman's safety, satisfaction, and freedom of choice concerning birth options. Thirty years of increasing cesarean birth rates have prompted government agencies, national organizations, state-level perinatal collaborative groups, and experts to address these rates and the impact on maternal-child health and healthcare systems. The purpose of this article is to explain cesarean birth's remarkable impact on obstetrics by reviewing key historical periods, current advances, and upcoming trends.