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This article examined the literature as it relates to the safety of cesarean births versus vaginal births and described a model developed to inform others about the preponderance of evidence in favor of vaginal birth. Leaders at the Maternity Center Association (MCA) of New York City (now known as "Childbirth Connections"), the oldest national not-for-profit organization advocating on behalf of mothers and babies in the United States, developed this model as a component of their long-term national program to promote evidence-based maternity care. When MCA identified the need to clarify and translate into practice best evidence about the relative harms of cesarean and vaginal birth, their main concern was that major surgery was being done in a healthy population without clear evidence to support the trend. Their systematic review was conducted to clarify the issue and publicize the results. They engaged national organization partners and created drafts of initial products, such as decision aids, consumer booklets, and practice guidelines. The next strategy used diverse dissemination channels about choice of cesarean section for reaching key audiences. The final stage evaluated the outcome of their efforts. The efforts of MCA to educate the public about the problems of increasing numbers of cesarean births have shown that not-for-profit advocacy organizations are well positioned to initiate and drive research translation efforts. Organizations deeply troubled by the urgent need to translate research into practice can use the MCA model to continue their ongoing advocacy for women and infants.

Maaly Kamal Gumei