ArticleProceedings of the National Academy of Sciences of the United States of America2017
Cliff-edge model predicts intergenerational predisposition to dystocia and Caesarean delivery.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 25 citations in OpenAlex.
- 'Everyone in my family has C-sections': increased likelihood of caesarean birth in family lineages in the United States.Evolution, medicine, and public health · 2025Article
- There is an obstetrical dilemma: Misconceptions about the evolution of human childbirth and pelvic form.American journal of biological anthropology · 2023Review
- Article
- Long-term gene-culture coevolution and the human evolutionary transition.Proceedings. Biological sciences · 2021Review
- Developing a theoretical evolutionary framework to solve the mystery of parturition initiation.eLife · 2020Review
- Evolution of the human pelvis and obstructed labor: new explanations of an old obstetrical dilemma.American journal of obstetrics and gynecology · 2020Review
- Mate Choice and the Persistence of Maternal Mortality.Reproductive sciences (Thousand Oaks, Calif.) · 2019Review
- Humans as inverted bats: A comparative approach to the obstetric conundrum.American journal of human biology : the official journal of the Human Biology Council · 2019Review
- Secular changes in body height predict global rates of caesarean section.Proceedings. Biological sciences · 2019Article
- Mortality Rate and Predictors Among Women With Obstructed Labor in a Tertiary Academic Medical Center of Ethiopia: A Retrospective Cohort Study.SAGE open nursingArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
Recently, we presented the cliff-edge model to explain the evolutionary persistence of relatively high incidences of fetopelvic disproportion (FPD) in human childbirth. According to this model, the regular application of Caesarean sections since the mid-20th century has triggered an evolutionary increase of fetal size relative to the dimensions of the maternal birth canal, which, in turn, has inflated incidences of FPD. While this prediction is difficult to test in epidemiological data on Caesarean sections, the model also implies that women born by Caesarean because of FPD are more likely to develop FPD in their own childbirth compared with women born vaginally. Multigenerational epidemiological studies indeed evidence such an intergenerational predisposition to surgical delivery. When confined to anatomical indications, these studies report risks for Caesarean up to twice as high for women born by Caesarean compared with women born vaginally. These findings provide independent support for our model, which we show here predicts that the risk of FPD for mothers born by Caesarean because of FPD is 2.8 times the risk for mothers born vaginally. The congruence between these data and our prediction lends support to the cliff-edge model of obstetric selection and its underlying assumptions, despite the genetic and anatomical idealizations involved.
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