CONTEXT: Many challenges prevent equitable access to safe, quality, and indicated cesarean delivery (CD) in low-and-middle income countries (LMIC), leading to an increased risk of maternal and newborn morbidity and mortality, including:

• Capacity gaps at primary and peripheral health facilities can drive referrals to CD facilities and/or contribute to CD preference/provision;
• Access to CD does not guarantee that care is appropriate or of adequate quality;
• Both underuse and overuse are barriers to maternal and newborn health; both now coexist in some of the same countries;
• Data on CD, including indications and maternal/newborn outcomes, is insufficient to guide and monitor interventions to address these challenges;
• Evidence on which interventions work to improve provision of safe and appropriate CD services is insufficiently summarized and inadequately disseminated, and a strategically visioned research agenda has not been developed.

MOMENTUM Safe Surgery in Family Planning and Obstetrics is launching a new Community of Practice (CoP) that catalyzes strategic change and enable actors at the global, regional, and country levels to identify solutions, share implementation experiences, coordinate, and collaborate on implementation initiatives, and accelerate action to ensure the safety, quality, and appropriate use of CD in low- and middle-income countries (LMIC). This CoP can provide a platform to advance the following aims:

• Naming/framing the challenge(s)
• Sharing conceptual frameworks and action agendas that have been developed by global and national leaders in safe/indicated CD
• Developing regional strategies to translate existing frameworks into concrete initiatives and interventions
• Sharing knowledge, evidence, and implementation experiences targeting improved safety, quality, and appropriate use of CD
• Identifying opportunities for coordinated monitoring and reporting, action, dissemination, and constituency building