Cesarean births are being performed at an alarming rate, challenging obstetric services to meet the same national safety standards and competencies as in the hospital’s main operating room, while continually striving to maintain family-centered care. Highlights include surgical consents, IV antibiotics, checklists, hand-off communication, team responsibilities, distractions, DVT prophylaxis, counts, safety pause, prep technique and solutions, sterile field, safe medication practice, fires, obese women, anesthetic complications, failed intubation, fetal intolerance, emergency prioritization, and training.