Reply to Grossman: The role of natural selection for the increase of Caesarean section rates


Recently, we presented the “cliff-edge model” (1) to explain why natural selection has not reduced the high rates of fetopelvic disproportion (FPD) in childbirth. This evolutionary model predicts that birth-relevant anatomical dimensions have changed in response to the regular use of Caesarean sections (C-sections). Grossman’s (2) interesting comment on our report allows us to clarify several issues.

Proceedings of the National Academy of Sciences 113:14680-14685