Rural areas are in need of maternity care services, including cesarean delivery. Multiple studies have linked lack of local obstetrical services with increased preterm delivery and infant mortality. Family physicians are the main providers of rural maternity care. With the paucity of non-family physician rural maternity care providers, it is essential that family physicians with caesarean capabilities be available to rural communities. Opportunities for family medicine cesarean training include residency, fellowship, and on-the-job training. The American Board of Family Medicine Obstetrics certification is a means to document competency.