Maternal and neonatal outcomes after French Ambulatory Cesarean Section (FAUCS): a prospective study

French Ambulatory Cesarean Section (FAUCS) has been proposed as a less invasive alternative to conventional cesarean section (CS), with the potential to enhance postoperative recovery. Evidence directly comparing maternal and neonatal outcomes between these techniques remains limited. This single-center observational cohort included 200 women (100 FAUCS and 100 conventional cesarean section [CS]). Five primary and seven secondary outcomes were analyzed, with Holm correction applied separately within each family. Unadjusted comparisons used available observations; archived multivariable and propensity-score analyses were treated as exploratory sensitivity analyses. FAUCS was associated with earlier first full meal (mean difference − 7.01 h, 95% CI − 7.54 to − 6.49), earlier mobilization (− 2.11 h, 95% CI − 3.31 to − 0.91), and lower WHO step-2-or-higher analgesic use (49% vs. 69%; OR 0.43, 95% CI 0.24–0.77); all remained significant within the primary family. Hospital stay was longer (+ 0.87 days, 95% CI 0.26–1.48; Holm p < 0.001). Among women with a recorded breastfeeding time, the mean difference was − 4.58 h (95% CI − 5.14 to − 4.02); this conditional comparison does not establish an effect on breastfeeding initiation in the full cohort. Mobilization and analgesic findings were not consistently supported across adjusted analyses. Blood loss and time to fetal extraction were lower and surgery duration longer (secondary Holm p < 0.001 for each). No neonatal endpoint was significant after correction: cord pH and Apgar < 10 each had Holm p = 0.129, pH < 7.20 p = 0.995, and recorded neonatal trauma/complication p = 1.000. FAUCS was associated with earlier postoperative recovery despite longer operative time, while neonatal outcomes were generally comparable between groups in this prospective observational cohort. These findings suggest that FAUCS may represent a promising alternative surgical approach in selected patients; however, confirmation in larger multicenter randomized studies is required before definitive conclusions regarding safety and effectiveness can be drawn.