Over the last two decades, research has extensively addressed the decline of rural maternity services in Canada and globally, highlighting the negative consequences of losing local servicess. However, there’s been limited focus on interventions to stabilize these services and their evaluations. This study examines the Rural Surgical Obstetrical Networks (RSON) initiative in British Columbia, which aim to sustain rural maternity care by ensuring local access to caesarean sections and enhancing surgical skills training for rural health care providers. The initiative, funded by the Joint Standing Committee on Rural Issues, utilized four pillars, including increased scope and volume, clinical coaching, continuous quality improvement, and remote presence technology, to address the challenge of maintaining rural maternity services and associated surgical care.