After the woman is anesthetized, an incision is made in the abdomen. There are two types of incisions that can be used for a Caesarean delivery:

• Vertical or longitudinal incision. This incision starts at the navel and extends down to the pubic hairline. The advantage of this type of incision is that the surgeon can have fast access to the abdominal cavity and reduce the amount of time the woman is under anesthesia. There is also less blood loss associated with this particular type of incision.
  
  
• Transverse or horizontal incision. The transverse incision is commonly referred to as the “bikini cut” because the incision’s scar is often hidden beneath a woman’s bikini bathing suit. This incision runs across the pubic hairline or sometimes slightly above it. After the first incision in the abdomen, the surgeon often makes a horizontal incision in the lower part of the uterus. The advantage of this type of incision is that the woman experiences less postoperative pain during recovery. Additionally, there is a lower rate of medical complications, such as the incision separating.

For women who have epidurals and are thus awake during the procedure, it is possible to feel some pulling, tugging or even some pressure in the abdominal area. After the incision is made, the obstetrician will gently remove the baby and the placenta (organ that connects the mother and her baby) from the uterus. Many times the baby will be taken out manually, but occasionally forceps or a vacuum extractor will be used.

Once the baby is removed, fluids are cleared from the baby’s nose and mouth using suction. The umbilical cord is then clamped and cut.

Finally, the uterus is stitched securely back together using stitches that will dissolve on their own. The abdomen is then closed using either stitches, staples, a combination of the two or a type of skin glue.