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The next step is to deliver the fetus

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where we would insert our hand below the head

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and we remove the retractor

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and as soon as the head is delivered

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before the delivery of the shoulder

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we would be first suctioning the mouth

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followed by the nostrils

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suctioning the mouth first would decrease the risk of aspiration

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and then we would deliver the whole baby

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and continue with the suction

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while we are clamping the cord

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the chord would be clamped

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at two points

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and would be cut by the assistant and the baby would be

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taken to continuing resusitation

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the next step now is to deliver the placenta

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theh placenta can be delivered by manual removal or controlled contraction

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the risk of bleeding and the risk of infection is found to be higher in removing it by manually

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so the preferable way is to remove it by controlled contraction, as you can see here

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also when the baby is being deivered

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we should give oxytocin to the mother

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and also during the delivery of the fetus also to give prophylactic antibiotics

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once we deliver the placenta

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it is always good to mop the inside of the uterine cavity

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to be sure we have not left any fragments of placenta or membranes

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and then we'll exteriorize the uterus to, both for easy visualization of the repair and also to see any bleeding,

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we should insert the X retractor at this point and we should look for any bleeders

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and this is where we are going to use a green armitage that you can see here holding, the surgeon holding

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and the green armitage is specific used for cesarean section because it is a clamp that can bring hemostasis without crushing the uterine wall

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all the bleeders would be clamped by the green armitage before we start

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the closure, closing the uterine incision

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This is the stage where we are going to dilate the cervix

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so we have good drainage

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using either fingers or sponge x