CNM as First Assist in C-Sections

Do any of you act as first assists in c-sections? If you do, what role do you play during the surgery? As in, what do you actually do? Also, have you ever heard of a CNM assisting in surgeries other than c-sections?

5 Answers

Specializes in OB.

I am learning to first assist currently. Many, many midwives first assist. The role of the first assist is to literally assist the surgeon in whatever they need. We help prep the patient and get her on the table. I help put up the drapes, set up the bovie, set up the suction. He/she makes all the incisions, I cauterize bleeders, hold retractors, and suction. I help with fundal pressure with the delivery of the baby. I help visualization of the layers when they're suturing the uterus and fascia. Some doctors want to suture the skin themselves, some are ok with us doing it. We have PAs where I work who do the bulk of first assisting, but we're being trained to be able to jump in in an emergency, which I am cool with because it's a marketable skill to have. I haven't ever heard of a CNM assisting in other surgeries but it's technically possible.

Specializes in Reproductive & Public Health.

When I was doing my integration I first assisted and I LOVED IT. I work strictly outpatient now that I've graduated and I miss that probably more than anything... and I am a former home birth midwife!

I am learning to first assist currently. Many, many midwives first assist. The role of the first assist is to literally assist the surgeon in whatever they need. We help prep the patient and get her on the table. I help put up the drapes, set up the bovie, set up the suction. He/she makes all the incisions, I cauterize bleeders, hold retractors, and suction. I help with fundal pressure with the delivery of the baby. I help visualization of the layers when they're suturing the uterus and fascia. Some doctors want to suture the skin themselves, some are ok with us doing it. We have PAs where I work who do the bulk of first assisting, but we're being trained to be able to jump in in an emergency, which I am cool with because it's a marketable skill to have. I haven't ever heard of a CNM assisting in other surgeries but it's technically possible.

When you say suturing the skin, do you mean closing from beginning to end or just the outer layer of skin?

Specializes in OB.

The surgeon sutures the uterus, fascia, and subcutaneous layers. The first assist can suture the skin.

Got it. Thanks!

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