First assisting in obstetrics: a primer for women's healthcare professionals

As the cesarean rate rises nationwide, many maternity nurses, certified nurse-midwives, certified midwives, and other women's health nursing professionals are expanding their scope of practice to include first assisting with cesarean delivery. Becoming qualified to assist with cesarean section requires evaluation of facility, state, regulatory, and professional standards related to first assistants. First assisting education programs offer didactic education and clinical experience designed to ensure that surgical assistants are competent. Surgical first assistants for cesarean section are expected to be knowledgeable regarding the procedure, the relevant surgical anatomy, potential complications, and options for treatment. Acquiring clinical skills requires significant intraoperative experience under the tutelage of a knowledgeable mentor. In this article, the cesarean section procedure and the role and expectations of the surgical first assistant are described to provide the women's health nursing professional with the information needed to determine whether to include surgical first assisting with cesarean section as part of their professional practice.