Labor and Delivery
Labor & Delivery Surgery focuses on operative care for pregnant patients, including scheduled and emergent procedures that support childbirth and maternal health. CSTs in L&D assist with cesarean sections, postpartum hemorrhage control, tubal ligations, and emergency obstetric interventions. This specialty requires rapid response skills, strong sterile technique, and the ability to work efficiently in a fast‑paced environment where both maternal and fetal outcomes depend on coordinated teamwork.
Role of CSTs
- Prepare L&D ORs for scheduled and emergent obstetric procedures, including C‑sections and postpartum interventions.
- Assist with rapid patient positioning, prepping, and draping during obstetric emergencies.
- Maintain sterile technique during high‑movement, time‑critical procedures.
- Anticipate surgeon needs during delivery, uterine repair, hemorrhage control, and tubal ligation.
- Manage obstetric instrument sets, laparoscopic tools, and emergency hemorrhage kits.
- Support anesthesia teams during spinal, epidural, or general anesthesia for emergent cases.
- Handle placental specimens, cord blood, and tissue samples with proper labeling.
- Assist with accurate counts and rapid room turnover between deliveries.
Essential Skills
- Strong understanding of maternal and fetal anatomy.
- Proficiency with C‑section instruments, retractors, and suturing tools.
- Ability to anticipate surgeon needs during delivery and uterine closure.
- Skilled in rapid setup and sterile technique during obstetric emergencies.
- Competence with suction, electrosurgery, and hemorrhage control devices.
- Ability to communicate clearly with L&D nurses, midwives, anesthesia, and pediatric teams.
- Adaptability for unpredictable case flow and emergent transitions.
- Familiarity with neonatal resuscitation workflows and OR support roles.
Common Procedures
- Cesarean section (scheduled and emergent)
- Postpartum hemorrhage control
- Dilation and curettage (D&C)
- Manual removal of placenta
- Tubal ligation (postpartum or interval)
- Repair of obstetric lacerations
- Ectopic pregnancy surgery (in L&D ORs depending on facility)
- Emergency hysterectomy for uncontrolled bleeding
- Cerclage placement
- External cephalic version support (OR‑ready)
Instruments & Equipment
Instruments
- C‑section instrument sets
- D&C instruments (curettes, tenaculums)
- Uterine clamps and forceps
- Retractors (Deaver, Richardson, O’Sullivan‑O’Connor)
- Laparoscopic instruments for postpartum tubal ligation
- Hemorrhage control tools (Bakri balloon, uterine packing materials)
- Suturing and stapling instruments
- Neonatal cord blood collection tools
- Specimen containers for placenta and tissue samples
Equipment
- Fetal monitoring equipment
- Suction and irrigation systems
- Electrosurgical generators
- Warming devices for mother and newborn
- Infant warmers and neonatal resuscitation equipment
- Laparoscopic towers (for tubal ligation)
- Emergency hemorrhage carts
- Rapid infuser (for severe postpartum hemorrhage)
- Positioning devices for supine and left‑tilt positioning
Workflow & Case Progress
- Rapid room setup with obstetric instruments, suction, and emergency supplies.
- Patient positioning with left uterine tilt to prevent vena cava compression.
- Prepping and draping with attention to abdominal and pelvic access.
- Initial incision and entry into the uterus.
- Delivery of the infant and handoff to pediatric or neonatal teams.
- Delivery of the placenta and inspection of the uterus.
- Uterine repair and hemostasis.
- Closure of abdominal layers and skin.
- Final counts, dressing application, and transfer to recovery or postpartum care.
Sterile Technique Considerations
- Maintain sterility during rapid, high‑movement obstetric emergencies.
- Protect the sterile field during neonatal handoff and pediatric team entry.
- Manage contaminated amniotic fluid and blood with isolation technique.
- Maintain sterile technique during postpartum hemorrhage interventions.
- Handle multiple instrument trays efficiently during back‑to‑back C‑sections.
- Ensure sterile technique during conversions from scheduled to emergent procedures.
Career Pathways
- Labor & Delivery Surgical Technologist
- Obstetric OR Specialist
- High‑risk obstetrics technologist
- Minimally invasive gynecologic surgery technologist
- OBGYN First Assist (with additional training)
- Clinical educator for obstetric and gynecologic instrumentation
- Device representative for women’s health surgical platforms
- Neonatal OR support technologist
How to Prepare
- Study maternal anatomy, fetal positioning, and obstetric surgical workflows.
- Learn C‑section instrument names, functions, and sequence of use.
- Practice rapid setup and sterile technique for emergent procedures.
- Review postpartum hemorrhage protocols and emergency interventions.
- Observe L&D cases to understand pacing and team communication.
- Build familiarity with neonatal resuscitation workflows and equipment.
- Strengthen sterile technique for high‑fluid, high‑movement environments.