Effect of Non-Dissection of the Inferior Rectus Sheath on Intraoperative Blood Loss

Inclusion Criteria: * \- Patients must be 18 years or older as well as willing and able to provide informed consent * Patients undergoing a scheduled or non-scheduled, non-urgent or non-scheduled urgent (delivery within 30 minutes of decision for surgical delivery) Cesarean delivery between \>35 weeks gestational age, * Patients who are expected to receive a Pfannenstiel incision * Patients with viable singleton intra-uterine pregnancy * Patients with fetus in cephalic presentation Exclusion Criteria: * \- Patients younger than 18 years, * Patients unable or unwilling to provide informed consent, * Patients who are illiterate, * Patients who are non-English speaking or reading, * Patients who are medical or nursing students at a school affiliated with University Hospital * Multi-fetal gestations (\>1 intrauterine pregnancy), * Patients with a BMI \>50 kg/m\^2 * Patients with a suspected placenta accreta or placenta previa * patients with 2 prior cesarean deliveries * Patient undergoing emergent cesarean delivery (delivery within 10 minutes of decision for surgical delivery) * Patients who will require a vertical skin incision, Maylard or Cherney incisions * Patients with a history of significant pelvic adhesive disease, as determined by prior operative reports * Patients with fetus in non-cephalic presentation * Patients with pre-gestational or gestational diabetes mellitus * Patients with estimated fetal weight \>5000 grams * Patients with estimated fetal weight \<10% for gestational age * Patients with who require general anesthetic * Patients who are on chronic pain medication * Patients with a history of drug abuse