For cesarean technique, we suggest: straight transverse skin incision 3 cm below the anterior superior iliac spines; blunt dissection to open subcutaneous tissue; open fascia with a knife and extend bluntly; open peritoneum bluntly away from the bladder; omit bladder flap; low transverse uterine incision, and extend with fingers in a caudal-cephalad fashion; delivery cephalad baby with manual elevation to the hysterectomy, apply fundal pressure; delay cord clamping for 60 seconds. Prophylactic intravenous tranexamic acid before incision, and at baby delivery, oxytocin and misoprostol, or oxytocin and ergometrine, or carbetocin; spontaneous placental delivery with gentle cord traction; uterine exteriorization if desired; continuous double-layer uterine closure with first layer unlocked if no concurrent tubal ligation; no peritoneal closure; fascial closure; subcutaneous tissue closure with sutures if >2 cm thick; skin closure with adsorbable sutures; dressing removal at 6 hours.