 Selection of Patients: All pregnant women, undergoing a primary their first cesarean delivery at Thomas Jefferson University Hospital will be offered randomization regardless of indication for cesarean delivery. Patients will be excluded from the study if they have a history of a previous cesarean delivery, history of a previous Pfannensteil skin incision for an indication other than for a cesarean delivery i.e. myomectomy, laparotomy, or a planned vertical skin incision prior to randomization. 