Caesarean births are getting a much-need makeover with a new technique giving moms the control by allowing them to lift their own newborns from their womb.

A cesarean section can often leave moms feeling disconnected from their births, having to lay on an operating table with a sheet between her and doctors, and a delay in skin-to-skin bonding.

But a new wave of obstetricians are making women feel more empowered in the operating theater by offering a maternal-assisted caesarean (MAC).

Doctors, doulas and new mothers are reporting a list of benefits for mom and baby after the hands-on procedure, including a huge boost to bonding and moods after birth.

A MAC is a relatively new and rare technique where the mother reaches down and helps deliver her baby by lifting them out of her uterus, up onto their chest, for an immediate cuddle.

Melbourne obstetrician Dr. Joseph Sgroi has been offering the procedure at Epworth Freemasons Hospital since 2017, and is likely one of the first in Australia to do MACs. 

He found many women electing vaginal births, after a caesarean, were craving a connection with their newborn they previously missed out on.

“It’s shown to be a massive difference, even women who I’ve offered a maternal assist to and they didn’t know about it, or been ambivalent, after have said they were so glad they did it,” he says.

Dr. Sgroi is collating data on the benefits of a MAC over a traditional c-section, which is showing that bonding between mothers and newborns is improved.

“The experience is a hell of a lot better than a c-section being a clinical, sterile environment – it’s still sterile, but it’s much more inclusive,” he says.

“Most of the (moms) are absolutely in awe of the whole process, and of themselves.”

With one in three Aussie moms saying their birth experience was traumatic, Dr. Natalie Elphinstone adds that a MAC is a positive option to give moms back control.

“It’s a powerful autonomous act of the woman to participate in bringing her own baby out into the world, something that many caesarean moms feel they didn’t achieve,” she says.

“It can be especially healing and redemptive if a woman has had a distressing emergency caesarean birth previously.”

Apart from the psychological benefits, the Mornington Peninsula obstetrician says there may be physical advantages to a MAC, such as delayed cord clamping, and immediate skin-to-skin contact – which can reduce cortisol levels in mom and baby, regulate baby’s heart rate, and improve breastfeeding.

Both of these benefits are World Health Organization recommendations that have traditionally been difficult to achieve at caesarean births.

Unfortunately, MACs aren’t readily available or known about.

Not all obstetricians perform them, and some even refuse to do it.

Dr. Sgroi says there is still an “amount of resistance” among some, particularly older, obstetricians.

He recently worked with a Sydney midwife, who approached him about a MAC, and he wrote up a surgical protocol to give to her local obstetrician, who had initially been against the idea but then changed his mind.

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“I get contacted by midwives and nurses in the US, Ireland and England and South America – it’s nice to know we are having a far-reaching positive impact here and outside the country,” he says. 

“When you think about medicine globally, it’s all about patient-centric care.

“If it’s what the patient is desiring, and you have the ability to provide them something that is safe and rewarding – the question isn’t why would you do it, it’s why wouldn’t you do it?”

Dr. Elphinstone adds possible reasons why MAC’s might not be available in a hospital are a lack of policy and legitimate concerns about safety – both of which she believes can be overcome.

One of the most common arguments against it is the “unfounded assumption” that it will increase maternal infection rates, but she argues moms do the same sterile preparation as the surgeon, and they don’t put their hands near the wound, they only hold the baby.

“Our lack of impetus for change begins with a failure to understand the value of this to women and their families,” she says.

 “To this day I have not had one woman who had a MAC wish that she hadn’t done it that way.”

Vanessa Salerno has been a doula, supporting moms before, during and after birth, for almost three years.

She works with Dr. Sgroi and has witnessed the post-birth benefits of a MAC when she visits moms in hospital wards and at homes over a number of weeks.

Salerno has seen an improvement in bonding between moms and babies, thanks to the immediate skin-to-skin, and actively being a part of the birth – instead of a passive surgery.

“I watch them during their recovery and it’s different, they were involved, they were empowered, they didn’t feel disconnected, yes they’re still in theater, but they’re involved in childbirth,” she says. 

“Clients say to me ‘Oh my God I did that, I’m so glad I did that’ – it’s like vaginal births when they touch the baby’s head, it’s transformative,” she says.

“C-sections have such a bad stigma, we don’t want women to say ‘I had to have this’ we want them to say ‘I had an empowering experience.’”

“I wish everyone did it, and it was standard.”