For Australian women facing a medically necessary caesarean section, the surgical reality can feel stripping. The usual script involves surrender; the mother is anaesthetised, positioned, draped, and then suddenly presented with a baby she did not actively receive. Many women feel somewhat removed from their birth experience with traditional caesarean sections.
A maternal-assisted caesarean section is an emerging technique in which the pregnant person becomes an active participant in the operative delivery process by lifting their baby onto their chest from the surgical incision. The procedure works like this: after sterilisation and draping, the surgeon partially lifts the baby. The mother then reaches down, guided by her obstetrician, and brings her infant onto her chest. From that moment, immediate skin-to-skin contact begins.
For women who have experienced traumatic births, this shift towards agency can be profound. For Stacey Allison, son Harvey was her fourth baby, but her first maternal assisted caesarean delivery. Stacey's first son Bailey was born by an emergency C-section 14 years ago. Her daughter Ruby, now aged five, and second son Toby, now aged two and a half, were also C-section births. Describing her experience, Allison reflected on the contrast: that whole experience from reaching down to pick up the baby to put them on your chest was quite healing. He was on my chest for so long and I definitely felt more of a bond straight away.
Research shows that 1 in 3 birthing people perceive their childbirth to be traumatic, and 4–6% go on to develop Post-Traumatic Stress Disorder (PTSD). Birth trauma is not limited to the physical; feeling powerless, unsupported, or unheard by healthcare providers—particularly when there is a lack of control, support, or communication during labour—can deeply affect the emotional experience of childbirth.
The option is gaining traction across Australia. More than 200 women have helped deliver their babies through a maternal assisted caesarean at Epworth Freemasons Maternity between 2020 and 2023. Hospitals in Melbourne, Brisbane, and the Gold Coast now offer this approach as standard practice. Yet uptake reflects a simple friction: many women do not know the option exists, and many doctors do not yet routine mention it.
The technique does carry real constraints. A maternal assisted caesarean is a relatively new type of birth that has yet to become a common practice in Australia. There are a number of instances where a MAC is not appropriate for medical reasons, such as low-lying placenta, twins, breech presentation, preterm baby, and preeclampsia. Preparation is essential; women will need to discuss this with their doctor during the course of pregnancy to consider whether this is something they are prepared to do, and whether it would be an appropriate choice in their circumstances. They will also need to participate in a counselling or education process to ensure that both they and their partner are fully prepared for the experience.
There is also frank discomfort to consider. The surgical drape that usually shields you from having to watch your operation is lowered, so that both you and your partner will see what is happening during the operation, including the incision in your tummy, your blood around the operation site, and the procedures used to deliver the baby. Some women find this empowering; others find it distressing.
What the evidence suggests, though, is that for the right candidate, choice itself becomes therapeutic. The overwhelming positivity surrounding maternal assisted caesarean speaks volumes about the impact it has on women's birth experiences. Women report feeling powerful, connected to their birth and an increased sense of sovereignty and self-belief.
The barrier now is visibility. A maternal assisted caesarean is not yet common practice in Australia. For women navigating a complicated pregnancy or a previous traumatic birth, the absence of this discussion can feel like another loss of agency in a context where agency is already scarce. Expanding awareness among patients and clinicians could give more women the chance to author at least one moment of their medical birth.
For further information about caesarean birth options in Australia, consult Pregnancy Birth and Baby, the official Australian government resource, or speak with your obstetrician about whether a maternal assisted caesarean is appropriate for your circumstances.