Darwin midwife, Shauna Newman has shared incredible images of the moment she helped deliver her own son by maternal assisted caesarean.
Rare, but possible this type of delivery allows caesarean mums and their babies to experience the immediate skin-to-skin contact and bonding that is normally denied to mothers who deliver via caesarean.
"In a normal caesarean delivery, the baby gets taken away to be checked over and the mother is really the last person who has anything to do with them," explains Newman. "When they do get to hold their baby, they really can't move and there is a gown between their baby and themselves, it's not ideal."
“I knew there was another way”
Already mum to a nine-year-old daughter and two-and- half-year-old twin girls – all three born via caesarean – Newman had never experienced that magical moment when a mother's child comes immediately up onto her chest.
Pregnant with her fourth child, Newman began to look into the idea of a maternal assisted caesarean.
"For me, this was my last baby and like many other women I didn't have the choice of a natural birth," she says. "But I knew, from my role as a midwife, that allowing and ensuring mothers and their babies to have skin-to-skin and to initiate breastfeeding within the first hour is crucial and has so many benefits for both mother and baby and bonding, and I wanted that for us."
Newman began researching and discovered that a Western Australian hospital had a policy for maternal assisted caesarean deliveries. She took that policy to her own Alice Springs hospital and began having conversations about the chances of them allowing her to deliver her child that way.
"Some people were open to it, and some were resistant, but eventually we got the anaesthetist on board and we began putting plans in place to make it happen," explains Newman.
“ … for the woman it’s the day her baby is born and this is significant”
Newman is determined that women should be empowered to make decisions about their own birth experience.
"At the end of the day, for the clinicians it's just a routine caesarean section, but for the woman it's the day her baby is born and this is significant.
"Maternal assisted caesarean deliveries will not be every woman's choice, nor would it be appropriate in all circumstances, however it is something that should be discussed and made more available to women if that skin-to-skin contact is a desire for them."
So how does it work?
As the first maternal assisted caesarean delivery in Alice Springs, plans had to be made. The obstetrician and anaesthetist had some meetings and worked out the best way to make it happen.
"They needed to work out how they would put the spinal block in, how they would keep the surgical area sterile, how they would keep me sterile and how the monitors would work - normally they'd be on my chest, but that would need to change," explains Newman.
"We did a run through beforehand and made it work by popping a paediatric monitor on my ear to keep my hands clear.
"They would pop the spinal block in, lay me down and place the sterile gown on me, then place the sterile gloves on me and nobody would touch me after that.
"There would be no drape up either, like a regular caesarean."
“There are no words to describe the feeling”
In a maternal assisted caesarean delivery the obstetrician and surgeons begin the procedure, and once the baby's head is out, the mother can reach down, grab their child under the armpits and pull them up onto their chest.
"Feeling the weight of your baby straight onto your chest, I can't describe it," says Newman. "It was incredible, there are no words. It was that moment that you see in the movies and see other people have. To have that weight of your baby straight onto your chest, straight from you to you, not via anybody else, it's unbelievable."
“It’s a boy!”
Another incredible experience Newman had for the very first time was being able to be the one who first knew the sex of her baby.
"We didn't know what we were having, we already had three girls, and we had no idea this time," she says.
"The surgeons asked 'What have you got?' and I lifted my baby off my chest and we saw that we had a son, it was a very special moment."
The attending midwives cut the surgical gown away and their baby began nuzzling and feeding straight away.
"He never left me at all. He and my husband were both able to come to recovery with me, my son was with me the entire time. He was even on the boob while they were suturing me up," laughs Newman.
"I knew that statistically it is shown that skin-to-skin and breastfeeding in that first hour has so many benefits, so it was good to have for the first time and to know that the physiological changes like the mum regulating the heartbeat and temperature were happening for us.
"My baby was not handed to me an hour and half later. It was all as it should be."
Try it yourself
Newman wants women to know that this kind of birth is possible.
"It's 2018 we're not in the stone ages, with the right techniques and sterility maternal assisted caesareans are entirely possible. For some women it might be the healing birth they've always wanted."
Her tips? Newman says women should begin the conversations early.
"Ask a midwife to be your advocate, the earlier you bring it up the more likely it is that your hospital will come around to the idea," she says.
"I hope that some other woman will read my story and feel empowered and do this for themselves and for their baby, and then it will maybe spread across Australia and even more women will have the chance that I did."