When Anna gave birth, she pulled her baby out of her own belly.


Anna Arstein-Kerslake will never forget her first glimpse of her daughter Freya. She looked down and saw her, halfway out of a small incision in her belly.

“My daughter was there looking at me,” she tells Mamamia. “I don’t even remember looking at my belly. I just saw her.

“I put my hands under her armpits and grabbed her and pulled her. It didn’t hurt, but I could feel the pulling. It sounds scary, but it wasn’t at all.

“I took her on my chest before they even cut the cord. She was crying when she came out, but the second that I put her on my chest she stopped crying and she looked up at me and it was really lovely.”

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Arstein-Kerslake, who gave birth to Freya two weeks ago in Melbourne, had a maternal-assisted caesarean. It’s something that’s becoming more common in Australia.

For Arstein-Kerslake, it was a very different experience from the birth of her first daughter. That birth, in 2016, in a different state, was also a caesarean.

“That was an emergency caesarean, at 27 weeks, due to bleeding caused by placenta previa [low-lying placenta],” she explains. “I was under general anaesthesia. It was such a strange experience to wake up and my daughter wasn’t in my belly anymore. She had been whisked away to the NICU [neonatal intensive care unit].


“She passed away after five days in the hospital, due to an antibiotic-resistant infection.”

When Arstein-Kerslake got pregnant again, she knew she wouldn’t be able to have a vaginal delivery because she’d had a “classical” c-section.

“Once you have those, it isn’t safe to labour at all because there’s a high risk of uterine rupture.”

But her obstetrician, Dr Peter Jurcevic, suggested a maternal-assisted caesarean, and explained exactly what it was.

“At first I was hesitant, because I was thinking, ‘Am I going to be too nervous in the operating theatre?’” she remembers. “But I really liked the idea of having the opportunity to be involved, since I knew that I wasn’t going to get the opportunity to have any kind of delivery aside from a c-section.”

Arstein-Kerslake had placenta previa again with her second pregnancy and was admitted to hospital at 30 weeks with bleeding.

“I was getting scared because it was looking exactly like my pregnancy in 2016.”

But the bleeding stopped at 32 weeks. Freya was delivered at 38 weeks.

In preparation for the maternal-assisted caesarean, Arstein-Kerslake was given spinal anaesthesia. Her hands were sterilised and gloves put on. A screen was put up, to initially cover her view of her belly, and Dr Jurcevic made the incision. Within a few minutes he had Freya halfway out, and the screen was removed. Then it was time for Arstein-Kerslake to pull her all the way out.

“It was a really lovely opportunity to be able to be the person that did the pulling,” she says. “You’re in an operating theatre and you can’t feel most of your body, so it’s really wonderful to have a bit of control and to feel like you’re part of the birthing process, even though it’s surgery and you don’t get to push and have that natural experience.”


Currently, more than 30 per cent of births in Australia are caesarean. Dr Jurcevic says one of the advantages of a vaginal delivery is that a baby can be placed immediately onto a woman’s chest, which enhances bonding, helps with breastfeeding and is better for the baby’s health.

Monique Bowley and Bec Judd chat to Midwife Cath about the different kinds of births and the drugs vs no drugs debate.  Post continues after podcast. 

A maternal-assisted caesarean lets a woman have that immediate contact, and also gives her some control in an otherwise very medicalised situation.

“I have been privileged to have performed quite a few maternal-assisted caesareans over the last year,” Dr Jurcevic tells Mamamia. “The one thing that has amazed me, some 6000 deliveries later, is that I have witnessed a new level of satisfaction over and above what I had previously noticed at a caesarean birth. When you feel emotionally overwhelmed yourself, when you see seasoned staff members with a tear in their eye, you know you are on a good thing.

“For me, assuming there are no contraindications, this should be the norm, not the exception.”

Arstein-Kerslake is now at home with Freya.

“She’s doing great. She’s feeding well.”

She says her family and friends in the US and Europe had never heard of maternal-assisted caesareans. But she would “definitely” do it again if she had the opportunity.

“It was a really wonderful experience.”