What it is, simply:
In a traditional c-section, the baby is lifted out entirely by the surgeon. In a maternal-assisted c-section, the mother reaches down and guides her baby out herself, she is the first person to touch and hold her baby.
It only takes 4 minutes extra of surgery time and 2 minutes of preparation.
What the research says:
The evidence is still emerging but promising. Studies point to:
- Improved bonding and maternal satisfaction: mothers report feeling more like an active participant, not a passive patient
- Equivalent safety outcomes to traditional c-sections when properly selected (no increased infection or complication risk in eligible patients)
- Possible oxytocin boost: the act of catching her own baby may trigger the same hormonal cascade as vaginal birth, though this is still being studied
- Positive impact on breastfeeding initiation when combined with early skin-to-skin
The Netherlands context
MACS is not yet standard in Dutch hospitals, but it is expanding. A handful of progressive hospitals are beginning pilot conversations. The Dutch midwifery and obstetric culture is already quite family-centred, which makes the soil fertile. However the NVOG (Dutch Society of Obstetrics & Gynaecology) has not yet issued formal guidelines.
The MAC was developed in the Netherlands by Dr. Koen Deurloo, working at the Diakonessenhuis in Utrecht. He introduced it after a mother with a previous traumatic birth asked if she could receive her own baby. A question, he says, that changed his entire perspective on birth care.
Dr. Deurloo is also the in-house gynaecologist for midwifery practice De Geboortezaak in Utrecht-Leidsche Rijn, where he emphasises shared decision-making and putting the pregnant woman in charge.
In February 2025, he co-launched the MACazine together with birth photographer Inge Berken, an online magazine filled with information, personal stories, and photography about the MAC.
The Research Data (from Utrecht)
Between 2017 and 2025, nearly 200 MAC births were compared with 200 gentle caesareans at the Diakonessenhuis. The findings: surgical outcomes and neonatal health were equivalent, blood loss and complication rates were the same. Mothers in the MAC group breastfed within the first hour more often (88.9% vs. 78.7%), used more positive language to describe bonding, and rated their overall experience higher (median 9 vs. 8). Women with previous birth trauma especially reported that the MAC helped them regain a sense of control.
If you are planning a c-section, this might be something worth exploring.
A MAC is particularly meaningful if you have experienced a previous traumatic birth, if you had imagined an active role in your baby's arrival, or if you simply want to feel more involve on the day your child is born. It is also an option some mothers choose after a previous c-section, reclaiming that first moment of contact.
Start by raising it with your midwife or gynaecologist at your next appointment. They will be able to refer you to the right place if needed.
In the Netherlands, the Diakonessenhuis in Utrecht is currently the most experienced centre, with over 300 MACs performed since 2017. Other hospitals, including Zuyderland (Limburg) and Gelre (Apeldoorn), have begun offering it. The practice is expanding, and more teams are being trained each year.
If you are based in Rotterdam: no hospital in the region currently has MAC listed as a confirmed offering but that doesn't mean the conversation is closed. The more families ask, the faster it becomes available. And if a referral to Utrecht is the right path, your midwife can facilitate that.