A West Lothian mother has praised the maternity and obstetrics team at University Hospital Wishaw for allowing her to be actively involved in the delivery of her daughter by caesarean section. The decision to go ahead with what's thought to have been the first maternal -assisted c-section delivery in Scotland was in response to the woman's very difficult previous experience of childbirth.

Details of the procedure, which took place in spring 2025, were shared by mum, Edinburgh Napier University lecturer, Dr Leila El Alti at a meeting of the board of NHS Lanarkshire.

Dr El Alti described the moment she pulled her baby from her abdomen and on to her chest for immediate skin-to-skin bonding as “the most magical experience of my life”.

She praised staff at University Hospital Wishaw in North Lanarkshire for agreeing to take on the challenge of the novel procedure – which saw her scrubbing her hands and forearms along with the doctors, nurses and midwives, and wearing a surgical gown and gloves to prevent infection as she helped deliver 7lbs 9oz Aurora.

Dr El Alti said she would recommend a maternal-assisted procedure, which she said gave her an “active and empowering role” in the birth:

“I felt euphoric for weeks after Aurora was born in March, and my joy was not just for myself – my having done this successfully has hopefully opened the door for other women to also have this wonderful experience as a valid birth option.

“I was anxious to have a maternal-assisted procedure to give me a vital sense of difference, empowerment and control because the caesarean births of my first two children were highly traumatic. I was prepared to go anywhere in the UK.”

Gentle method

Dr El Alti explained to the meeting that she had discovered that NHS Lanarkshire already had a policy for “gentle method” c-sections where the procedure is slowed down, the mother can see the birth, and there is immediate skin-to-skin contact with the baby.

She explained:

“I did a lot of work and research and, through social media, I found a woman in England who’d given birth the maternal-assisted way. I put her midwife in touch with the NHS Lanarkshire team, which helped them gain confidence and understanding of the procedure.”

Dr El Alti had worked in her native Lebanon as a registered nurse in intensive care and palliative care before moving to study in Sweden.

“I became pregnant for the first time when I was in Sweden. I was completing a PhD in healthcare ethics, so I was already writing about issues like consent, shared decision-making and the importance of care that’s centred on a person’s individual needs.

“My pregnancy with my first child was very difficult and I was depressed and in great pain throughout. I asked the Swedish hospital staff for a c-section but was denied that option, and was coerced to have a very traumatic induction.

“When that didn’t work the clinicians relented and I had a caesarean but what happened before and after it was horrendous – there was no proper attempt to explain what they were doing to my body or to genuinely get my consent for anything, including intimate examinations and very painful procedures.”

Getting it right

Dr El Alti said she was diagnosed with post-traumatic stress disorder after her first daughter’s birth and waited over five years to have her second child, a boy, by which time she’d moved to the UK.

“I was so traumatised that I couldn’t bond with my son for a year and I was in that state when I unexpectedly became pregnant with Aurora,” she recalled. “I knew I had to have a maternal-assisted c-section this time along with safeguards and guarantees on my needs for respectful care – appropriate informed consent, shared decision making and protecting my dignity during birth.

“I was delighted when the NHS Lanarkshire team agreed to the maternal-assisted option and my other needs and wishes, and we had multiple discussions and a full simulation session using a doll – a first for the clinicians.

“When she was being born, the lead obstetrician brought Aurora’s head and shoulders out and I then completed the birth by grasping her under her arms and lifting her on to me. The team was also marvellous in accommodating a list of my requests, which included no announcement of the baby’s gender, lights dimmed after I lifted her, and a quiet moment to speak to Aurora so that my voice was the first one she heard. But I ended up uncontrollably sobbing with joy.

“My recovery was very easy compared to the previous c-sections. Aurora and I had no complications and we were able to go home the very next day.”

NHS Lanarkshire Executive Nurse Director, Trudi Marshall said:

“We’re immensely proud of our maternity and obstetrics colleagues for the way they stepped out of their comfort zone to offer Leila the opportunity to give birth in the way she wanted and needed.

“It’s a fantastic example of what we strive to provide – care that’s person-centred and trauma-informed and reflects Scotland’s health and social care policy of Getting It Right For Everyone.”

 

Read more: Scotland leads world first in premature baby gut trial; Spotlight on innovation in neonatal care; Worried about ‘baby bust’? Avoid unhappy pregnancies;

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