I'm a CNM and have first assisted at c sections. Most of my patients appreciated knowing I was on the other side of the curtain. For some scheduled sections (placenta previa, breech), we actually bantered back and forth from over the curtain.
I can't speak much more to the experience of the patients, but I can speak for me. I was a CNM employee in an MD owned practice, and my boss sent me to a c section workshop. A year later I got let go, and another year after THAT I started a private home and hospital birth practice with another CNM.
I ABSOLUTELY loved being able to "do it all". I could help someone have her baby at home; if she needed a transfer I could continue to care for her and catch her baby; and if she needed a c section I could STILL help her baby out.
Speaking to a previous poster, I did some advocating as the first assistant. At one the doctor was going to close her uterus with a single layer, which we know increases the risk of uterine rupture in future pregnancies. It was a little tense, but the doctor did a double layer when I mentioned that she wanted more children.
Another piece of advocacy that may be a bit less "important" than a double layer uterine closure is that I ALWAYS asked the doctor to close the skin with a suture/technique that would minimize scarring.
Finally, once the surgeon told anesthesia to give an antibiotic after the baby was out, and I said, "She's allergic to that one". Chances are quite good that the anesthesia doctor would have noticed it, but wow, it's SO GREAT to know my patients as well as I do.
I understand another previous poster that it seems "wrong" and "against midwifery philosophy" to be a surgical first assistant. CNMs make complicated decisions for complicated reasons. In some academic medical center somewhere, CNMs learned how to do circumcisions because the residents were screwing them up. I'm ethically opposed to circs, so I don't see myself expanding my skill set in that way. In rural areas some CNMs do vacuum assisted births. I'd consider learning how if it were truly needed wherever I was working.
I'll admit, though, that I like first assisting because I like it. My former midwife partner teased me that I'd be going to med school soon. I think my wretching noises convinced her otherwise. :)
Oh, another thing: I'm a reiki master, so when we were closing I would sneak in some reiki during pauses. Who knows if the reiki energy could make it through the surgical gloves, but I like to think that that helped the healing process to some degree.
Where in Canada are you? I'm applying to the bridging program at UBC. I'm done with the crap over here in the states.
I'm happy to share more if you like-pm me.