I have done macro in various ways since day 1.
Without flash, then you'd need both the camera and subject to be prefectly stationary for the whole duration of the exposure and it may take some time if the light isn't good. So this is not actually a good idea unless you are shooting still life in a fixed location (where there will be no wind or movement).
With a monopod or hand-held, I would need an external flash (esp. with the long barrels of the macro lenses fully extended) to reach over the lens and reach the subject without shadows. Controlling the light is the key here and with a suitably controlled amount of light, you can reach quite a few subjects and still not spook them too much.
Using tripods would be the better option if you intend to stack shots and/or the subject is not very mobile. With this form of set-up, you can elect to use hot-shoe mounted flash, remote flashes on arms or any other permutations. This also allows us to use macro rails which eases the focusing without changing the magnification ratio.
Remember to get a remote release also (wired or wireless) to prevent further shaking of the whole set-up.