Birth: one (controversial) way to prepare for any eventuality....

There are two things we know for sure when it comes to birth:

  • It’s unpredictable

  • How it happens can have potential future health implications for a baby

With all the will in the world, birth is something that we are never going to have full control over. Of course its great to have a plan, but, the chances of curve balls being thrown along the way are real. We have also learnt that there are differences in the gut microbiota of a baby born vaginally vs one born via C-Section. Something that the evidence is increasingly linking to development of potential health complications further down the road click here for more. Associations have been linked to: obesity, type 1 diabetes, asthma, allergies and neurodevelopmental disorders.

’Disrupting the mother-to-newborn bacterial transmission by C-Section delivery may increase the risk of disease in later life’ (3)

However: there is some potentially good news if like me a C-Section is on the cards:

Many people (me included) end up having a C-Section birth. The actual process was really quite straight forward. However, the worst thing to do (which is what I did to myself when I learnt about the implications for the gut/future immune health etc) is to beat yourself up about it, as with most things in life there multiple factors at play so it doesn’t automatically mean anything bad.

One reason is that here is a lot you can do after the baby has been born to help this process anyway click here for more. Even more crucially a C-Section birth is often lifesaving and if a decision has been made to do it, then that means it is in you and your baby’s best interest - so thats a major positive and should never be discounted. I wasted time and energy being upset about mine in the end which is exactly that: a waste of time and energy.

However, what I have subsequently learnt is that there is something you can potentially do to compensate for the fact that the baby has not gone down the birth canal.

Now this is where it gets a bit controversial (i’ll put my hard-hat on…):

The main difference in the gut microbes of a C-Section baby vs one born naturally is that the C-Section baby misses out on the bacteria that is present in the birth canal. So what if you can still provide that to a C-Section baby?

When I first heard that people were transferring microbes from the birth canal to a (C-Section) newborn baby’s face and mouth in a process known as Vaginal Seeding I was a bit shocked. However, it is discussed relatively extensively in scientific literature click here for more - here is a quick snippet from a highly respected paper looking at the infant gut and its implications:

‘Vaginally delivered infants harbor bacterial communities resembling those of the maternal vagina, whereas caesarean section-delivered infants are enriched in skin microbiota. The deviation of microbiota development is associated with long-term effects on host metabolism and impaired immune development. Restoration of the microbiota development of infants born via caesarean section could be achieved by exposure of the neonate to maternal vaginal and fecal contents. Recent results suggest that the fecal, skin, and oral microbiotas of the exposed neonates more closely resemble those from vaginally born than from caesarean section-born babies. Although the long-term health consequences of restoring the microbiota of caesarean section-delivered infants remain unclear, these results demonstrate that vaginal microbes can be partially restored at birth in caesarean section-delivered neonates.’ (1)

How is this done?

A typical method is the following (this is taken from another research paper looking to assess the effects of this process):

‘the microbial restoration procedure consists of incubating a sterile gauze in the vagina of mothers that were negative for Group B streptococcus (GBS), had no signs of vaginosis, and had a vaginal pH below 4.5, during the hour preceding the C-section. Within the first two minutes of birth, babies were exposed to their maternal vaginal contents by being swabbed with the gauze, starting with the mouth, then the face, and finally the rest of the body.’ (2)

What did the study conclude?

‘Although our sample size is limited and sampling extends only through the first month after birth, our results suggest that, by exposing the infant to the maternal vaginal microbiota, the bacterial communities of newborns delivered by C-section can be partially restored to resemble that of vaginally delivered babies.‘ (2)

The research is still pretty new and underdeveloped and certainly not complete, but, if nothing else it is food for thought and perhaps something that at the very least is worth discussing with your doctor. That being said, it is of course not something for everyone and not something that everyone is comfortable with.

‘While the risks involved in this procedure should be similar to those during vaginal delivery, research is warranted to optimize the safety and mechanism of such exposure. Given the rapid development of the infant microbiome, early introduction of key founder populations may be crucial in facilitating a more natural microbial ecological succession and host immune and metabolic responses.’ (1)

One risk that has been flagged is that doing this can pose a risk of infection with group B. Streptococcus which is the most common cause of neonatal sepsis and is carried by 20-30% of pregnant women. That being said, in a paper by Knight and Gilbert in support of Vaginal Seeding where they argue it does indeed modify the infant’s microbiome, they advise screening for group B. Streptococcus. The good news is that in the US and Canada that is offered as standard. Unfortunately it is not universial currently in the UK and Ireland, however if you are considering this technique it makes sense to speak to your obsetotrician about screening ahead of time.

Bottom line: clearly more evidence is needed, however, what has been done is compelling. Options and awareness remain key. After that it is a personal choice and up to you. No harm at least having a discussion about it with your doctor.

References:

  1. MILANI C, DURANTI S, VENTURA M: The First Microbial Colonizers of the Human Gut: Composition, Activities, and Health Implications of the Infant Gut Microbiota: Mirobiology and Molecular Biology Reviews: 2017 Dec: 81 (4)

  2. DOMINGUEZ-BELLO MG, DE JESUS LABOY K, CLEMENTE JC: Partial Restoration of the microbiota of caesarean-born infants via vaginal microbial transfer. Nature Medicine. 2016 Mar: 22(3): 250-253

  3. MOYÀ-PEREZ A, LUCZYNSKI P, CRYAN JF: Intervention Strategies for Caesarean section-induced alterations in the microbiota-gut-brain axis. Nutrition Reviews. 2017 Apr: 75(4): 225-240

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This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.