Vaginal Seeding after Caesarian
Vaginal seeding after Caesarean is it ‘risky’? – BBC Article 23 August 2017.
When I was newly qualified as a naturopath, having studied hours of anatomy and physiology on the way, I decided that the human body was not designed correctly.
With that arrogance so often characteristic of the newly educated and academic, I declared that God had made a mistake placing the avenue for birth so close to the organs of elimination (the urinary bladder and the bowels). I said that once I got up to Heaven (airily assuming my suitability for such lofty heights!), I was going to have a word with God about his design mistakes.
Fast forward to the years we spent in a house with a very large garden where we kept some amazing chickens. I learned that chickens lay eggs through the same channel (the oviduct) that they use for defecation. Egg shells are porous, allowing the bacterial film called the biofilm (think of a snail’s slime trail and you get the idea of the biofilm), to coat the outside of the egg as it is laid. This allows the bacteria to migrate through the porous shell and ‘invade’ the developing embryo. During the 21 days a chicken egg incubates, the bacteria or whole microbiome (which is more than just bacteria, it includes viruses, yeasts or mycelium as well), can reach the interior of the chick and set up colonies in the chick’s developing digestive tract. The chick is hatched with a complete microbiome in its gut ready to eat, forage and grow into an adult chicken.
Far from being a problem, the proximity of the birth channel to the elimination channel, allows for the transmission of the gut flora to the emerging young. Although we humans don’t use egg shells, the same principle applies to human birth.
In a normal vaginal delivery, the infant has its face pressed tightly against the membranes of the birth canal and the vaginal microbiome is forced into the nose, ears, mouth and eyes of the infant during the passage of the baby from the womb to the outside world.
Also during this process, the baby’s head acts like a squeegee and practically guarantees that any fecal matter residing in the mother’s rectum is pushed out ahead of the baby into the birth ‘landing zone’. Additionally, in a perfect, text-book delivery, the baby is facing towards the mother’s backbone, again ensuring that any fecal material emerging along with the baby is right in the baby’s face. Not pleasant? Birth is a messy process and it seems that it is supposed to be like that. In that glorious biological mess lies the beauty of the microbial world and all its protection for the emerging infant. Natural vaginal seeding.
We thrive in the world – not despite the bacteria and microbes – but more likely because of them.
A baby in the womb is in a sterile amniotic sac, or so we thought. There are a few species of bacteria in very low numbers who are present. The placenta has its own microbiome and once the birth process starts, the baby begins to acquire the microbiome as a gift from its mother.
Babies born through C-section, are denied both the vaginal microbiome and the peri-anal exposure. Studies by the Royal College of Midwives have shown that children born by C-section are more prone to allergies, suggesting that the absence of gut flora at birth has a detrimental effect on their immune responses.
Certainly, at the Taymount FMT clinic, we always ask what the birth method of the prospective patient was, and we frequently find a correlation between gut problems and C-section births, maternal health and antibiotic use of the mother prior to birth.
The emerging awareness and appreciation of the value of our microbial passengers, as evidenced by the hundreds of studies of the human gut microbiome, is a testament to our understanding that we need these invisible symbionts to help us live a healthy life. It makes sense to give our C-section-born babies the introduction to the microbes by the practice of vaginal seeding – a swab to ‘seed’ the baby with the microbial populations.
If this practice of seeding by swabbing vaginally and peri-anally to anoint the baby with the mother’s microbiome is thought of as being risky, then the whole process of birth should be considered to be a huge risk from a microbial point of view, not just the mechanical dangers.
It needs to be asked what risks the doctors are considering if they think the mother’s body is a risky thing for the baby to come into microbial contact with?
In some crude and basic home-spun experiments done a few years ago with primary school children, petri dishes were used to grow bacteria taken from swabs of various places around the home and person. The worst offender was the bottom of the fridge, closely followed by the unwashed hands of the primary school children. The toilet bowl came a lowly third with very small colonies of bacteria blooming on the plates. Although a very rough and ready study, this does suggest that babies are more at risk from being handled by unwashed hands (do you insist that your relatives wash their hands before picking up your baby to coo over?), than they are from being vaginally and peri-anally seeded with protective microbes from the mother’s body.
Don’t take our word for it, Professor Tim Spector (head of the department of Genetic Epidemiology at Kings College, London), describes this process in his book: The Diet Myth (ISBN 978-0-2976-0919-3). On pages 241-245, Professor Spector gives his opinion, his medical rationale and the scientific reasoning behind this protective practice, far more eloquently than we have here. In our opinion and experience, there is far more risk from coming into this world without the microbial gift from the mother’s body, than any imagined and unspecified ‘risks’ from vaginal seeding with the biofilm from the vaginal and perianal region of the body which has safely incubated you for the previous 9 months.