25 Sep 2014
Microbirth is a thought provoking new documentary film investigating the microscopic processes and the consequent effect on our microbiome that takes place during childbirth. It’s presently being premiered in midwifery and natural childbirth centres all over the world, and it seeks to help redirect our approach to childbirth.
The documentary raises the following question: Considering we are such an incredible species with the ability to cure, create and extend life, why are we therefore sicker than ever before? The researchers present us with the concept that we are facing a huge health crisis. The rise of non-communicable diseases such as diabetes, cardiovascular disease, obesity, coeliac and mental health disorders is already responsible for 63% of deaths globally and is predicted to rise by another 17% in the next decade1. But why? We already know that smoking, alcohol, poor diet and lack of exercise can contribute to these, but are we missing a link somewhere? The film talks about the possibility of our gut bacteria playing a larger part than we think. Whether or not the link between bacteria passed from mother to baby during natural birth, and our overall health, is as large as the film would suggest, we are excited to see more attention on the significance of our natural bacteria, its role in our health, and the part childbirth has to play in the question.
We now know that our body's human cells are outnumbered by our microbes, or bacterial cells, by an enormous 1:10! We are 90% bacteria. And as our environment is a finely balanced ecosystem, so is our microbiome; our internal bacteria. We have about 1000 species of bacteria in our gut, 700 in our mouth and 700 on our skin for example. This diversity keeps the microbiome and its ‘owner’ healthy. Interestingly this is in fact mirrored in the ecosystems in our environment. Our microbiome is responsible for upregulating our metabolism and has a crucial role in our immunity. It’s the diversity that is key to this health influence and researchers now suggest that western populations in particular have now lost 1/3 of this diversity, the ‘disappearing microbiota hypothosis’. This is now believed to be one of the reasons for increasing ill health.
So where does the microbiome actually come from? Crucially, scientists believe that a baby in the womb is sterile. Before birth, the bacteria is thought to actually gather in the mother’s vaginal tract and breasts. When the baby is born it ingests this bacteria as well as taking it on its skin. The baby in this way is ‘seeded’ with the mother's microbiome. This is considered to be the beginning of an incredible process to create the child’s bacterial diversity. (Skin to skin contact afterwards is also considered important for the transfer of bacteria between mother and child, and of course vitally, breastfeeding. Breast milk actually contains a carbohydrate (oligosaccharide) which is indigestible by the baby and always confused scientists as to the reason for its presence. However, remarkably these carbohydrates feed and nourish the bacteria that the baby has just gained. Read more about oligosaccharides on the page: What are prebiotics?. This is a remarkable natural process priming the baby with the right bacteria and ultimately with its healthy immunity and metabolism. We now know that this is how bacterial populations are passed from one generation to the next. The producers of Microbirth talk about this seeding of the microbiome, and describe it as a 'maternal heritage'.
Skin to skin care is thought to be important by many, especially for C-section babies - this is largely a question of sharing bacteria between mother and child.
Whilst many mothers are aware that vaginal births are preferable for the health of mother and baby, our understanding is often that Caesarean sections (C-sections) may be more emotionally stressful for the baby, and that vaginal, or 'natural births' are preferable for these reasons. However a huge factor, if not the main factor, differentiating C-sections and vaginal births is the question of the mother's bacteria passing on to the baby. The documentary goes on to outline that the effect of a C-Section therefore is to prevent the baby from being seeded with the microbiome. We know that a depleted or unbalanced microbiome can be linked to these non- communicable diseases developed later in life. So could this be the missing link? We are now facing a rise in this way of giving birth. A ¼ of women in the UK, ⅓ of women in the US and ½ of women in china are now having C-sections rather than vaginal births.
Microbirth challenges us by asking the difficult question. Will a C-section therefore break the natural chain in our development of the microbiome? And will the increasing number of them therefore have huge ramifications long term for our health?
It is however important to stress that C-Sections are of course at times necessary and indeed life saving for either the baby or mother or both. It is essential to follow the guidance of one's midwife and doctors, and it's also vital that the mother feels comfortable and able to make a decision with regards to her baby's birthing process. This is also part of a larger picture of our modern life so should be kept in perspective on an individual basis. It is however fascinating and a great knowledge base for us to look after our health with.
Mothers, for example can take probiotics whilst pregnant; enhancing their natural bacteria before birth. An in-vitro study has discovered that L. acidophilus Rosell-52 has been shown to adhere to the cervical epithelial cells and can prime the mother for passing on her microbiome2.
Mothers can top up their levels of 'good bacteria' during pregnancy, to pass these on to their baby at birth.
Researchers at Harvard University are already investigating the possibility of assisting in the transfer of the mother's bacteria when a vaginal birth has not been possible. They do this by leaving a swab in the mother’s vagina for an hour before the C-section is performed. Once the baby is born the swab is this then passed over the baby’s mouth and rest of body and in this way the bacteria are transferred. This is a 3 year study in its infancy but the early results have already shown that the inoculated babies were more similar in terms of bacteria levels to natural birth babies than those by C-Section.
This fascinating documentary, Microbirth, is yet another in a series of endeavours to more fully understand the diversity, origin and function of the microbiome. Epigenetics, simply put is ‘the study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself.’ It is possible that we now may need to add C-sections alongside the long list of damaging effects that modern life has brought to this subject. On the plus side this is yet another aspect of modern life that we can address. We are already a nation challenging our eating habits and lifestyle in a positive manner. Perhaps this documentary will give this a boost and help us protect the next generation with more knowledge.
For related reading, you may also be interested to read nutritional therapist Kathy's take on the BBC's recent programme about gut bacteria and allergies, so take a look if so!
What did you think? Have you seen Microbirth, and what did you think if so? Let us know in the comments below.
image sources: blog.mariobadescu.com/post-pregnancy-skin-care/ and http://www.precisionnutrition.com/exercise-during-pregnancy
2. Atassi F. et al. (2006). In vitro antibacterial activity of Lactobacillus helveticus strain against diarrhoeagenic, uropathogenic and vaginosis-associated bacteria. Journal of Applied Microbiology. 101 647–654