In an essay titled “My Baby, My Microbiome,” assistant professor of environmental health Karen Levy expresses a growing concern among microbial researchers and mothers alike — are C-sections bad for babies?
“Like many women,” Levy writes, upon hearing that a cesarean delivery might be necessary for the birth of her second child, “I wondered how my scar would look in a bikini and how I would take care of an infant while recovering from major surgery. But as a microbiologist, these were not my primary concerns … my first thought was of my vaginal microbiome.”
Levy is referencing a growing body of research into the microbiomes within us — billions and billions of microbacteria, the vast majority of which helpful and even necessary for our survival, that share the mini-ecosystems we call ourselves.
“We are only 10 percent human,” writes Michael Pollan, best-selling author and professor of journalism. “For every human cell that is intrinsic to our body, there are about 10 resident microbes — including commensals (generally harmless freeloaders) and mutualists (favor traders) and, in only a tiny number of cases, pathogens.”
What does this have to do with babies? According to some scientists, quite a lot. A baby’s gut is effectively neutral while in-utero — a sterile space, not yet exposed to the trillions of bugs with which we cohabitate. Then, from birth until the first few years of age, it becomes a teeming playground for rapidly-developing communities of microbes that develop in complexity as the child grows.
“Most of the microbes that make up a baby’s gut community are acquired during birth,” Pollan explains, “a microbial rich and messy process that exposes the baby to a whole suite of maternal microbes.”
“Researches have shown that if a baby is born vaginally,” Levy continues, “its bacterial community resembles that of the mother’s vagina. If a baby is born by C-section, its bacterial community resembles that of the mother’s skin.”
She notes that some researchers are drawing connections between children born by C-section and a number of long-term health complications, including “obesity, asthma, allergies, type 1 diabetes, food allergies, eczema, and celiac disease” — diseases observed at disproportionally high levels in developed nations.
This is concerning some researches, as cesarean rates are rising dramatically around the world — 46% of all births in China, according to the World Health Organization (WHO), in addition to 35% of births in Latin America, and 31% in America. This phenomenon is motivated by a number of factors including doctors being hesitant to perform traditional deliveries on older women, hospitals looking for additional profits, and the chronic fear of malpractice that permeates so much of our medical industry.
“I think it’s safer for the mother and child to have C-sections,” mentioned Trang Thanh Van, a 25 Vietnamese woman quoted in the WHO study, just a few days away from her due date. “And the relatives feel more secure because it’s very simple and common now.”
New evidence points to the contrary, however, with some studies indicating that women who undergo unnecessary cesarean operations are more susceptible to complications including blood transfusions, admission into intensive care units, and eventual hysterectomies.
And what of the babies? Levy ultimately delivered her child vaginally — but for those mothers who don’t or can’t, she was well prepared with a backup plan in a way that only a microbiologist can:
“I would have taken things into my own hands, quite literally, and inoculated her myself shortly after birth by putting some of my vaginal fluid into her mouth.”