Microbiomes & Cesarean Birth

I came across an article in the U-T today talking about “vaginal microbial transfer” and its importance in cesarean birth. You might be thinking “What in the world is that?!?,” but I’ll tell you why I am intrigued by this topic.

First, when I did my doula training Penny Simkin, one of the most respected leaders in the field of childbirth (she co-authored the book Terry and I used as the “textbook” in our childbirth education classes back in 1986. And, yes, I realize many of you were not even born yet!) talked about the importance of microbiome seeding in the birth process. She has some great videos on the topic which can be found on YouTube. Frankly, I didn’t really get what the fuss was all about at first but in the years since my training I have read much more on the topic.

Second, this topic intrigues me because our country has abysmal cesarean rates. At San Diego hospitals rates range from 25-48% of births with most of the larger hospitals in the 30-40% range. Babies delivered by cesarean are statistically more likely to develope obesity, asthma, allergies and immune deficiencies. They also miss out on having their guts colonized during the birth process. The study this article references found that babies who were born via cesarean had significantly less Lactobacillus – the “friendly bacteria” – in their anal samples.

Third, this topic intrigues me because there is a possible solution which can help babies born via cesarean birth to gain at least some of the benefits of vaginal birth. Now, to the average expectant mom or dad this next part might seem a little gross, but bear with me. This study found that by inserting a gauze pad into the mother’s vagina during labor or prior to a cesarean and then swabbing the newborn baby’s mouth and body with that gauze after birth, at least partial restoration of the microbiome occurs. This is exciting information for those times when a cesarean becomes the necessary  choice for birth.

Read the study here for yourself: j.mp/vmicrobiome

Some other ways to protect your baby’s microbiome in the immediate postpartum period:

•As much as possible, have only mom and dad’s hands on baby

•Bring blankets from your home with your microbiomes to use on mom and baby after birth

•Forego the hat instead keeping baby warm via skin-to-skin contact with mom




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Welcoming Ezekiel

This week I was afforded the very special privilege of being invited to be a part of the birth of my grandson, Ezekiel Alexander Jordan. It is a privilege I do not take lightly, especially when it is my daughter-in-law doing the inviting. This was my third daughter-in-law to grant me this blessing.

It was a long, but fairly uneventful process which began with an induction for medical reasons. This was followed by a very long season of waiting. Thankfully, we were at a facility which is very patient allowing mama and baby to navigate their birth journey at their own pace. Ezekiel loved labor!

In the end, that slow pace jumped into hyperdrive and this Grammie almost missed the birth as I had left to go to my daughter’s volleyball match. As I walked into the gym my phone rang and I was soon scurrying back to the hospital.  My daughter-in-law was a pro at pushing and Ezekiel was born gently about 15 minutes after I got back to the birth room.

Seeing my sons become fathers has been such a joy. One advantage of a large family is having sons who are completely comfortable with babies. I’m so thankful my sons love babies and are adept at changing diapers, rocking their sons (yes, my sons have ALL sons!), and taking over the household tasks as their wives recuperate.

When our first grandson was on the way, my wise friend Redetha told me that the feelings I would have for my grandchild would be similar to the feelings I have for my own children. How right she was! Being a grandparent is truly the best. I love babies, and holding someone else’s baby is wonderful. But holding my own grandchildren is a completely different feeling. There is an amazing connection there which causes the same feelings in my arms and heart as when I held my own children – those amazing people who have grown up to bless our lives with -now – eight beautiful grandchildren, seven boys and our princess Alice.

Here are some tips for grandmas who are invited to their grandchild’s birth:

  1. Mama calls the shots! It is her birth. If she wants to go all natural, be her biggest cheerleader. If she wants an epidural, tell her it is fine. Leave when she wants privacy and don’t be offended. By anything. At all. It’s not about you.
  2. Check your fears at the door. Whatever your birth story, leave it behind you when you walk in the room. Some things should never be heard in the labor room:  “You should….” or “You shouldn’t…”  “Are you sure you don’t want something for the pain?” “Just listen to the doctor, honey.” (Not that the doctor doesn’t have wisdom to share, but parents have brains, too, and they have a right to informed consent and to make choices based on risks and benefits.)
  3. Protect her “cave.”  Moms need to be able to go into “Laborland.” A quiet, respectful atmosphere is key. Most moms like a dark, quiet room, especially as labor progresses.
  4. The “golden hours” belong to the new parents and baby. Once baby arrives, he or she will be placed skin-to-skin with mama. Talk ahead of time about what mom and dad want in the way of photography (and be sure to keep it off social media unless they have given consent!) The first couple of hours are very important for bonding, and new research is showing the importance of colonizing the baby’s gut by mom and dad’s microbes. I know how much you want to hold that new baby – I totally sympathize! – but it really is best if only mom and dad touch baby at first.
  5. Be sensitive to mom’s needs and desires when trying to initiate breastfeeding. While breastfeeding is natural, it doesn’t always come naturally to mom or baby. Moms have differing levels of comfort trying to feed the baby in front of other people. In the first 24 hours it is extremely important that baby latches on at least 8 times (often 10 – 12 or more!) and suckles for at least 10 minutes each time. Agunnamedain, take your cue from mom or simply ask what is comfortable for her. If you know how to help her and she desires that help, have that discussion. Realize, of
    course, that there is always new research out there and the ways we learned may have been updated. If you bottle fed, just be supportive of what mama wants to do. Please don’t offer to bottle feed the baby “so mom can rest” or say something to make her question her supply. Do encourage her to see an IBCLC, a board certified lactation consultant, if she has any problems getting established. And if after all that she decides to formula feed, support her in that, too.

All those things one hears about how wonderful it is to be grandparents…I have a little secret for you:   they are all true!

Congratulations, Jacob and Zinnea, and thank you again for inviting me into your very special birth day.

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Natural Breastfeeding

Like most breastfeeding moms in my generation I learned the three basic breastfeeding positions: cradle hold, football hold, and side-lying. Because I liked to get as much sleep as possible, some of these positions got adapted, especially at night, to a more laid-back position where the baby was supported on or across my body. With the twins, I adopted this laid-back position most of the time as I needed all the help I could get keeping two babies latched at the same time. Imagine my surprise and “Aha” moment years later when I learned about “Natural” or “Laid Back” breastfeeding – using gravity-assisted positions to help newborns and mamas get an easier start.

This excellent article explains this concept so well. Take a look and if you have any questions, feel free to ask. I am convinced the reason I had no problems nursing my twin sons was that I adopted these principles out of necessity.


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Birthday Milestones

Last weekend I attended the first birthday party of one of my doula babies. I remember the details of his birth so clearly it hardly seems possible that a year has passed. This milestone reminds me of others. My first “official” doula baby – the first birth I attended after my training – is now 2-1/2 years old. The OB didn’t make it for his birth, but there was a great nurse who pulled on her gloves and calmly caught him. My first grandson, whose birth I was especially privileged to attend since it was my son’s wife who was laboring, is almost eight. He now has a little brother – he arrived just as I pulled into the hospital’s parking structure – who will be five in another month. Their new baby brother arrives some time in January. January also heralds the 29th anniversary of the very first birth I witnessed. My sister-in-law had a much longer labor than I had experienced just five months earlier. At one point as she was tapping out her labor rhythm in the rocking chair her baby’s heart rate plummeted suddenly and sharply. Our doctor moved quickly to get her into a position with her head lower than her body and baby stabilized quickly. When she was born we could clearly see what had caused the sudden deceleration. My niece had a true knot in her cord!

From that first birth to the ones for which I am currently on call, I continue to learn something new with each birth I witness, from each labor which I have the privilege to attend. Labors do not always go the way I wish. Sometimes there are “knots” in the form of medical situations or unhelpful attendants or extra long, hard labors. But whatever the outcome, each birth day ushers in a milestone – the first day of a brand new lifetime of possibilities.

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