The Vital Role of the Microbiome in Birth

Photo Credit: Erin Heuser Photography

Every birth is a unique journey, but one aspect remains constant – the importance of the microbiome. The microbiome, often referred to as our "forgotten organ," plays a crucial role in the health and development of both mother and baby. In this blog post, we'll explore why the microbiome matters during birth and how doulas can support its optimal development.

The microbiome refers to the diverse community of microorganisms that inhabit our bodies, particularly in the gut, skin, and reproductive organs. These microorganisms, including bacteria, viruses, and fungi, form a complex ecosystem that influences various aspects of our health, from digestion to immune function.

During birth, the baby is exposed to its first dose of microbes as it passes through the birth canal. This initial microbial exposure is critical for seeding the baby's own microbiome and establishing a foundation for lifelong health. Research has shown that babies born vaginally tend to have a microbiome that closely resembles their mother's vaginal microbiota, while babies born via cesarean section have a microbiome more similar to the skin microbiota.

The differences in microbial colonization between vaginal and cesarean births can have significant implications for the baby's health. Studies have suggested that babies born via cesarean section may have a higher risk of certain health conditions, including asthma, allergies, obesity, and autoimmune disorders. This is thought to be due, in part, to the altered microbial exposure during birth.

Birth doulas can play a crucial role in supporting mothers and babies during the birthing process, including advocating for practices that promote optimal microbiome development. Here are some ways doulas can support the microbiome during birth:

1. Encouraging Vaginal Birth

While cesarean sections are sometimes necessary for medical reasons, we can educate mothers about the benefits of vaginal birth for microbial seeding. We can provide emotional support and guidance to help mothers navigate their birth preferences and advocate for practices that support vaginal birth whenever possible.

2. Skin-to-Skin Contact:

Immediate skin-to-skin contact between mother and baby following birth promotes bonding and facilitates the transfer of beneficial microbes from the mother's skin to the baby's skin. As doulas, we can encourage and facilitate skin-to-skin contact, even during cesarean births when feasible.

3. Delayed Cord Clamping:

Delaying cord clamping allows for a longer period of placental circulation, providing the baby with an extra boost of oxygen-rich blood and stem cells. This practice has been associated with improved iron levels and better microbiome development in newborns.

4. Breastfeeding Support:

Breast milk is not only the perfect nutrition for babies but also contains essential nutrients, antibodies, and beneficial microbes that help colonize the baby's gut microbiome. As doulas, we can provide breastfeeding support and education to help mothers establish successful breastfeeding relationships.

5. Minimizing Antibiotic Use:

In some cases, antibiotics may be necessary during childbirth to prevent or treat infections. However, excessive or unnecessary antibiotic use can disrupt the balance of the mother's and baby's microbiomes. Doulas can advocate for judicious antibiotic use and explore alternative options whenever possible.

6. Avoiding Soap and Other Cleansers:

During birth, it's important to avoid using soap or other cleansers in or around the vagina. These products can disrupt the natural balance of the vaginal microbiota, which may affect the baby's microbial exposure during birth. During the pushing stage it is important to ensure that baby shampoo is not being used as lubricant to stretch the perineum. Oil such as mineral oil, coconut oil, or even olive oil are excellent natural lubricants. Make sure to talk to your medical provider about their use of an antiseptic called Betadine. Some providers use it preventively just before the baby is born. If there is no medical need for antiseptic, opt out of its use. Instead, rinsing with warm water is sufficient for hygiene purposes.

7. Vaginal Seeding:

In cases where cesarean birth is unavoidable, vaginal seeding may be considered as a way to transfer maternal vaginal microbes to the baby. This involves swabbing the mother's vagina with gauze or a cotton swab and then gently wiping the baby's mouth, face, and body shortly after birth. While research on vaginal seeding is still emerging, it holds promise as a way to support microbial colonization in babies born via cesarean section.

By prioritizing practices that support optimal microbiome development during birth, a doula can play a vital role in setting the stage for lifelong health and well-being. Every decision made during childbirth has the potential to impact the baby's microbiome, and as birth doula, my hope is to empower and support families in making informed choices that give their babies the best possible start in life.