Warning: vaginal seeding doesn’t work and may be harmful

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The latest trend in the world of natural childbirth is vaginal “seeding,” swabbing babies’ mouths with mothers’ vaginal secretions.

The theory is that C-section birth “deprives” babies of prolonged contact with the bacteria in women’s vaginas and that putting that bacteria in babies’ mouths “restores” the normal bacteria.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The recommendations of the natural childbirth industry are based on what they believe will increase market share, not on scientific evidence.[/pullquote]

There’s two major problems with that claim:

1. There’s no evidence that babies benefit from exposure to mother’s vaginal bacteria.

2. There’s considerable evidence that babies can face serious illness and death from bacteria and viruses that live in the mother’s vagina.

That’s the warning encompassed in an new editorial in the British Medical Journal (BMJ), “Vaginal seeding” of infants born by caesarean section. The authors Aubrey J Cunnington, clinical senior lecturer, Kathleen Sim, clinical research fellow, Aniko Deier, consultant Neonatologist, J Simon Kroll, professor of paediatrics and molecular infectious diseases1, Eimear Brannigan, consultant in infectious diseases and infection prevention and control, Jonathan Darby, infectious diseases physician, know whereof they speak.

Evidence is accumulating that the human microbiota can also be manipulated to benefit health, but not (yet) that vaginal seeding is beneficial to the infant. Indeed, such evidence will be difficult to gather, requiring large clinical trials with many years of follow-up. It might seem reasonable to perform this simple and cheap procedure, even without clear evidence of benefit, but only if we can be sure that it is safe.

We lack that certainty at present. Newborns may develop severe infections from exposure to vaginal commensals and pathogens, which the mother may carry asymptomatically. These include group B streptococcus (the most common cause of neonatal sepsis), herpes simplex virus, Chlamydia trachomatis, and Neisseria gonorrhoeae (the last two, causes of ophthalmia neonatorum). These pathogens would probably also be transferred on a vaginal swab, potentially abrogating the protection from infection afforded by elective caesarean section.

In other words, there’s no evidence that vaginal seeding is beneficial and considerable evidence that it can be harmful and even deadly. Indeed, vaginal bacteria are the leading cause of infectious death of newborns.

So where did the recommendation come? From the natural childbirth community through … the movie Microbirth.

The issue of vaginal seeding can serve as a paradigm of much of what passes for “evidence” in the world of natural childbirth. Natural childbirth, a philosophy that unmedicated vaginal birth is superior to any other form of birth, is largely the “unresearched antithesis of obstetrics.” That’s how gender scholars Annandale and Clark describe contemporary midwifery, which is essentially the whole hearted embrace of natural childbirth philosophy.

An alternative is called into existence in powerful and convincing terms, while at the same time its central precepts (such as ‘women controlled’, ‘natural birth’) are vaguely drawn and in practical terms carry little meaning.

Simply put, much of contemporary midwifery is merely unreflective defiance of obstetricians. Whatever obstetricians recommend, midwives recommend the opposite. In contemporary natural childbirth advocacy, every day is Opposite Day.

Obstetricians medicalized childbirth to make it safer; natural childbirth advocates pretend that childbirth was safe before obstetricians got involved.

Obstetricians offer pain relief; natural childbirth advocates insist that feeling the pain improves the experience, tests one’s mettle and make childbirth safer.

Obstetricians whisk babies off to pediatricians to make sure that they were healthy; natural childbirth advocates claim that skin to skin contact between mother and infant in the first moments after birth is crucial to creating a lifelong bond.

Obstetricians can perform C-sections; natural childbirth advocates demonize C-sections in every way they can think of insisting that C-section rates are too high, C-sections cause [insert your favorite illness: allergy, asthma, diabetes, hypertension, etc.], and C-sections damage both the infant gut and infant DNA.

Not a single one of the claims of natural childbirth advocates is true. So why do they make them? To retain market share. Obstetricians are the chief economic competition of midwives and natural childbirth advocates and midwives and natural childbirth advocates are determined to increase market share.

Vaginal seeding was popularized by natural childbirth advocates in the movie Microbirth. Its thesis?

…We believe “seeding of the baby’s microbiome” should be on every birth plan – for even if vaginal birth isn’t possible, immediate skin-to-skin contact and breastfeeding can still help to provide bacteria crucial to the development of the baby’s immune system. In the scientists’ view, if we can get the seeding of the baby’s microbiome right at birth, this could make a massive difference to the baby’s health for the rest of its life. Consequently, we believe that “Microbirth” is of extreme importance for global health and potentially, for the future of mankind!

Who do is the “we” when the producers of Microbirth announce “we believe”? It wasn’t microbiologists since there is no scientific consensus on the composition of the neonatal microbiome, let alone what it ought to be. It wasn’t neonatalogists and pediatricians since they aren’t going to “believe” anything about the microbiome that isn’t established by microbiologists. That goes for obstetricians, too.

So the “we” in “we believe” is natural childbirth advocates who promote the largely unresearched antithesis of obstetrics. Natural childbirth advocates recommend vaginal seeding for no better reason than defiance. The fact that there was never any evidence to promote vaginal seeding, and considerable evidence that it could be dangerous or deadly was never even considered. That’s what you would expect from a marketing tactic completely divorced from the scientific literature.

As the authors of the BMJ editorial note:

In the absence of evidence of benefit, or of guidelines to ensure the procedure is safe, how should health professionals engage with the increasing demand for vaginal seeding? We have advised staff at our hospitals not to perform vaginal seeding because we believe the small risk of harm cannot be justified without evidence of benefit. However, the simplicity of vaginal seeding means that mothers can easily do it themselves. Under these circumstances we should respect their autonomy but ensure that they are fully informed about the theoretical risks.

Parents should be advised to mention that they performed vaginal seeding if their baby becomes unwell because this may influence a clinician’s assessment of the risk of serious infection. Health professionals should be aware that vaginal seeding is increasingly common and ask about it when assessing neonates who may have an infection…

I would add an additional caveat:

Parents need to remember that natural childbirth is an industry, and an unregulated industry at that. Just like any unregulated  industry, the recommendations of the natural childbirth industry are based on what they believe will increase their market share, not on scientific evidence.

Parents should treat the natural childbirth industry with the same level of skepticism that they would treat any industry. You wouldn’t get your advice on solar power from the oil industry, and you shouldn’t get your advice on microbiology from the natural childbirth industry.

  • Megan

    As a future nurse-midwife and a practicing doula with a degree in biology, I have some issues with the claims and viewpoints presented in this article. First, to say that there’s no benefit from vaginal swabbing is a bit misleading. There have not yet been any longitudinal studies comparing long-term health outcomes of seeded and un-seeded CS-born babies, so it is true that no studies have demonstrated a direct link between re-seeding and certain health benefits. However, while there is still much research to be done in regards to the microbiome, based on at least 2 studies I am aware of that show that vaginal swabbing does cause CS babies to have gut flora more similar to those of vaginally-born babies, and based on the fact there is research suggesting that the composition of gut flora is related to certain diseases, it is not unreasonable to hypothesize that there could be some benefit to this practice.

    Second, the claim that re-seeding may cause great harm to babies is also misleading. Yes, babies can face serious illness from bacteria and viruses in the mother’s vagina (e.g. GBS, herpes, chlamydia). However, babies born vaginally would be exposed to the exact same pathogens. If a mother tests positive for GBS, she is given antibiotics in labor to reduce the risk of infection of the baby; if she has an active herpes outbreak, vaginal delivery would not be safe, and swabbing in that case certainly would be unsafe. But if vaginal delivery would have been considered safe, then there is no evidence that re-seeding would pose any other additional risk over vaginal delivery. To make a blanket statement that re-seeding is likely harmful to all babies is a gross overgeneralization.

    Next, Dr. Tuteur claims that midwifery is “merely unreflective defiance of obstetricians” and that midwifes always recommend the opposite of OBs, no matter what. Um…Not sure what to say to that except that that is blatantly untrue and a gross overgeneralization. Sure, there are differences in philosophy and differences of opinion among midwives and OBs, just as there may be disagreements between two midwives or between two OBs. Midwives are trained to make decisions based on evidence. As a doula, I have seen midwives agree with OBs and recommend certain interventions or even a Cesarean when it is warranted; I hope people reading this article can see through this bold statement that midwives make decisions based on defiance.

    Dr. Tuteur goes on to say that not a single claim of natural childbirth advocates is true. Let’s examine one claim of theirs she mentions – that avoiding pain relief makes childbirth safer. There is clear evidence that epidurals carry risks, such as: of a dangerous drop in maternal blood pressure, permanent nerve damage (though very rare), epidural headache, and an epidural fever that is indistinguishable from one caused by infection, which can lead to the baby undergoing a spinal tap to rule out infection, which in itself carries its own risks. I have seen OBs and anesthesiologists themselves spell these risks out for patients. So if it is true that pain relief carries some risks, then it is also true that natural childbirth CAN be safer – thus, how can Dr. Tuteur claim that “not a single one of the claims of natural childbirth advocates is true”?

    There is plenty of peer-reviewed, scientific evidence that there are risks to many medical interventions (if you want to look it up, start with evidencebasedbirth.com or Cochrane reviews). To say that the natural childbirth “industry” is not based on scientific evidence suggests to me that Dr. Tuteur does not have a good understanding of the current evidence. Perhaps she is more worried about midwives cutting into her market share.

    I don’t believe there is a “right” or a “wrong” way to give birth. Women need to be given choices and along with accurate information to make those choices. There are times when interventions are safer than doing nothing, but there are also times when interventions carry extra risks that should not be ignored. You are certainly no less of a mother if you choose to have an epidural or have a Cesarean birth. But please don’t make claims that ignore scientific evidence.

    • Who?

      All that’s very fine.

      What we are talking about is taking a piece of fabric, rubbing it around inside the vagina (before or after the cs? that’s not clear), then rubbing the result all over a newborn.

      How long does this piece of fabric hang around before the wipedown? Can any bacteria etc that are on it grow during that time? Should it be in the fridge to protect against that? Would putting it in the fridge mess with the wonderfulness of it? If the collection is done after the cs, isn’t it mostly mum’s blood? Is the effect (if any) different if the cs is done before mum is in labour?

      This all done in the service of a sketchy hypothesis concerning baby’s health, from the same broad group that push breastfeeding at all costs, but who can’t pick a breastfed six month old out of a lineup.

      It sounds paganistic, ritualistic and gross. And one more hoop for women to jump through for no proven benefit.

      • Megan

        If you had read about the study, you would know that the gauze is placed inside the vagina for an hour before delivery. Of course, in a true emergency C-section it wouldn’t be possible to leave it in for an hour, but often there is enough forewarning of a C-section.

        “Can any bacteria etc. that are on it grow during that time?”
        Yes, even a half hour is long enough for colonies to begin to multiply. But when you say “bacteria etc.” are you referring to bacteria in the mother’s vagina, or from other sources? Obviously, the gauze would be sterile before being placed in the vagina so there would not be other bacteria aside from that already in her vagina.

        “Is the effect (if any) different if the cs is done before mum is in labour?”
        That’s a great question. The landscape of vaginal flora fluctuates all the time, so I am not sure if there would be a change as the woman nears labor. I know that there has been some research about the health benefits to the baby if cesareans are done after labor starts instead of before.

        Who is “the same broad group” that you refer to? The journal in which the study on vaginal swabbing was published, Nature? Nature is regarded as one of the most respected scientific journals out there. Any article published in it has been peer reviewed by outside scientists and is held to a rigorous standard.

        And how is this “paganistic, ritualistic and gross?” Is a baby being born via the vagina gross? I guess given that pagans probably delivered their babies vaginally, it could be considered paganistic in that regard. And how exactly is it one more hoop for women to jump through? Nowhere in this study is it suggesting that all women should be required to do this. If they don’t like the sound of it, that should be their choice. But it doesn’t mean that we shouldn’t investigate something that may have health benefits for babies.

        • Megan

          Reading your question again, I realize you may be asking about the time between taking the gauze out of the vagina and wiping it over the newborn, not how long it remains in the vagina. My understanding is that the gauze is immediately wiped on the newborn; no time to hang around and be contaminated with other bacteria. Although, any “other” bacteria hanging around that could come in contact with the gauze could also come in contact with the newborn.

          The newborn is going to be exposed to bacteria in the environment as soon as it is born, and some of it may end up in the intestines anyways. The point is that there are different species of bacteria in the vagina that the baby is NOT exposed to when it is born by cesarean, so the swabbing is exposing it to this bacteria first.

    • Roadstergal

      “However, while there is still much research to be done in regards to the microbiome, based on at least 2 studies I am aware of that show that vaginal swabbing does cause CS babies to have gut flora more similar to those of vaginally-born babies”

      Links, or PMIDs? Did you actually read them? I know of one paper, and if you read it, you should come out the other side highly unconvinced that they showed anything vaguely close to what they said they did.

      “There have not yet been any longitudinal studies comparing long-term health outcomes of seeded and un-seeded CS-born babies, so it is true that no studies have demonstrated a direct link between re-seeding and certain health benefits.”

      This is all pre-supposing that there is a health detriment to a C/S born baby that is due to the C/S (not due to conditions that lead to a C/S), which has not been proven – or even all that well supported by any paper I’ve read.

      • Megan

        I realized I may have misspoke when I said there were two studies. I first read about a pilot study (which I was remembering as a separate study) a year ago, and the same researcher recently published her work: http://www.nature.com/nm/journal/v22/n3/full/nm.4039.html.

        Yes, I have read the study and other information about this topic; in fact, I presented on the topic to a microbiology class last year.

  • Anna

    I was born and raised in France where women who wish to go all natural for labor are rare.Epidurals are seen in a positive light and health care providers talk about the procedure without an hint of negative judgement.When I was a kid,my mother explained me that there were two ways in which a baby could be born (vaginally or surgically) and she told me that she opted for an epidural for her three babies and found that the pain relief was amazing.My first son was born vaginally with the help of an epidural which was very effective.The whole natural childbirth ideology is just not for me and the logic behind it still puzzles me.Why suffer when you can avoid it without risking your baby s health ?
    My two youngest sons were born by c-section and never received any of my vaginal flora in any manner and as you guess they are healthy and happy boys just like their older brother .

  • Liz Leyden

    Wouldn’t it make more sense to isolate the “good” bacteria and give it in capsule form, like probiotic caps for people who don’t like yogurt?

    • Guest

      Forgive me, but aren’t we talking about re-seeding newborns? Not sure how a baby would take a capsule or eat yogurt…

  • Babychu

    My last csection baby was seeded the surgeon swabbed my vag. Never heard of such a thing but was told it MAY help with the microbiome and immune system (they mentioned food allergies). All my children are csections and the previous two have multiple food allergies. I was GBS neg and no other issues so we said go for it. Who gives sh*t, they get this crap all over their face, eyes, mouth, and nose coming out vaginally anyway.

    When she gets her food allergy testing I’ll come back with a verdict. Lol.

  • ObiWan Kenobi

    Dr. Tuteur, thank you for taking the time to educate the online community with the straight and rational truth, it’s so important that these resources are available to the public.

  • Anna

    So gross! Everytime I think it couldn’t possibly get any worse about some NCB weird stuff and they keep doing it again! Coming up with all the more absurd things all the time. Poor babies. It’s plain abuse of them.

    • Megan

      If it’s gross, absurd and abusive for babies to be swabbed with vaginal bacteria, is it also gross, absurd, and abusive for babies to come through the vaginal canal, where they are exposed to the exact same bacteria?

  • Margo

    Bello a microbiologist and Neu paeds have done some resesrch. Neither are midwives. Might be “defiant” though.

    • Chi

      “some resesrch (sic)” Is hardly conclusive and does not a medical consensus make. Also can you link to their supposed research?

      • Margo

        I agree, their research is yet to be published, I understand it was on a very small scale I was just making the point that some research is being done by microbiologists and paeds. I actually agree with BMJ, this procedure should be treated with caution. As a midwife I would want a whole lot more research done before I proceeded.

  • Guest

    Hello. I’m 20 weeks pregnant with my first and I’m 24. I live in an area saturated with wealthy, new age, too-much-time-on-their-hands middle-aged people who are very much involved in the “natural” birth industry. So many people have offered to be my doula already… When I say I don’t have a doula, I don’t have a midwife, I have a lovely, female, experienced OB who’s overseeing me, albeit from a distance since I’m the definition of low-risk, they treat me like I’m naive and being taken for a ride by the MEDICAL INDUSTRIAL COMPLEX (cue terrifying music).

    The Natural Birth industry scares me much more. The nurses at the hospital ask me questions about what I want to do, if I need any further information, if I’m nervous about anything in particular,etc. I’ve never felt like they were pushing me into anything. These women who feel they have the right to come into my office while I’m working and tell me that the anti-depressants I take or the flu shot or whooping cough booster I get will give me an autistic baby are far pushier. I feel victimised by them. Most of the women in my locality have their first baby in their late thirties or early forties, which IS a demonstrated risk factor for all kinds of birth defects and they don’t seem worried about that. They seem to think my naivety is because of my age. Anyway, I actually did the math, and to have a “natural” birth would be literally ten times more expensive for me than a standard hospital birth, including all the costs of tests, vitamins, appointments, and everything else (I live in Australia, where we have Medicare to cover some necessary medical costs).

    Sorry to ramble. I feel very alone in this community. I feel like I’ve been accused of being a bad mother because I’m daring to put my baby’s safety first. The whole natural birth industry seems to grounded i the belief that every whim of the mother should be held sacrosanct and the safety of the baby is an afterthought. I don’t look forward to my labour, I don’t like going to hospital, I don’t like the idea of a C-section, or episiotomy, I don’t even like ultrasounds for that matter, I find them intrusive and unpleasant. But I’m open to all of this because it could make my baby safer. Natural birth advocates are like Christian Scientists: leave it all up to God and it will work out if it was meant to. No, modern medicine is an extraordinary privilege and to shun it because it makes you uncomfortable is such an insult to people who have no choice but to have their babies on dirty floors.

    Choosing a medical doctor with a decade of constantly updating education who has delivered 1000 babies and having my pregnancy monitored by a first world healthcare system makes me a bad mother. But going with a high school graduate with a “keen interest” in childbirth who’s delivered 50 babies who tells me to put garlic in my vagina and not take pain relief during labour (the only justification for this anywhere seems to be in the bible, the curse of women is that they should suffer during childbirth, why are we still listening to this bullshit?) makes me a super Earth Mother.

    The point of this whole thing was to say thank you to all the people here, especially Amy Tuteur. You have made me confident in my choices, and less afraid to explain myself. Thank you.

    • Hilary

      I can totally relate! Until you said you’re in Australia, I thought maybe you lived in the same place as me (I’m in the USA). The parent demographics where I live are basically the same- younger parents are mostly Mexican immigrants, and I don’t speak Spanish. I had my son when I was 25.

      I had a low-risk pregnancy that suddenly went very very complicated, ending in a c-section and NICU stay. High tech modern medicine saved my baby’s life and possibly mine. I have no patience anymore with all the woo. None. Nil.

      Good luck with the rest of your pregnancy and birth. I hope everything goes smoothly, but if it doesn’t, at least you’ll be in the right hands!

    • BeatriceC

      Good for you for sticking to your guns! Unfortunately, this will be the first of many battles you will fight, but it sounds like you’re a smart woman who will make good, sound choices for you AND your baby.

    • Who?

      I’m glad you’ve found good care for your pregnancy. Sorry about your neighbours and workmates, I’m sure they want to help but I get that it’s unhelpful. Everyone who is happy with their experience wants you to be happy too, and some of them think the only way to do that is for you to do exactly as they did.

      Sounds like you’re all over what you need and want to do, here’s hoping for an unevenful pregnancy and delivery.

    • Marie

      I also thought we might be neighbors until you said Australia! I just had my son in November and am a few years older than you. I encountered all the NCB judgment too. I had a scheduled c-section a week before thanksgiving. Multiple people suggested that my doctor was just pushing a c-section so I wouldn’t deliver over the holidays. It was so very irritating to me.
      Congratulations on your pregnancy and best wishes for a happy healthy baby.

    • The Computer Ate My Nym

      being taken for a ride by the MEDICAL INDUSTRIAL COMPLEX

      I read this at first as “taken a ride on the MEDICAL INDUSTRIAL COMPLEX”* and so, of course, now I have a whole scenario going on in my mind about the Medical Industrial Complex theme park. Think I can convince any venture capitalists to back me in making it a reality? I’m thinking the cascade of interventions water ride, the hospital acquired MRSA haunted house, the side effect roller coaster…

      *Yes, in case you’re wondering, I am dyslexic. And autistic. Despite being born in the era of only a few basic vaccines AND having been breast fed AND having been a “natural” birth.

    • demodocus

      Good luck! I’m 24 weeks along with my 2nd, though 15 years older, and I (another random person on the ‘net) think you’re being wise.
      Episotomy is pretty uncommon these days. I needed stitches only ’cause my 1st has a big head.

    • Jamie

      Rest assured you are doing the right thing. I myself am a former believer in the “natural” way. What I’ve come to learn is that I was ignorant to the other side the the “natural” way. I never bothered to find out facts and truth for myself. I thought the people I was paying to offer me advice were actually helping and had my best interest in mind. I paid a lot of money for a natural child birth class to help me achieve a VBAC, only to end up with a complication during labour, for which another c-section was necessary.

      After I had the baby, I took to the doula I took the class from SHE HAD NO IDEA WHO I WAS!!!! I had just given her $250 not three weeks before! I was there again for breast feeding support. She started off the meeting by going on and on about the dangers of vaccines. So, I got up and left, and never went back. I think many of the people in that industry refuse to see the trees through the forest, and frankly, like the smell of their own farts.

    • StephanieA

      Rest assured that you are doing the best thing for you and your baby. I’m sorry that you’re surrounded by nutters, and I’m happy you’ve had good experiences with medical personnel. I was 24 when I got pregnant with my first (I’m 27 now and just had my second), you will do great.

      Edit: did not mean to copy Jamie’s intro, ha.

    • sdsures

      You’re going to be a great mom. <3

    • Maya Markova

      Tell the bullies that you already have a doula, and you have engaged a wonderful midwife who, unfortunately, is forced to work in a hospital because of the pension plan… anything of this sort, to have them off your back!

    • Montserrat Blanco

      You will be a great mother. You already are. And do not listen to the bullies, they are not going to take care of your baby if there is a problem, so they have absolutely no say on the matter.

    • Brix

      Just give them a death stare until they walk away. You don’t owe anyone an explanation. Best of luck on your pregnancy, birth and motherhood.

  • Hilary

    I thought this was satire at first. Yuck.

    Sort of OT – I was GBS positive and my son was delivered by c-section after hours of labor. Although he didn’t come out vaginally, they still treated him with antibiotics for suspected sepsis (although he ended up testing negative). Is that standard? He was also premature. I’ve heard that GBS can cause preterm birth but I don’t know if that’s true.

    • nomofear

      From what I understand, if your water had broken, he was exposed to GBS during labor. No idea on the preterm part.

    • Anne

      Yes, this would be to prevent early onset GBS sepsis if the baby showed any signs of sepsis. Knowledge of a woman’s GBS status is very helpful in these cases. The precautionary principle applies in any signs of sepsis in neonates, especially preterm infants. Treat until culture results return then cease if negative or continue with appropriate antimicrobial cover. GBS is unlikely to be a cause of preterm birth, but being preterm is a risk factor for neonatal GBS sepsis.

      • Hilary

        Thank you for explaining that! Those early days were a blur and I never got a chance to ask about it. It said “suspected sepsis” on his paperwork but the cultures were negative.

        • Blue Chocobo

          It’s a “better safe than sorry” protocol. The risks of antibiotics are very low compared to the risks of GBS sepsis, and the sepsis can escalate very quickly.

    • Emily

      In Ontario, Canada, if you’re GBS+ you’re on antibiotics if your waters break for the remainder of your labour. Even at home births!

    • Montserrat Blanco

      Depending on how premature, it was a standard to give antibiotics to every baby at our NICU. Mine got them. He was born by CS, no rupture of membranes. I did not get the GBS test though, it was too early.

  • namaste863

    I still don’t get it. At the risk of sounding like a broken record, WHO GIVES A SHIT if a baby comes out of an existing orifice, or a new one has to be created for it? Even if (As I seriously doubt) there are long term health consequences, without getting the baby out alive in the short term, there won’t be a long term to worry about!

    • Roadstergal

      I really think these ‘risks of C-section birth’ narratives are most damaging to women who want a C-section to spare physical and/or psychological damage to themselves. It’s one thing to say ‘my baby was at risk of dying, and that took precedence over her/his long-term health,’ but they want to put moms in the position of saying ‘my continence/sexual function/recovery/happiness was more important than my kid’s long-term health,’ in the hopes of shaming them out of such considerations. When the data just isn’t convincing.

      I mean, the whole message that this ‘re-seeding’ is pushing (ha) is that kids are missing out on something critical if they don’t transit your vagina.

  • Valerie

    I was just thinking about the links (albeit tenuous) between CS and asthma. This isn’t anywhere near my area of research, but it seems more naively believable to me that childhood asthma has to do with neonatal respiratory distress than a CS-related microbiome. There is research indicating that transient tachypnea of the newborn is linked to CS and that TTN, in turn, is linked to asthma. Why do we need to evoke the microbiome? Maybe this is way out there, but some have suggested that the mechanics of vaginal birth (i.e. squeezing some of the amniotic fluid out of the lungs) is protective for TTN. Why don’t doctors research into safe ways to replicate this physical manipulation for babies born by CS? If artificial birth-like compression was designed to be at least as safe as a vaginal birth and had some effect at preventing neonatal respiratory problems, that would be useful, even if it’s long-term effects on asthma were difficult to demonstrate. It’s going to be very difficult to show that seeding the microbiome has any effect on childhood asthma, as it’s been difficult to demonstrate any causal link between CS and asthma to begin with.

    • Roadstergal

      I don’t think we should be putting C/S babies through a juicer before we have more solid evidence that there’s any association, let alone a causal one.

      • Valerie

        Reminds me of Violet Beauregarde from Willy Wonka.

        I’m not suggesting squeezing CS babies to prevent asthma- I’m wondering if mechanical manipulation has been examined as a possibility for the prevention of neonatal respiratory distress, for which CS is a well-known risk factor (at least, from the little I’ve read). Obviously nothing should be attempted for babies in peril who are born by emergency CS, but I don’t see how it could be even approaching the risk level of a vaginal birth for an elective CS on a healthy infant.

      • BeatriceC

        My 16 year old wants to know what kind of juicer would be used; a vegetable juicer or a fruit juicer?

        • Monkey Professor for a Head

          I would suggest an old fashioned laundry mangle.

        • Charybdis

          Magic Bullet .

          • canaduck

            I really miss those older Magic Bullet commercials, with Mick and Mindy and drunken Grandma…

    • Jen

      Just out of personal experience, I don’t think the compression of the canal has anything to do with asthma. Out of 4 of my children, only one has asthma. She was born vaginally and it was a long labour and delivery. My only one born via c-section has no indication of asthma. My husband and his sister were both born via c-section and only my husband suffered from asthma. I think it has more to do with the way the lungs and airways are developed rather than how they were born. She had pneumonia as an infant and has suffered ever since.

      • Valerie

        I guess that’s what I’m trying to ask- does the tenuous link between CS (or lack of vaginal birth) and asthma disappear if TTN is accounted for? If they grouped children by TTN or no TTN instead of CS vs vaginal birth, is there a stronger correlation? I don’t think it’s going to explain every case of asthma, as there are so many other known risk factors, but I think it would be useful to know if this is the mechanism by which CS is linked to asthma risk.

  • Lumen

    Dr. Tuteur, I’d very much like to hear your thoughts on a closely related study. There was a Science Friday episode on NPR (Feb 5th episode) that discussed a related (but not the same) area of research that was focused on swabbing the babies skin after a C-section. (definitely not putting it into their mouths). It sounded like a very recent study that might indicate some advantages for immunity, though I was somewhat skeptical of the insistence of the researcher that this was adaptive, and she seemed a little too insistent to me. Of course that just might be a passionate researcher.

    If you have any time to look up the study they were discussing I would love to know your thoughts. The microbiome seems like an interesting area of research, though I do think right now it’s too early to make half the claims that are being made and the general public is too quickly jumping onto it (as are the quacks) and deciding it’s the magic answer that will solve all health problems. Thank you.

    • yentavegan

      If children born via c/sec had statistically significant occurrences of illnesses not suffered by their vaginally born counterparts ( correcting for all variables) then we would be looking at the possibility that there is something to the vagina-seeding theory. BUT THERE IS NOT!!! And in the real world I could envision such a departure from acceptable parenting behaviors( by purposely dipping vaginal secretions into the mouths of newborns) as being criminal.. It is disgusting and something I , the mother to 2/5’s of my children being c/sec’s never would have considered doing. . And I am un-apologetically crunchy.

      • CSN0116

        LOGIC!!! 😀

        How is this worth the investigation if there’s no difference in the cohorts TO BEGIN WITH?! Thank you for saying it.

      • mostlyclueless

        I shared in a comment below, there IS evidence that children born via c/s are significantly more likely to experience some diseases — whether this is caused by the c/s or residual confounding (despite efforts to control for all logical confounds) is unknown — here is the comment with links to meta-analyses.

        http://www.skepticalob.com/2016/02/warning-vaginal-seeding-doesnt-work-and-may-be-harmful.html#comment-2533023701

    • Roadstergal

      I went through that study briefly in the comments a few posts back. Basically, way too few ns, very unbalanced groups, and some conclusions that were at odds with the hypothesis.

      I would state the conclusion as “maternal antibiotics might have some effect on the bacteria in a kid’s mouth and stool, and so might method of feeding and possibly mode of delivery. There is no reason to think that the differences, if they exist, have any functional consequence.”

      • Lumen

        Thank you. This is helpful.

        I’ve only recently started listening to that podcast but my skeptical meter keeps flaring a bit when I do. It’s not that I’ve gotten the sense that much of it is exactly wrong, so much as he’s covering studies way too early before there is enough conclusive evidence to make any kind of statement to the general public. And that is exactly the kind of thing that sets up a platform for quacks to work from. A shame. NPR for the most part has very solid news coverage. I’m a huge fan of “On the Media” and their very skeptical reporting.

  • Guest

    Bit off topic, but I’ve been lurking for a while and you seem like a very sane bunch of people, so I just wanted to say hi. I’m based in the UK and nearly 41 weeks pregnant. I’m freaking out a bit about the possibility of going much more overdue because I have a family history going back at least three generations of very large babies (my mother suffered a very traumatic stillbirth after being left to labour too long with a baby that turned out to be almost twelve pounds). I also have some intensely personal reasons for being very distressed by the thought of vaginal delivery. I think I can cope when the time comes but I can’t guarantee it. My midwife has been very negative about the possibility either of induction before I’m two weeks overdue or of a Caesarian section (she says no midwife would recommend a Caesarian because they’ve all seen the damage they do to babies). My family history hasn’t been entered in my medical notes (I was told first that it wasn’t relevant because there couldn’t possibly be a genetic component, and then there might be a connection but that it wasn’t relevant because a vaginal birth would still be recommended even if the signs were that the baby was going to be very big). This all makes me very nervous because it’s something I’d like the team at the hospital to know when I get there, if only by way of background. I’m feeling very isolated and googling is driving me nuts because all I keep stumbling across is the netmums “you won’t bind with your baby unless you have a perfect birth” brigade and I really want to slap them.

    • Roadstergal

      “(she says no midwife would recommend a Caesarian because they’ve all seen the damage they do to babies)”

      FFS. My (UK) friend’s C-section baby went home with her after three days. Her VBAC was in the NICU for a full week. What a horrible bunch of vagina-obsessed women.

      • Guest

        I know. My most vivid childhood memory is of my mother crying uncontrollably, to the point where she could hardly breathe, in front of a television program which had just sprung a stillbirth scene on her without warning. That was years after her baby died. I think she’d still react the same way now if she saw something like that. I don’t care if this baby comes out through my chest, like John Hurt in Alien, as long as I don’t have to suffer what she suffered.

        • Roadstergal

          It’s just so nasty that they can keep putting you off and putting you off and hoping that the VB you don’t want just ‘happens naturally.’ Ugh. A commenter here, Dr Kitty, is an NHS doctor who got the C/S she wanted (with some fighting) – she might have some practical advice…

          • Dr Kitty

            Honestly, it was minimal fighting because a) my consultant was totally on board and b) I didn’t go into labour.

            I have decided, should I ever have another baby, that I will have “I AM A DOCTOR AND I WILL NOT AGREE TO ATTEMPT A VBAC BECAUSE I HAVE SEEN A BAD OUTCOME FROM UTERINE RUPTURE FIRSTHAND. THIS IS NOT UP FOR DISCUSSION” in big letters on the front of my notes.

      • guest

        I’m still looking for the damage to my c-section babies. I can’t find it anywhere!

    • AirPlant

      Do you have a path for escalation? It doesn’t sound like your midwife is listening to you, maybe she has a charge nurse that you can appeal to?

      • Guest

        I think that might have to be my next step. Thank you very much for the advice.

        • AirPlant

          This is your body and your baby. Don’t be afraid to be a squeaky wheel, and good luck and congratulations!.

    • CSN0116

      Given the evidence, I strongly believe that every woman should be entitled to an elective cesarean. I have had two, personally. And I took it a step further and requested general anesthesia as well (per a trauma that occurred years prior, I could not fathom being awake without the ability to move my body).

      God bless my male obstetrician and hospital staff. I couldn’t imagine having those choices stripped from me. Your caregiver sounds uncompassionate, uninformed and cold. I wish you the best and hope you can find other options, if you so choose.

      • mythsayer

        I had one. Best thing ever.

      • Guest

        Thank you – I really appreciate it. Yes, it’s funny how many people have tried to terrify me with the idea of male obstetricians, yet I’ve never felt as thoroughly gaslighted/ dismissed as a neurotic and hysterical woman as I have been by my midwife.

        • demodocus

          I also really like both my regular male OB and the guy who was on duty when I went into labor with #1. They’re decent blokes The only thing different is a wish that Dr. E had pianist’s rather than boxer’s fingers. lol
          She sounds like a midwife i’d have problems with, too.

    • namaste863

      Get. Help. Now. It sounds like your midwife is more attached to the idea of you having a vaginal birth than she is of keeping both of you healthy. I will be here in sunny California praying to any deity who might listen for you and your baby. All the best to both of you. Good luck, FSM Bless.

    • Who?

      Hope it goes well. Can you make a note about your family history to pass to them when you get to hospital?

      Don’t be scared to ask for what you want, and if you have a support person with you have them asking too. Over and over again if necessary.

      I’m so sorry you’re going through this-I had my kids in the UK in the early nineties and there were none of these shenanigans. It is so disappointing to hear how it has all gone.

      Thinking of you in Australia, let us know how you get on.

    • DaisyGrrl

      Do you have a GP who might help you with navigating the local health system? They might know the best person to contact for assistance.

      The NICE Guideline on Caesarean sections has a section on Maternal Request caesareans (section 1.2.9 at the following link: http://www.nice.org.uk/guidance/cg132/chapter/1-Guidance). In theory, you should be able to request a CS and have that request respected provided you have received informed consent and confirm that you do not wish to have a vaginal delivery.

      I don’t know the policies of your local Trust, but you might also want to check their website to see if there is someone to contact directly to see a consultant.

      Wishing you all the best. Let us know how it turns out.

    • Charybdis

      Do you have an OB or GP that you can consult? The ability to get a second opinion, even if you have to pay for the appointment? An alternate midwife you can consult? (Not terribly sure about the UK NHS and how exactly it works). There must be a way to get your concerns heard and addressed in an acceptable manner. A cavalier dismissal of your legitimate concerns simply reeks of the patriarchal, high-handed attitude that midwives attribute to the OB’s. Maybe mention that…

      As much as I dislike making a scene, I would suggest you make one. It is YOUR baby, YOUR body and YOUR decision and you need someone who is not blinded by ideology to help you with your legitimate concerns. Start going up the chain of command, keeping notes as you go: names, dates, advice given, questions asked, etc. Keep moving up the chain until you get someone who will help you.

    • Amazed

      Do tell the team when you arrive at the hospital. Tell about it to more than one person. Also, can’t you contact your midwife’s superiors and demand a consultation with another healthcare provider, an OB, preferably? Going a week overdue is definitely a reason to be watchful. Chances are, of course, at your side, but no one can be overly cautious. May the god of boring looks your way through the rest of your pregnancy and when the day comes.

      Oh, and fuck the netmums. Don’t google. I wonder why netmums think moms so weak and lacking of feelings. I bonded with my newborn niece right away, the moment she first opened her eyes and then her mouth to cry, then stirred a little, the cradle moved a little and she fell silent, not quite sure what had happened. Why they think moms are so deficient that they’re the only ones who cannot bond properly? Let them give themselves their pumpkin awards for the mommiest mommy. They live in another reality. Crunchlandia.

    • DelphiniumFalcon

      The whole “but then your baby won’t bond!!!111” stuff always confuses me. I mean, are they mistaking human babies for ducklings or something?

      • ObiWan Kenobi

        You didn’t know? If women don’t birth from the vagina, delay cord clamping, have their “golden hour” with their infants crawling up to their breast on their own to latch and suckle, bonding goes right out the window…I mean, your kid will be looking at a lifetime of drug abuse, prostition and increased risk of c-section when they have children of their own.

    • Are you nuts

      Best of luck to you. I hope you have great nurses on call when you go in – I think that can make all the difference. Please do keep us posted!

    • Inmara

      Have you had an ultrasound for fetal weight estimation recently? If not, seek for a consultation with OB and ask to get it, with your family history it’s important to make sure that baby is not too big for a vaginal birth.

    • The Computer Ate My Nym

      she says no midwife would recommend a Caesarian because they’ve all seen the damage they do to babies

      My midwife recommended I have a c-section after I failed to progress on pitocin for several hours and had early signs of infection (low grade fever.) Nor did she ever say that the baby would have any issues–the only reason that she recommended pitocin before c-section when I clearly wasn’t having normal progression was to avoid damage to me, i.e. a c-section scar and recovery. May I recommend a new midwife or referral to OB?

      PS Baby is now almost 13 and an apparently normal,smart and creative, nonasthmatic, nonobese early adolescent. So much for c-section damage.

      • Dr Kitty

        I have to say, I work with MWs professionally, and the majority of them are wonderful, including the ones who have cared for me.

        My Community MW in my second pregnancy had two CS herself, and her own daughter (also a MW) had just had her first baby by CS after a long, difficult labour. She was extremely supportive of my desire not to have a VBAC. She even offered to help me make a complaint against an unsupportive Dr and MW, who had clearly been judging my decision, and told me to ignore the advice they usually give about making sure labour is well established before heading to hospital.
        “You feel a trickle or a twinge after 37 weeks, you go up that road like a rocket to the hospital and get them to book that operating theatre girl!”

        But the ones that think that they are “saving” women by “helping” them have “normal births”… Save me from them.
        Several of them, you may be unsurprised to find out, have never been pregnant themselves, but just “know” that they’d have textbook pregnancies, easy labours and lovely natural births.

    • Dr Kitty

      Have you got a date for induction? Is it before 42w?

      NICE guidance is that in the absence of risk factors induction should be offered between 41+0 and 42+0. 42w is the upper limit, not the lower one.

      http://pathways.nice.org.uk/pathways/induction-of-labour#content=view-node%3Anodes-information-and-decision-making

      If you haven’t got a date for an induction before 42w, I have a plan for you.
      Call your labour ward. Ask to speak to the midwife in charge. Tell them you have looked at your options and wish to proceed with an induction between 41w and 42w as per NICE guidance, but that your MW is being obstructive and that you feel you have no option but to go around her.

      Tell them about your family history of obstructed labour, macrosomia and stillbirth.

      Explain that you are considering formal complaints over substandard care and failing to meet nationally approved guidance, and that you are pro-actively collecting evidence for litigation should there be foreseeable complications.

      If you don’t get an induction date in the appropriate time frame, ask them to confirm, in writing (email is fine) within 24hrs why they are not adhering to best practice in your case, or explain that you can record their verbal explanation immediately if they prefer.

      If you still get push back, ask to speak to the doctor on call.
      Do it today.

      I’m serious, if you are almost 41w, it is likely the ward may already have all their induction beds booked for the next week.
      You need to do this now and you have NOTHING to lose.

      • Dr Kitty

        I should say, I’m giving you the very hardball gameplan.
        You won’t make friends, but you should get what you want. It is what I would do for a patient in that position (except I say I am documenting extensively for defensive purposes and that the phone conversation is being recorded).

        Your own GP might be able to do this for you if you feel it is too confrontational, but it is probably going to be harder to arrange to see or speak to them.

        What you don’t want is to attend your 41w appointment, be offered a sweep and be told that due to staffing levels or demand the earliest you can be induced is 42w4d or something equally unacceptable.

        This is absolutely the time to tell people that your sibling died because they were too big for your mum to deliver safely, that this was not detected during labour and that your midwifery care so far has given you no faith that anything different would happen to you.

    • Guest

      Just to update you all, I’ve got an appointment with a consultant this afternoon to discuss my options and I’m cautiously optimistic that I’m going to have more luck getting my concerns heard. I just wanted to say thank you so much to those of you who replied for being so supportive and encouraging me to stick by my guns – you’re a great bunch of people!

      • Dr Kitty

        Great news. Please let us know how everything goes.

        • Dr Kitty

          Oh, and please don’t leave us waiting too long or I’ll worry.

          • DaisyGrrl

            I’m hoping we haven’t heard back yet because the consultant agreed to induce her immediately and she’s too busy enjoying the new baby.

          • Megan

            That’s what I was hoping. I just saw all of this last night and I was worrying.

          • Dr Kitty

            Me too…

      • Who?

        Well done you. All crossed for a positive outcome.

      • AirPlant

        I hope you come back and comment more! We all like a happy baby story 🙂

      • Amazed

        Good luck! Let us know how things are going!

  • Michelle Singleton

    1) Ew,
    2) … Nope. That was it. See #1.

  • Adelaide GP

    I’ve been reading this wonderful blog daily for about 4 years now and am still amazed at the capacity of the NCB worlds ability to reach ever rising peaks of crazy. This one ( almost) takes the cake for me. But then what do I really expect from a mentality that thinks eating placenta and delivering in a whirlpool of shit is normal. And it’s yet another example of dreadful biological determinism. That “outcomes” in parenting rely so heavily on Vaginas or bacteria or whatever. It’s a moment in time followed by a million other social / environmental factors that will shape an eventual adult.

  • It just occurred to me (yeah, I’m a little slow) that it doesn’t matter if seeding has any benefit. The point for the proponents is drawing another line between women who give birth the “right” way, and the poor souls who had their babies cut out of them *clutches pearls* and therefore need to take these restorative measures to try to make up the deficit created by their inadequacy. It’s nothing but a status marker.

  • demodocus

    I first heard of mother’s microbes transfering to infants born vaginally in National Geographic several years ago. It had an icky but interesting quality. The impression i got was this was a very new area of study. Certainly not well enough studied to overthrow the general community wisdom that c-section kids seem to do just as well as vaginally born ones, and definitely not enough to get me to put any more of my secretions on my kid than I can help.

  • AirPlant

    But… Question. Can babies even open their mouths when they are in transit like that? I had assumed it was a tight enough squeeze that motion was pretty much not a thing.
    Also: Isn’t colostrum supposed to be the perfect antimicrobial agent? Wouldn’t the immediate skin to skin plus breastfeeding thing kind of put the kibosh on the whole thing?
    I am trying to find an internal consistency and it isn’t working…

    • Mad Hatter

      That’s why colostrum fortified with vagina juice should be a thing.

      • AirPlant

        It defies all logic, so I am guessing it will be a thing within the year.

      • seekingbalance

        now THIS must be the use for the aforementioned Magic Bullet…. maybe we can add it to placenta smoothies? but now I’m getting myself all confused–should baby drink it, or mom???? 😉

        • ObiWan Kenobi

          Babies drink it, moms encapsulate it with their placenta.

    • MaineJen

      Babies are born with all kinds of…schmutz all over them. I can’t imagine that some of it doesn’t get into their mouth during/after birth. *shudder*

    • Beth

      colostrum knows to only kill the bad microbes, and leave the good ones, of course.

      • Sarah

        #trustcolostrum

    • Megan

      There are different species of bacteria colonized on the skin than there are in the vagina, so babies put skin to skin immediately without going through the vaginal canal are first seeded with skin bacteria, not vaginal bacteria. The immune system learns to recognize “friend” from “foe” from birth, so the theory is that babies with skin bacteria in their systems have immune systems that develop differently from those seeded with vaginal bacteria.

      But you are right that colostrum supports healthy gut flora. So even if a baby is born by Cesarean, colostrum is still immensely beneficial in getting them off to the right start.

  • mostlyclueless

    Seems like a pretty egregious oversight that this editorial didn’t think to reference the only published data on vaginal seeding: http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.4039.html

    • attitude devant

      Uh gee, do you think that might be because both articles were published in separate journals only this month?

      • mostlyclueless

        Uhh gee, call me crazy but using my internet machine, I can see articles the same day they’re published. If I were the authors of that editorial I would be super embarrassed to be pretending to be an authority on vaginal seeding when I didn’t even know the available literature.

        • Amy Tuteur, MD

          The editorial was undoubtedly written weeks ago. There’s a long lead time in publishing.

          • mostlyclueless

            If I had been that action editor I would be more than happy to let the authors update their piece.

          • attitude devant

            Honestly not meaning to be snarky, but biomedical publishing is notoriously slow

          • Roadstergal

            And you can’t just change it up after it’s been reviewed and accepted.

  • Warrior_Mama

    Dear God, women have been dropping their babies in fields for centuries and now this article is condemning midwidery? At what point did ‘natural’ anything become its own cult? My vagina and I are hurt and stunned.

    • attitude devant

      (please be a Poe, please be a Poe…)

      • Megan

        Sigh. They never are. How are we to maintain any faith in humanity?

    • Amy Tuteur, MD

      It became a cult when people started to use the term “natural” to profit from products and services.

      • Warrior_Mama

        Wait…and the mainstream medical community doesn’t profit from products and services? Seriously? How about advocating for what is best for the individual instead of pushing an agenda that, to me, is still not clear–unless it’s c-sections. Then I get it.

        • Amy Tuteur, MD

          The mainstream medical community also profits from its services although generally not its goods. The key point is that the natural childbirth industry is no different. They don’t have your interests at heart; they have THEIR interests at heart. The smart consumer understands that anyone selling anything has a financial interest and judges claims accordingly.

          • Warrior_Mama

            The mainstream medical community’s biggest ‘goods’ profit is vaccines, which have been proven to be unsafe for SOME PEOPLE. While of course any industry is no different, somehow the natural childbirth idea, while not a new one (hence my point, missed by everyone, about dropping a baby in the field), is somehow woo woo. I don’t get it. Wait. Yes, I do. As a woman who had one at home with a midwife and one in a hospital with a doctor, I do know the difference, and strangely felt that both had my best interest at heart.

          • Amazed

            And strangely, only one of them probably had the knowledge (if you used a CPM) and only one of them for sure had the equipment to do something about you and your baby if things had started going pear-shaped.

            Having someone’s best interest at heart doesn’t mean squat. I might have your best interest at heart but you must be nuts to hire me just because I have them at heart… and also have a bogus education. But you seem to feel that well-wishing is the beginning and end to all. I’ll tell you a secret: to many CPMs, your best interest consist of pushing a baby out of your vagina. Dead or alive.

            Vaccines are “goods”? I can’t even. How much does a doctor win from the evil Big Pharma by recommending a shot? How much would they get if they treat the actual illness vaccines help prevent? Hint: much, much more. A small measles epidemics is far more profitable than getting a whole state vaxxed/

          • momofone

            I live surrounded by (cotton/rice/soybean) fields, and I can say with a high degree of confidence that women have not been “dropping babies” there for many years. That is pure romanticized BS.

          • Roadstergal

            “The mainstream medical community’s biggest ‘goods’ profit is vaccines”

            OMFG I shouldn’t laugh so loudly at work. You haven’t a clue what makes money.

          • Guestll

            Wow, and all this time, I’d read about statins and dick drugs being the most profitable, while vaccines were actually reported to be a money-loser. Thanks for clearing that up for me, I feel like such a dumb sheeple. Would love to continue this edification process but I must run and pick up my earthside hatchling. Actually I won’t run, since running has been proven to be unsafe for SOME PEOPLE.

          • Roadstergal

            I’m now imaging the universe where protection from disease is more valuable in the marketplace than getting an erection. It sounds like a nice universe, but it’s a long way from this one. 🙁

          • demodocus

            Getting and maintaining! Don’t forget the maintaining! But not more than 4 hours

          • Roadstergal

            That’s true, the pills are only for maintaining. But getting is also a highly lucrative business, from porn to escorts to Cinemax.

          • BeatriceC

            Hey, man, don’t knock the dick drugs. They’re a great thing for some of us (I don’t know who likes them more; me or MrC).

            That said, you’re right. It is a sad state of affairs that sex is prioritized over preventing illness.

          • Roadstergal

            Oh my yes – we shouldn’t knock sex down the priority list, we should bring disease prevention up it. :p

          • Charybdis

            Hey now! I understand that Viagra started life as a blood pressure drug and is still sometimes used for that purpose.

          • Monkey Professor for a Head

            I don’t believe that Viagra is used for high blood pressure, but it is useful for certain types of pulmonary hypertension.

          • Hilary

            You are correct about the pulmonary hypertension. It’s also being used in experimental trials for some vascular anomalies.

          • Charybdis

            Ahh… that’s what I meant. My pharmacology is a little shaky these days.

          • BeatriceC

            My youngest was on it in the NICU for pulmonary hypertension. And yes, it was originally being developed as a anti-hypertensive.

          • demodocus

            *snicker* that’d be me, ’cause i haz da grace

          • Roadstergal

            When you go pick your baby up, don’t worry if you drop him/her – as long as you do it in a field. Women have been doing that for ages.

          • Monkey Professor for a Head

            “vaccines, which have been proven to be unsafe for SOME PEOPLE”

            It’s true that certain vaccines are contraindicated in a small portion of the population with certain conditions (allergies, immunosuppression etc). And I think you’d be hard pressed to find anyone in the medical community who would push for people with genuine medical contraindications to be vaccinated.

            The same is not always true if the NCB community. There have been multiple cases where women who are high risk have been encouraged to home birth for example – by both midwives and lay people.

            So which community is more ethical here?

          • Roadstergal

            You’ll find a miniscule number of providers in the legitimate medical community who will go the other way – promoting anti-vaccination – and they do it because Natural Is Lucrative. VERY lucrative. Bob Sears will outright sell you ‘medical exemptions’ for your Special Snowflake.

          • demodocus

            Mom had her kids without pain killers or any other “interventions”. In a hospital, just in case. We have never met anyone who’s allergic to any vaccines. They are very rare. My docs were willing to let me try for a nonmedicated labor, but in the end, I decided i wanted pain killers, ’cause my threshhold for pain is no where near as high as my mother’s. *much* to the relief of my husband and sister.

          • MI Dawn

            ok. Lying doesn’t fly here. Vaccines are NOT the source of profit for medical communities OR pharma. Try Vitamins, Supplements, chronic illness drugs like BP med or cholesterol meds.

            If you can’t keep that straight, how can I trust your other facts?

          • Warrior_Mama

            The truth doesn’t change because you get offended. Do your own research. Time to get off this crazy train.

          • momofone

            Just to clarify, when you say, “Do your own research,” do you mean to conduct the actual research (which many people here do, by the way), or do you mean “Find things on the internet you agree with and call that research”?

          • Roadstergal

            I’ve done research for decades, and published a good bit of it. Please, share yours. 😀

        • attitude devant

          You cannot be serious. I am a member of several natural childbirth Facebook groups, and fully a third of posts in any given group are selling something, anything: rebozos, wraps, tinctures, podcasts. Some groups even start the posts with a ‘marketplace’ section. And in all the discussions of placental encapsulation (at least one a day) there is the consensus that there’s no research to support it, but clients want it, and it does make money, so I’ll do it for them….

        • Hilary

          Yes, the agenda behind c-sections is clear. It’s that whole preventing-death-and-brain-damage thing.

          • Warrior_Mama

            Oh be serious! Have some faith in your body’s ability to birth. It isn’t new.

          • Megan

            If I’d had “faith in my body’s ability to birth” my baby and probably I would’ve died leaving my husband a widow. But who cares about those of us who can’t birth vaginally for whatever reason, right? You know what else isn’t new? Dying in childbirth and stillbirths.

          • Hilary

            My baby had a tumor in a location with a documented probability of shoulder dystocia, which we learned about via those evil prenatal ultrasounds. It had nothing to do with faith or even with my body (no woman’s body is shaped to accommodate a large tumor there) although I was also told I have a narrow pelvis.

            While my situation isn’t common in its specifics, it’s a reminder that bodies do all sorts of unexpected things, and when you have two bodies involved, either of which might do something unexpected, you face major compatibility issues. Ignoring this reality and calling it faith is stupid and dangerous.

            Now I’ll stop feeding the troll, unless you have something intelligent to say.

          • Warrior_Mama

            I’m so sorry for your troubles. Obviously every situation is different. This is what I responded to: Yes, the agenda behind c-sections is clear. It’s that whole preventing-death-and-brain-damage thing.

            No idea, other than the above, what you were talking about. Best of luck to you.

          • Hilary

            You completely missed my point. Why do the details of my situation change anything? There are a lot of reasons that vaginal birth can result in death and brain damage. Why is my reason acceptable (in your opinion) but someone with a narrow or oddly shaped pelvis and large baby having a c-section to prevent dystocia is not? I have a friend whose child got stuck for exactly that reason and suffered a birth injury. (In pre-emergency c-section days, they might both have died.) Doctors do c-sections to prevent situations like this, not for personal gain.

          • Hilary

            And while we’re at it – how about the woman I know who had a c-section because her son would have been strangled by a nuchal cord? Is that a good enough reason? How about the woman I know who was airlifted to a hospital with life-threatening pre-eclampsia and had a c-section because induction didn’t work? Should she have had faith in her body? These are real life acquaintances, not stories I found on the internet.

            Where on earth do you get this idea that birth is safe? At least half the mothers I know have had serious complications, whether they gave birth in a hospital or at home. Those who don’t are just lucky. I see no empirical evidence for “having faith in my body.”

          • Monkey Professor for a Head

            Plus the whole “trust birth” concept has a nasty flip side – if your delivery went well because you “trusted birth”, well then anyone who suffered a complication must have not believed hard enough.

          • Who?

            Yes, pretty trivial, avoiding death and brain damage, hey? Fancy it even being a thing! Why bother getting anyone out of bed for that?

            Or to quote the homebirth hobbyists ‘What’s a few dead babies?’

          • guest

            Do you also have faith in your body’s ability to give out? To vary from normal? To die?

            Because I do. My body will do what it does, and when it’s not doing things advantageously western medicine is there to help.

          • Nick Sanders

            True, giving birth is not new, but neither is considering it extremely dangerous.

          • Amy Tuteur, MD

            It’s not new; that’s how we know it’s routinely deadly. Childbirth is and has always been, in every time, place and culture, a leading cause of death of young women and THE leading cause of death of babies.

            The only reason that you can prattle mindlessly about having faith in birth is that it seems safe to you … precisely because of the liberal use of childbirth interventions made possible by modern obstetrics. Ironic, isn’t it?

          • Dr Kitty

            *My* body decided to stick three extra vertebrae to my sacrum and not to bother properly forming any of those to adequately protect my spinal cord.

            *My* body decided that endometrial tissue should not be confined to the uterus, but should, instead, be allowed to roam freely in my abdomen and pelvis.

            *My* body decided that THREE separate classes of antibiotics should be responded to with life threatening reactions.

            *My* body made two babies at exactly 9th centile-borderline IUGR- neither of whom were able to descend or engage in my pelvis, because it has a wonky shape and is smaller than it should be.

            I’m not trusting my body to give birth, and why would I? I had two lovely CSections and two neurologically intact children.

          • seekingbalance

            indeed! and this is just our *unpregnant* bodies’ questionable judgement! two of my five pregnancies tried to kill me before we even got to the point of viability, and only two of them (different two) resulted in a live baby. nature can be beautiful, but it’s also harsh, and it’s certainly not trustworthy. trust is a human construct. to impose it on nature is to anthropomorphize… well… everything non-human. what’s that saying about hoping for the best but preparing for the worst? we can be optimists and still be realists.

          • Sarah

            What on earth would I want to do that for?

          • demodocus

            My body went into completely unexpected pre-e several hours into labor but still 14 hours to go. If I’d been giving birth in my backyard, I’d probably have had a stroke.
            My kid has complete faith in his body and has a bunch of bruises to prove it.

          • momofone

            My body had the bad judgment to develop cancer in my twenties, and not quite two decades later to wreak some havoc that resulted in double mastectomies. I don’t trust it as far as I could throw it. The best thing it ever did was to grow my son, and even then, it flaked out on the placenta toward the end–thank goodness for a cautious OB and close monitoring–and of course the c-section he performed. THAT is what I trust. Interventions all the way, baby!

          • Nikat

            This argument enrages me beyond words. I’m literally shaking with rage and grief right now. You know what my body does? It kills babies. Repeatedly. Over and over again. Do you even have idea what that feels like?

            The NCB movement’s focus on blaming the mother for her failures, telling her that it’s her own fault for not trusting her bod moves me to violence.

            If trusting in your was all it took to have a baby my first would never have died. I’ve learned from my losses. I do NOT trust my body because my body is completely untrustworthy.

            By putting all my trust in medical science, each pregnancy has lasted a little longer. Will it take this time around? Who knows. But if it does, it won’t be because my baby-killing piece of shit body “knows what to do.” It’ll be because my doctors and my medical team throw a 110% of themselves into it every time to save my baby.

        • Charybdis

          So then why does advocating for what is best for the individual suddenly default to all natural, all the time? If someone chooses something other than unmedicated vaginal birth, then somehow we are being bullied into interventions and maybe even *gasp* a CS? And why the CS and intervention hate? A whole lot of us LIKE and WANT the interventions, and are mightily put out by the inference that we just need more information/education/browbeating to see things the way the NCB crowd wants us to see them.

    • MaineJen

      “Dropping their babies in fields…” I can’t *imagine* why no one wants to go back to doing that!

    • crazy grad mama

      Are you for real?

      • attitude devant

        Gotta love the handle…particularly the underscore

    • Amazed

      Would you share your preferred brand of sickle to cut your babies’ cords with? I’m totally sure that’s what women have been doing for centuries. Do share.

      • Roadstergal

        Sickle? Keep your Western medical interventions away from the natural mamas. Bite the cord or GTFO.

        • AirPlant

          That doesn’t appeal to me as a raw vegan.

        • Amazed

          I protest! It isn’t a *Western* medical intervantion! It’s an *Eastern* European one and the granny midwife who was telling the national TV of her long years of serving women in her rural region was pretty disgusted with it. Damn proud that she had had the chance to be trained in a big regional hospital, though. Her first job when arriving to attend a delivery was having dad park the car right next to the door and stay duty, in case they needed to transfer. I think that alone gives her a huge lead on CPMs.

      • Bombshellrisa

        How dare you imply that cutting the cord is anything other than a way for Big Bad Medical Community to start programming women to not trust their bodies. Real mamas practice the ancient art of lotus birth. I am sure all those mother with child pics painted in the renessaince just left that part out.

        • Amazed

          Damn it, you caught me. I was fancying myself so smart.

      • momofone

        I only use organic, free-trade sickles, fresh from the rain forest and made from branches harvested (only after they fell to the ground on their own, of course) by forest elves.

    • Roadstergal

      Why on earth are women dropping their babies? Slippery hands? Why are they wandering around in fields holding babies?

      My vagina only hurts after a _really_ good weekend, and some swimming and stretching clears it right up. It’s never been stunned, though, despite what the guy at the pet shop said.

      • Bombshellrisa

        “Why on earth are women dropping their babies?”
        Probably because they are so weak from laboring for days on end and using cinnamon for PPH.

        • AirPlant

          Sort of off topic, but whenever I hear about herbal remedies I can’t help but wonder how in the hell our wise woman ancestors were supposed to come by all these specialized plants. I am reasonably certain that cinnamon is not native to most of the world so I guess only the women of Sri Lanka and Indonesia get to survive PPH…

          • Bombshellrisa

            I wondered about that too, of certain herbs help this or that, what about in the areas where shepherd’s purse or blue cohosh doesn’t grow?

      • MI Dawn

        Well..in my experience, it was because the poor girl had SEVERE carpal tunnel syndrome in both hands which no one recognized. Poor thing was totally numb and scared to pick up the baby, so everyone prattled on about “lack of bonding” instead of asking her what was wrong!

        After treatment, she never wanted to put the baby down…she’d lost 6 weeks and wanted to make up for it.

    • Guestll

      “women have been dropping their babies in fields for centuries”…is this supposed to be a good thing?

    • Bombshellrisa

      What really hurt and stunned my vagina: natural births. But what do I know?

    • Who?

      And what’s good enough then is good enough now, is it?

    • Nick Sanders
  • attitude devant

    Sometimes the disconnect in my world is so huge my head spins. On the same day I had on my facebook feed a breathless article about vaginal seeding and in my professional reading a discussion regarding whether douching before scheduled c/s would lower the already low risk of ascending infection when membranes are intact.

  • Madtowngirl

    I may be behind, but I have yet to see any real evidence that suggests vaginally born babies grow to become healthier adults than babies born via c-section. Why then, are there these ridiculous ideas floating around out there that make it into medical practice?

    Oh, right. Woo.

    • The Bofa on the Sofa

      1) C-sections are bad.
      2) See 1.

      What other evidence do you need?

      • attitude devant

        If a midwife can’t do it, it’s bad. Maybe we’ll see a trend toward lay c-sections?

        • Roadstergal

          After reading all these accounts of lay midwives giving women ‘vitamin C’ orally, using the vacuum, and cutting epis then telling women they ‘tore,’ I think the only reason they don’t do lay C-sections is because convincing a woman she didn’t have one after the anesthesia and the abdominal incision would require George RR Martin levels of narrative.

    • mostlyclueless

      Well, the evidence exists — the question remains whether the evidence is believable or better explained by residual confounding or deficits in study design — an inevitable problem when randomization isn’t an option.

      Increased risk of asthma in babies born by c-section (meta-analysis): http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2007.02780.x/full

      Increased risk of type 1 diabetes in babies born by c-section (meta-analysis): http://link.springer.com/article/10.1007/s00125-008-0941-z

      Increased offspring body weight/BMI/overweight/obesity in babies born by c-section (meta-analysis and systematic review): http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0087896

      • crazy grad mama

        The giant, elephant-in-the-room confounding variable is that women have C-sections for a reason! And that sometimes that reason is because the mother has a potentially heritable health issue. It makes complete sense to me that we’d see higher rates of diabetes in C-section babies, but not because the C-section itself did anything.

        • mostlyclueless

          Yes, but there are efforts to statistically control for those factors in many of the studies. The people who do these analyses aren’t dumb-dumbs, you know?

          Like I said, maybe there’s residual confounding? I don’t think the issue is open-and-shut in either direction, and I’m open to the possibility that c-sections may in fact increase the risk of some illnesses by a small percent in exchange for saving the lives of many mothers and babies.

          • crazy grad mama

            Gosh, and here I thought all medical researchers were idiots.

          • Roadstergal

            See comments above. You can be a not-dumb-dumb and still publish unconvincing data.

        • demodocus

          My sister was obese, had GD, and a not-discovered-until-they-pulled-the-baby-out case of ovarian cancer. But sure, it’s the lack of vaginal microbes that increases my nephew’s risk of diabetes and cancer.

      • Roadstergal

        #1 – not very convincing, to me. They noted heterogeneity, excluded some studies, and lost statistical significance. Additionally, they noted in the paper that they didn’t correct for confounders.

        Also, I’m not a stats person, but the funnel plot looked like bias towards a positive odds ratio to me – anyone else think so?

        #2 – we’ve discussed this one here before. The issue I had the most trouble with is that they considered maternal T1D, but not paternal T1D, as a confounder, which is a bit ridiculous. That’s on top of a very small effect with unconvincing statistics (“adjusted OR 1.19, 95% CI 1.04–1.36, p = 0.01”).

        #3 – there was only one study in the meta-analysis that actually included maternal height and weight as confounders, and that one showed no difference of mode of delivery. That’s telling, to me, as overweight women have more difficulty with VD and are more likely to have overweight offspring…

        Overall, I remain unconvinced that there is any ‘there’ there.

      • Lumen

        Thanks, this is interesting. I think the problem is that once again the hype for the solutions is ahead of the evidence. It seems there is an effect to look at. Micro biome is an idea to look at. There are probably other factors to investigate as well. But of course the probiotics and microbiomes are hot and cool right now so popular news media, the public etc jumping on the hype train.

  • Amy M

    If the baby’s gut can be colonized by vaginal secretions in its mouth, then it can be colonized by microbes on anything that goes in its mouth. If the baby nurses, it will be exposed to whatever is on mom’s skin. I’m sure that bottles and pacifiers, no matter how clean, end up transferring at least a little bacteria to baby. Lots of babies suck on a parent’s finger. And when baby is old enough to put things in his mouth on his own, he’ll eat the dog food off the floor and get exposed to all sorts of microbes. I don’t understand the fixation on vaginal secretions at the time of birth. Even if the “ideal” gut microbiome is found in vaginally born babies at birth, it will change over time, so who cares what it is on the first day or so of life? This just seems like a ridiculous thing to get all in a twist over.

  • Mad Hatter

    And if the mom has GBS? I had several doses of IV antibiotic during my labor/delivery for that. Why not just make a probiotic supplement for newborns? Something that could be clean, safe, and regulated. Vaginal seeding just makes me want to puke!

    • AirPlant

      Are you insinuating that science can do something better than a vagina? Obviously you are anti-woman and anti holistic health.
      /sarcasm

      • Mad Hatter

        Obviously, I don’t trust my vagina enough!

        • AirPlant

          That just hurts my heart. Have you tried therapy?

          • Mad Hatter

            I’m trying to schedule some private therapy sessions with Dr Mercola… will that help your head?

          • AirPlant

            I scheduled mine with Dr. McSteamy. My vagina can’t thank me enough.

          • Roadstergal
          • AirPlant

            Once a year whether it needs it or not….

          • Charybdis

            Gives a new meaning to “time to get the carpets cleaned”!

          • Roadstergal

            Or polish the hardwood floors…

          • BeatriceC

            I’m really rather fond of therapy sessions with MrC. I will just keep with the current program.

          • AirPlant

            Oh, those sessions are not for my benefit, they are for Mr. Plant. He was born via C-Section and it is important that I do everything I can to fix him after that tragedy.

          • BeatriceC

            There’s a joke in here about vaginal secretions and mouths. I can’t quite figure out how to phrase it without crossing a line.

          • AirPlant

            On the bright side, I think we all have a fun new euphemism to use and enjoy?

          • Roadstergal

            I will happily vaginally seed anyone who is a: over 18 and b: hot.

          • SarahSD

            There it is!

          • BeatriceC

            To help your head with this type of therapy one might be required to use one’s mouth instead of one’s vagina.

    • guest

      Not that I would have done seeding anyone, but I was GBS+ and had the antibiotics, and my preemies were then dosed with antibiotics in the NICU as a preventative measure, so microbe colonization wasn’t going to happen just then anyway. And there are all the NCB types advising against prophylactic antibiotics for preemies. They believe all this “harm” is done by antibiotics, and that you definitely shouldn’t give them when you’re not actually sick. But preemies are so fragile any infection is incredibly dangerous!

      The kids are three now. They don’t appear to have suffered in any way from a lack of vaginal seeding.

      • MaineJen

        But NCB types don’t believe in preventative anything…they would rather rescue a disaster after it happens than prevent one.

        • guest

          After is too late for a premature baby. And for a lot of term babies, really.

        • seekingbalance

          right. you can’t get “credit” for stuff you prevent, because it’s typically pretty much invisible (not referring to research methods to draw it out–just in terms of observable day-to-dayness). so it’s harder to feed one’s self-congratulatory heroism with prevention than with rescue.

    • Madtowngirl

      Maybe next we’ll have vaginal fluid donors.

      • Who?

        You do know, don’t you, that now you have said that it will turn out to be already happening.

        Grossy, gross, gross, gross.

  • SarahSD

    I feel conflicted about this. I would want to balance the statistical risks of infection from seeding (which should be similar to the risks of infection from low-risk vaginal birth, right?) with the risks of high-risk vaginal birth, IE, refusing a recommended C-section for things like breech, twins, low fluid etc – all the things we read about NCB people claiming are variations of normal. If the option of vaginal seeding makes high-risk women feel better about choosing a C-section, wouldn’t that be preferable? Particularly if women undergo the same testing (STDs, GBS, etc) that they would for a planned vaginal birth, and seeding suggested as an option or not based on that?

    This is not something I would choose to do unless there was actual evidence that it DID help, not simply speculation. But I’m wondering given the culture, whether this could actually be a compromise to get C-sections to people who would otherwise refuse them.

    • Roadstergal

      I see where you’re coming from, but I don’t think it’s the job of medical professionals to stretch the truth to make people feel good. It sets a bad precedent that could go wrong in any number of ways.

      I mean, as one example of how this could go, what if women start soliciting vagina juice from their ‘healthier’ friends to give their baby the ‘best start’? Or what about woman who are perfectly happy with their C-sections, but get pressured into doing this because medical professionals supported it for other women?

      • SarahSD

        There is already precedent for things like this, though. Think about birthing tubs in hospitals, skin to skin after birth, and delayed cord clamping. Most are things that make the parent feel better but have limited evidence supporting their benefits. Medicine operates in a cultural matrix. Doctors do and say all kinds of weird things to get patients to make safe choices and/or keep clients happy. I’m not saying this is right, but that it is the way it is. And, given that 1. we don’t know whether vaginal seeding has benefits – which it might, and 2. the risks of vaginal seeding, if proper testing is done, are probably low, I would not be surprised if doctors began to offer this as an option for exactly the reason listed above.

        • CSN0116

          Like giving a tantruming 2-year-old a lollipop.

          • SarahSD

            I was thinking more like an olive branch (a gross, bacteria-soaked one, but nonetheless something that signals a willingness to compromise.)
            Also if giving the two year old the lollipop stops them from running out into traffic, then that might be an ok calculation to make. That’s all I’m saying.

          • momofone

            I don’t know; compromise implies that there is merit to both perspectives.

          • SarahSD

            Jury’s out. Even the authors of the article admit this when they say that there is “not (yet)” evidence that vaginal seeding is beneficial to the infant. There is research being done, and I don’t think it’s a pointless question.

          • momofone

            I don’t think it’s a pointless question either, but I’m uncomfortable with the idea that it becomes the OB’s job to coax a reluctant patient into a c-section if there are clear indications that it’s necessary or advisable. I understand that c-section is not necessarily many people’s first choice (it wasn’t mine either), but if a c-section is medically indicated, the OB can communicate that without offering some inducement other than the medical situation (that is way too wordy, I know). I know I’m biased; I don’t want to be mollified by my doctor, I want solid recommendations and reasoning (if there’s time), and then I can decide. I don’t need the lollipop.

          • SarahSD

            Me neither. But I’m not thinking about me (or not me now, at any rate). I’m thinking about my many peers who would do anything to avoid a c-section, who might feel like their concerns were being heard if a doctor indicated, by being open to something like this, that the medical establishment takes some of my concerns (“will my baby be at a disadvantage because of this c-section?”) seriously. Obviously, a long-term solution would be changing the culture, not demonizing c-sections and not supporting a “natural is best in every situation” agenda. But I don’t think it’s useless to bring up in situations where it might improve an otherwise adversarial doctor-patient relationship.

          • Roadstergal

            The answer to the concern “I’m afraid my baby will have chronic health conditions if I have a C-section” should be “There is no good evidence of any sort of causal relationship, whereas you are risking some acutely bad outcomes by refusing a C-section. You are free to refuse a C-section, but I am giving you my best advice as a medical professional for the health of you and your baby.”

            I just can’t see lying about reality to be a good thing even to the individual patient. Again, that way lies lay midwifery and BFHI.

          • momofone

            I had hoped to avoid c-section, but I would have fired my OB on the spot if he had remotely suggested rubbing my vaginal secretions on my baby.

          • Rachele Willoughby

            The first time I heard about vaginal seeding I spent an hour sobbing because I was so afraid that the OR staff had done it to my daughter without my knowledge. Admittedly, I was pretty newly postpartum and touchy but still…

          • SarahSD

            “Research is being done that looks into whether vaginal seeding can restore the newborn microbiome but there is no significant evidence for its benefits yet. It has some risks, which are similar to the risks of infection from a vaginal birth. If it makes you feel better and you’re healthy, having a c-section and then swabbing your baby with your vaginal fluids is an option that is less risky than refusing the c-section” ^ this is not lying about reality.

          • Roadstergal

            That presupposes that C-sections have a negative effect on the microbiome to start with, which is a hypothesis that lacks data. That’s where the conversation should be.

        • Roadstergal

          “birthing tubs in hospitals”

          Tubs during labor are for the comfort of women who desire them; tubs during delivery have real risks and are contraindicated by ACOG

          “skin to skin after birth, and delayed cord clamping”

          Those are under debate because they have wiffly benefits and real risks.

          Again, I don’t think we should compromise science to make women feel better about a C-section they only feel bad about because of misinformation in the first place. The job of a medical professional is not to make women feel good, it’s to give them real information on which to make informed decisions.

          Giving women incorrect or wiffly information to make them feel good is what bad midwives do. It’s patronizing, it’s unfair to women.

          • SarahSD

            I agree that giving incorrect information is wrong and patronizing and prevents informed decisions. I think where we disagree is when it comes to “wiffly” evidence and/or grey areas. I don’t have a problem with a medical professional discussing, recommending, or supporting a patient in choosing to do things for which the evidence is unclear or limited, that they see as possibly useless but probably mostly harmless, but which, in allowing, discussing, seeming open to, they improve their relationship with a patient.

            But, they should be clear about their assessment of the evidence.

          • Mattie

            OT: With the birthing tubs in hospitals, we have them in the UK and women can use them during labour and birth. How does it work in the US if the woman is in there and does not want to get out to give birth? Does she stand for the birth, or is she not allowed in after a certain point in labour? Just curious 🙂

          • Megan

            AFAIK, you are allowed to labor there but not deliver there. They will lift you out if you need help.

          • Mattie

            Ok cool 🙂 I was just wondering if the woman got in and refused to get out lol we had some ladies who got in the pool and then refused to move for VEs or fetal heart rate monitoring. It was tricky to say the least.

          • guest

            I think they ask you to get out during transition. My hospital settled the issue by not fixing theirs after they spring a leak. “Oh yes, we have birthing tubs, but sorry, they’ve been out of order for five years.”

          • Lindsay

            What’s the danger in delayed cord clamping? I’m not doubting; I’m uninformed. I discussed delayed cord clamping with my doctor, and she didn’t advise against it.

          • Roadstergal

            I’m not an OB, but some OBs here have said that it increases the risk of jaundice for term infants.

      • demodocus

        Considering my various poor health choices/issues/lack of moral fiber, i’m probably better off soliciting thinner, more well off friends for seeding the spawn.
        Blech.

        • AirPlant

          Hey, long time no see. I noticed that you have clear skin, a fast metabolism, and no allergies. Would it be possible to get some of your vaginal secretions to rub on my child?

          • demodocus

            eww

    • guest

      But seeding is something they can do themselves, so there shouldn’t be any reason for them to refuse c-sections based on inability to seed. You can’t stop it from happening unless you lock the baby away from its parents – it’s so fast and easy to do. I don’t think this will be a major risk of discouraging seeding.

    • Amy Tuteur, MD

      The people who recommend this are the people who make women feel bad about C-sections in the first place. The best thing to do would be to stop demonizing C-sections.

      • SarahSD

        Agreed. I’m just imagining myself in the position of a woman being told she should have a C-section she is already convinced she doesn’t want. If my doctor was like “hey, if you were considering vaginal seeding, we should doublecheck the results of these tests…” I might feel like it was an olive branch – (A gross, bacteria-soaked olive branch.)

        • Amy Tuteur, MD

          It all of a piece. It’s like Big Pharma marketing a drug that you don’t need or might actually be harmful. We should address the lack of evidence for the drug and the risk of the harms, not try to figure out compromises so that people could buy the drug.

  • BeatriceC

    I was talking to MrC the last time this topic came up, when we were discussing the (poorly done) study on “restoring” the microbiome in c-section babies. I wondered aloud if this was another case of nature only being good enough and not perfect, and that exposure to vaginal secretions was really just an acceptable risk in order to perpetuate the species.

    • Amazed

      Nature is only good enough and not perfect with mechanium (or whatever a midwife, GmaGardner, wrote instead of meconium in ancient times before you found us). She lets babies inhale it and die. Why would it be different with vaginal secretions, I wonder?

  • Roadstergal

    We are living in a world where women refuse to vaccinate their kids, but intentionally rub vagina juice all over them.

    • CSN0116

      Really puts shit into perspective, doesn’t it?

      • Roadstergal

        How long before women are selling vaginal gauze over Craigslist, a la breast milk? Or sending it to friends in ziplock bags, a la chicken pox suckers?

        • Amy M

          How would they know who has the best microbiome though? 🙂

          • Roadstergal

            “I have allergies, but my friend Linda doesn’t…”

          • AirPlant

            the WHO recommends in this order:
            1. The mother’s own vagina juice, straight from her vagina
            2. The mother’s own vagina juice on a swab
            3. Donor vagina juice
            4. Not loving your child.

          • Roadstergal

            Oh lord. This is definitely going to be a Thing.

          • AirPlant

            Oh for sure. The best thing to do is get the popcorn and wait for the new terminology to take hold. I personally am still snorting at the phrase “creamy hind milk”

          • Mad Hatter

            #4 should be donor colostrum fortified with vagina juice.
            Someone should start marketing that!

          • It’s easy. Everyone knows that mamas who babywear (with the right carrier), cloth diaper (with the right diapers), make their own toiletries and cleaning products with essential oils, and treat all illnesses with breast-milk-and-kale smoothies have the best, most nurturing, warrior-mama vaginal secretions. It’s a well-known fact that strollers and jarred baby food are terrible for the mama’s microbiome.

          • Kelly

            I am laughing so hard at this conversation that my 16 year old almost deaf dog keeps looking at me strangely.

        • AirPlant

          I really want to be a fly on the wall for the conversation in which one woman gives another her vadge juices in a ziplock.

        • Charybdis

          My brain has conjured up an image of one of those old-fashioned citrus juicers…you know the ones that look like a little dish with a mountain of sorts in the middle where you smash the orange half down on the mountain then proceed to twist away to your heart’s content, fully extracting the juice from the pulp.

          Yeah, one of those, but on a larger scale, like some sort of S&M bidet. You squat on the mountain thing in the middle when it is covered with gauze, flannel, chamois, whatever cover trips your trigger. Maybe it has a warming, vibrating “massage” function to….ahem…encourage vaginal secretions which will be collected and saved lovingly until the birth. At the onset of labor, the mother would extract the saved secretions from the absorbent material and soak a receiving blanket in the secretions. This would then be used at the hospital to wrap the newborn in or lay over the baby when the mom is being forced into skin-to-skin, killing two birds with one stone, as it were.

          I see a market opportunity here somewhere…

  • CSN0116

    So today I learned what vaginal seeding is.

    Yeah.

    I’m calling it quits for today…

    • FrequentFlyer

      When I read the title I thought of cloud seedling. Are we supposed to put something in our vaginas to make them rain? Then I read the post and saw that no, they are not seeding the vaginas, but what they are doing makes just about as much sense.

    • DelphiniumFalcon

      It was not what I expected.

      There is not enough even for me to can’t…

      Edit: It would it be can’t for me to even? Either way!

    • Zornorph

      Every time I have had sex without a condom, I have ‘seeded’ a vagina.

  • AirPlant

    Well shit, now what am I going to do with all this vagina gauze?

    • Roadstergal

      Sell it on Craigslist.

      • Megan
        • Megan

          (That was a joke, btw. Not a real link)

          • Roadstergal

            I wasn’t about to click on it to find out. 😀

            Good on you for putting your stake down, though. That domain will be worth good money shortly.