Do we need to rethink C-sections and vaginal seeding?

The goal of most mothers is to deliver a happy, healthy baby on or close to her due date. For about two-thirds of women in the United States, this happens via a vaginal delivery. But for the 25 to 30 percent of moms who deliver by Cesarean section, they are often left wondering if a surgical birth may lead to health issues for their newborn baby.

It’s not hard to see why these moms feel this way: from using words like “natural” childbirth for vaginal deliveries and thus making C-sections seem unnatural and inferior, to recent studies showing that perhaps babies born by C-section are more likely to have certain health issues as adults, it quickly becomes obvious why having a baby surgically may riddle a mom with feelings of guilt, failure, and worry.

One of the biggest trends the media has picked up on recently is the concept of vaginal seeding. This is the practice of placing a gauze in a mother’s vagina and then swabbing her newborn baby who was delivered by C-section and thus did not pass through the birth canal. This is supposed to help expose baby to all the good bacteria his or her mother was carrying.

This is based on the concept that the process of passing through the birth canal helps a baby to pick up Mom’s bacteria, which helps to literally “seed” the baby’s own gastrointestinal tract with beneficial bacteria that can eventually help with things like digestion, nutrient production, and avoidance of allergies and other diseases.

Why are new parents even thinking about this? Well, we do know that babies born via C-section are more likely to have certain issues into adulthood. This includes higher rates of asthma, food allergies, obesity, and metabolic syndrome, the last two of which can lead to type 2 diabetes. Of course, these are all things no parent wants for his or her new bundle of joy, so what parent wouldn’t be interested in hearing about a practice that says it may be able to decrease these risks?

If vaginal seeding claims to make a C-section seem more like a vaginal birth to a baby, then why has the American College of Obstetricians and Gynecologists put the brakes on and asked women to not do this? In short, it’s because the idea is very new and has only been tested in a very small number of babies—in fact, the most publicized study that promoted vaginal seeding only included 11 babies! And there’s a real risk of transferring harmful bacteria that can make a newborn baby severely ill.

Additionally, we have no long-term data on whether or not these effects even last. A recent study has actually shown there is no difference seen in the type of gut bacteria that grow in babies born either vaginally or by Cesarean as they get older.

This last study that called vaginal seeding into question also put forth another important idea: that it is not the C-section itself that leads to these medical problems for these babies, but rather it’s whatever made the mom need the C-section in the first place. For example, was the mom obese and suffering from hypertension, which altered the mom’s own gut bacteria, which led to a C-section, and it was the mom’s different bacteria that colonized the baby’s gut in utero…and it had nothing to do with the fact that the baby never went through the birth canal?

It may sound complicated, but it is important for us to understand the science behind it before we jump on the vaginal seeding bandwagon.

So does this mean that maybe C-sections aren’t all that bad? Possibly, from the standpoint of the baby who experiences it. However, we know that still, for the most part, a vaginal delivery is far less risky for all involved and should be preferred when possible—keeping the focus on when it is possible, but not at all costs.

For the moms who give birth by C-section, though, they should try to take the issue of whether or not they harmed their baby by not exposing them to their vaginal microbiome off the table, at least until we know more. It can be hard to have a birth plan go off track, and for a woman who is mourning the loss of her ideal vaginal delivery, she does not need another (potentially unscientific) issue to worry about.