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  • Does the way women give birth have long-term ramifications?

    Author: Karen Keast

Australian midwifery researchers are part of an international collaboration investigating whether the way women give birth has a long-term impact on babies and their future offspring.

With the nation’s high intervention rates during labour, Western Sydney University midwifery professors Hannah Dahlen and Maralyn Foureur have joined professors Soo Downe, of the University of Central Lancashire, and Holly Powell Kennedy, of Yale University, to put childbirth practices under the microscope.

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The researchers founded the international EPIIC (EPIgenetic Impact of Childbirth) research group and developed a hypothesis which focuses on the epigenetic effects of labour and birth, or intrapartum period, on health and epigenetic remodelling.

The researchers propose the use of synthetic oxytocin, antibiotics and caesarean section could affect a critical formative phase for the human genome.

In a paper, Is society being reshaped on a microbiological and epigenetic level by the way women give birth?, published in the December 2014 edition of Midwifery, the researchers say it’s a “profoundly disturbing question that warrants urgent research”.

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“Those who might argue for increased intervention during labour and birth in the name of safety might also pause to consider that the preservation of physiological birth as far as possible might be the passport for the lifelong health and well-being of not only an infant, but also for its future offspring,” the paper states.

“The day of birth may turn out to be one of life’s most defining events.”

Professor Dahlen, a privately practising midwife and spokesperson for the Australian College of Midwives (ACM), says the way babies are born is vital in setting down an ideal microbiome that becomes a defence shield for life.

“When the baby is born through the vagina it goes past and through 300-odd different types of bacteria that are really important for feeding that microbiome, when that baby comes up onto the mother’s chest it then again, as it finds the breast, it’s getting more important bacteria and when it breastfeeds it’s getting a particular component in the breast milk that only the good bacteria can digest.

“The birth and that first few weeks of life, particularly if the breastfeeding is exclusive and they are not having anything else, and they are having that skin to skin and close contact with mum is setting up a defence shield for life.

“More and more evidence is showing that babies born by caesarean section have different bacterial microbial make-up in their gut compared to babies born by vaginal birth.

“This may explain why we see a 25 per cent increase in type 1 diabetes in babies born by caesarean compared to vaginal birth, and asthma and allergies, so that’s one hypothesis that we talk about in this paper.

“The other is the epigentics, which is the emerging research showing that labour and birth are actually priming us genetically for optimal responses and by missing out on that labour and birth, for example with elective caesarean section, that there is a silencing that can go on with some of our genes so the expression of our genes becomes silenced.

“That has implications later on for defence and autoimmune disorders.”

Professor Dahlen said women should not be concerned about a medically justified caesarean section.

“This is not about saying if you have a caesarean your baby is doomed to a life of autoimmune disorders - absolutely not,” she says.

“All statistics are about an increased likelihood, they don’t mean that you’re going to have this disorder.

“What we do know is if you have to have a caesarean section then giving that baby skin to skin and exclusively breastfeeding them can do an awful lot to make up for what they’ve missed in the birth process.”

Professor Dahlen said the investigation should also prompt midwives to re-focus their attention on supporting women to give birth without unnecessary intervention.

“I think midwives have got to realise that midwifery care is the best way to reduce caesarean sections so that’s the preventative action that’s in the hands of midwives,” she says.

“The number two thing is when a caesarean section is needed, midwives are the ones that are in that operating theatre that need to be advocating for the women to have skin to skin and them supporting them with exclusive breastfeeding - so actually, at the end of the day, so much of the solution to this problem is midwifery.

“And so midwives should feel very empowered and strong and proud that the answer to this and many of the potential world’s problems that may come from this is in their hands.

“Unfortunately midwives obviously feel very disempowered and helpless and I think we’ve got to change that mentality around and midwives have got to stand up and say - actually we are important, and they’ve got to start advocating at a much louder, stronger level.

“We have all of this scientific evidence mounting, we need to be taken seriously and the government needs to put resources and promotion behind the profession of midwifery.”

The researchers have applied for funding for their first study and hope to soon begin testing their hypothesis.

The EPIIC research coincides with the recent short film Microbirth, that features Professor Dahlen, and investigates the latest research about the microscopic events that occur during childbirth.

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords