Let Them Eat Dirt. B. Brett Finlay

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СКАЧАТЬ and they could look above the vegetation by standing upright. However, this advantage came with the anatomical price of narrower hips in order to achieve better balance and support the body’s weight on two legs. Another aspect that makes humans unique is the large size of our brains. Thanks to our developed brains, humans can do math, build skyscrapers, and read books. Big brains (and, consequently, big heads) plus narrow hips? Any human can do this math: this causes the level five painful contractions Elsa was feeling and the medical need for C-sections.

      C-sections are a medical miracle in terms of their ability to save the lives of so many mothers and babies. Try to imagine how much scarier Elsa’s birth would have been had a C-section not been an option. Elijah’s umbilical cord had twisted, preventing him from getting enough oxygen and blood flow. Elijah could have suffered a serious brain injury or even died from asphyxia if a trained doctor hadn’t been able to pull him out surgically. A hundred years ago, dying during birth was a lot more common for both mothers and babies and modern C-sections played a pivotal role in changing this.

      The history of when and where the first C-sections took place is a bit murky, but there are accounts of C-sections dating as far back as Ancient Greece. It is commonly believed that the name of this surgical procedure originates from the birth of the Roman emperor Julius Caesar. Regardless of whether this is true or not, Roman law decreed that all dying or dead birthing mothers had to be cut open in an attempt to save the child. Unfortunately, mothers rarely survived these early medical procedures and they were performed only as a last resort. Once anesthetic and antiseptic practices became the norm, C-sections became a much safer procedure and were used to save many lives. At the beginning of the twentieth century, for every 1,000 births, 9 women and 70 babies would die during childbirth, compared to 0.1 women and 7.2 babies today. That’s more than a 90 percent reduction in mortality, a true triumph for modern medicine.

      Still, for many decades C-sections were performed only when it was medically necessary: if the lives or health of the mother and/or the baby were at risk. However, towards the last quarter of the twentieth century, C-section rates skyrocketed. In 1970 the C-section rate was 5 percent in the US, rising to almost 25 percent by 1990 and to 33 percent in 2013. It has gone from a rate of 1 in 20 babies to 1 in 3 babies in the span of forty years. Canada’s C-section rate is slightly lower at 27 percent, but it has still experienced a 45 percent increase since 1998.

      Unlike the initial decrease in mother and infant mortality, the surge in C-section rates experienced in the past thirty-five years did not bring an improvement in mortality or morbidity (disease) rates. On the contrary, a C-section performed without a medical indication, also known as an elective C-section, is riskier than a vaginal birth. A C-section is a major surgical procedure that poses an increased risk of blood loss and infection for the mother. Also, any mother that has birthed via C-section can attest that healing takes much longer than a vaginal birth, not to mention the limited mobility of the new mother, who must let the incision to her abdomen heal; it’s harder to hold the baby, to get up to change diapers (wait—maybe this is a plus), and sometimes even to breastfeed. Since 1985, the World Health Organization (WHO) has determined that the ideal rate for C-sections should be between 10–15 percent. Newer studies show that the number is likely closer to 10 percent. When C-sections rates approach 10 percent in a population, mortality surrounding birth decreases. But when the rates rise above 10 percent, mortality does not improve.

      There are many explanations for this unnecessary but widespread increase in C-sections, and discussing them and their complexities are probably the subject for an entirely separate book. Suffice it to say, C-section rates are still increasing, and they are becoming epidemic and an emerging global health issue. Many experts disagree with this view and support the current rate of C-sections, because even if they are riskier than natural births, they are still very safe procedures. Modern obstetricians are extremely skilled in this surgery, and most complications that result from it, which are rare, can be treated with good outcomes in a hospital setting. There are maternal advantages associated with an elective C-section as well, including a reduction in urinary incontinence (loss of bladder control), avoidance of labor pain, reduction of fear and anxiety related to labor, and the overall convenience of planning the timing of birth. To some, the idea of a planned, painless birth is a dream come true.

      On the baby front, C-section supporters claim that the health complications for babies born by elective C-section are rare and usually treatable. Babies born via C-section do look a bit different than babies born through the vaginal canal (their heads don’t get squished), but after a few days they all look the same. However, while C-section advocates may be correct that severe birth complications, such as a stillbirth, are very rare in elective C-sections, we are now learning that there are significant health concerns associated with C-sections, including an increased risk of chronic disorders later in life, such as asthma, allergies, obesity, autism, IBD, and celiac disease. The elevated rates of these issues associated with C-sections hover around 20 percent for most of them. This is tremendously worrisome, considering that many countries have a C-section rate well above what the WHO recommends. Approximately 6.2 million unnecessary C-sections are performed around the world, with Brazil, China, the United States, Mexico, and Iran accounting for 75 percent of them. Brazil and China have an outright C-section epidemic; many hospitals in those countries deliver more than 85 percent of their babies surgically. The situation in Brazil has reached critical levels, as many women there have to give birth by C-section without the medical need for it, simply because of the shortage of hospital beds allotted for vaginal deliveries (see Brazilians Love C-sections, page 69).

      The good news (kind of) is that it isn’t the procedure itself that causes these disorders. Rather, it’s something extremely important that does not occur during the few minutes it takes for a doctor to surgically remove a baby from the womb: the baby does not come in contact with his mother’s microbe-rich vagina and feces.

A Dirty Birth Is a Good Birth

      A baby’s very first encounter with microbes most likely happens when his head comes out through his mother’s vagina. As previously mentioned, the vagina contains an extremely high number of microbes, so the seconds (or minutes) it takes for a child to exit the birth canal are enough to impregnate a newborn’s mouth, nose, eyes, and skin with many of them. It’s also very common for women to defecate during birth, especially during the pushing stage. Babies usually exit the birth canal with their mouths facing their mom’s anus, and it is now proposed that this position allows for additional exposure to maternal fecal microbes.

      It makes total sense. The world is full of microbes, and all babies are going to get soaked with them immediately after birth, regardless of how they are born. Why not make sure that a baby gets coated in the microbes from which she will benefit most? Nature sees to it that the type of microbes first encountered by babies born vaginally are the ones that are going to aid in the digestion of milk, as well as contribute to the development of a baby’s immature immune system, and even protect them against infections. Vaginal secretions are packed with Lactobacillus, whereas another milk-digesting bacteria known as Bifidobacterium come from feces. You’ve probably heard these two types of bacteria mentioned in yogurt advertisements. It’s no coincidence that these bacteria are used in the dairy industry, as they’re experts at digesting or fermenting milk and are also associated with health benefits. Unknowingly, every mother seeds her baby with a special custom package of microbes that will best suit her baby’s needs. Babies instinctively seek their mother’s breast shortly after birth, and breast milk is exactly what these microbes need to flourish in the baby’s gut. This wonderful synchrony of biological events is a fine lesson in how nature works.

      However, not every birth ensures the passage of beneficial microbes to newborns. As discussed in chapter 3, if the vaginal microbiota is unbalanced (low amounts of Lactobacilli in vaginal secretions), or if a woman has tested positive for Group B streptococcus (GBS), a baby will not get the same kind of microbial bath from her mom. Given how important it is to receive those beneficial microbes at birth, it’s critical that women pay special СКАЧАТЬ