Vaginal Seeding: What is it and Why it matters

For a variety of reasons, 29% of pregnant Albertans will give birth via Cesarean section. While this number is unfortunately much higher than the World Health Organization’s recommendation of 10-15%, it’s important that we as a birthing community support those who require a c-section to safely birth their baby. At the end of the day, there will always be cases of individuals who require this medical intervention to preserve both them and their child’s health and safety.

How Birth Effects the Infant Gut Microbiome

One of the biggest concerns for those who give birth via cesarean is that it will impact the development of their infant’s gut microbiome. During a vaginal delivery, as the infant makes their way through the birth canal they are exposed to a large number of healthy bacteria that will assist in the development of the uniquely vast and important bodily system known as the gut microbiome. The gut microbiome is responsible for a number of important bodily functions including immune and metabolic function. According to evidence, there are many chronic inflammatory conditions that are present in infants who were born via c-section and it is thought that these conditions are microbiome-mediated - meaning a reduction in the proper development of the microbiome could have caused such conditions. There have been tests done on infant feces from both of those born vaginally and surgically, and these tests show a variety of positive bacterial cultures in the vaginally-born infants and very little variety (including some negative bacteria) in those born via belly birth. So how do we help those babies who had to come earth-side via c-section? This is where Vaginal Seeding comes in!

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What is Vaginal Seeding and How Do You Do It?

Vaginal Seeding is a practice that refers to using a piece of gauze that has sat in the vagina and soaked up vaginal secretions to “seed” the baby after they are born. This is done by removing the gauze and wiping the babies eyes, mouth and other extremities as to mimic what the baby would have experienced coming through the vaginal birth canal. While vaginal seeding does require a level of preparation and personal advocacy, there is strong evidence to suggest that this technique can partially restore the microbiome. The procedure itself is also quite simple - the only tools required are a piece of sterile medical gauze and a sterile container to store the gauze before the infant is ready. You’ll insert the gauze into the vagina at least 30-60 minutes before the birth. Once you head in for the procedure you will remove the gauze and place it in the sterile container (a urine sample collector is a great option for this) with a lid to be stored until use. Once you, the parent, have access to the infant you can rub the gauze on the eyes, nose, mouth, ears and hands of your baby. Easy peasy!

    Vaginal Seeding supplies :
​Ask your medical staff or bring your own. 

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What does the evidence say?

Despite this practice going against most hospital guidelines (more on this below), a number of studies suggest that vaginal seeding alters the infants microbiome to more closely resemble that of an infant born vaginally. Of course there needs to be more randomized placebo- controlled trials to fully demonstrate said benefits. Fun fact, there are currently 2 US-based studies on this currently taking place and one more worldwide!
What the previous meta-analysis and large observational studies have shown is that babies born via cesrean who were seeded with the process listed above had an increase in Bacteroides and Bifidobacterium spp. in their gut which are important strains of bacteria for priming the microbiome. Lacking the former bacteria strain in a microbiome has been associated with a microbial imbalance that could lead to being overweight later on in childhood. While some studies were done by administering a diluted form of these bacteria orally to the infant, these studies did not have the same beneficial impact as the studies where the infant was seeded with the gauze method.

Controversy around Vaginal Seeding

Like many other physiological practices that birth-givers seek out in a hospital setting, many who work in the health care field and even many health care institutions frown upon or forbid this practice under their care. There are a variety of reasons behind this resistance. The biggest one is the fear that these vaginal secretions could also contain harmful infections such as Group B Streptococcus, HIV, herpes simplex virus (HSV), and human papillomavirus, and therefore seeding the infant could increase the chance of the infant being exposed to this. Many people undergo planned c-sections due to a known infection and therefore seeding would increase the infection risk. However, it is important to note that of all of the controlled studies currently done on vaginal seeding, there has never been a reported transmission of infection. Another issue brought up by skeptics is that infants receive their first exposure to maternal microbiome in the womb, so seeding is unnecessary. It is important to note that this claim has also been studied, and in the most recent studies no resident microbiota were present in the placenta of a term pregnancy before birth.

​Wrapping Up: Should You Try Vaginal Seeding?

As a birth doula and childbirth educator, my role is not to push you in the direction of any procedure and rather encourage you to make the decision that is right for you. However, as evidence suggests, the risks of vaginal seeding are low and the benefits are massive. Consideration must also be put into whether your current care provider or birthing institution would support this practice, and how comfortable you are with advocating for yourself and negotiating this practice to occur. I encourage anyone who is considering vaginal seeding to read the linked resources below and be mindful of claims made of the dangers of this practice without coinciding, high-quality evidence to back this claim. At the end of the day, your infant deserves to be exposed to your unique microbiome to ensure the proper development of this important function of the gut. Be sure to use BRAIN to effectively weigh the pros and cons to this practice and be sure you are making the right decision for you!

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237654/https://birth-ed.co.uk/blog-1/2022/4/8/vaginal-seeding-what-is-it-and-how-do-you-do-it

For more information : 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464665/
https://med.stanford.edu/news/all-news/2022/06/infant-gut-microbiome-breast-milk.html
https://www.webmd.com/parenting/features/baby-microbiome
​https://microbirth.com/