What Is Vaginal Seeding — And Does It Work?

The growing trend among new mothers has sparked a big debate in the medical community.

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Rubbing bacteria all over your precious newborn is probably the last thing you'd consider adding to your birth plan. But that's exactly what many new mothers are doing, according to a February 2016 editorial published in the British Medical Journal (BMJ).

It's called "vaginal seeding:" Before a cesarean section, gauze is inserted into the expecting mother's vagina to soak up vaginal secretions, much like a tampon. The saturated gauze is then removed and kept in a sterile location while the C-section is performed.

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Once the baby is delivered, the gauze is used to swab the newborn's mouth, eyes, face, and skin, which is supposed to mimic the baby's exposure to the mother's good bacteria that would occur during a natural birth. Because the process is relatively simple, many patients perform it on their own without help from a medical team.

According to the Centers for Disease Control and Prevention, almost 33 percent of all births in the United States are performed by C-section each year. That's more than twice the ideal rate for C-sections performed in a population, according to the World Health Organization (WHO).

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"Caesarean sections should ideally only be undertaken when medically necessary," the WHO concluded in an April 2015 report.

Our penchant for surgical birth could have lifelong ramifications for our children. In a February 2015 review published in Trends in Molecular Medicine, researchers found that children born via C-section were at higher risk of developing autoimmune diseases, asthma, allergies, and obesity than their vaginally born peers — findings that have led many to believe the trip down the birth canal is vital for setting baby up for a healthy life. So, where a vaginal birth is not an option, parents have started to get creative.

Bess McCrary, a New Jersey mom, decided to try vaginal seeding at the suggestion of her doula when her November 2015 induction failed to bring on labor and she needed a C-section. "We were trying to compensate for any lost benefits of a vaginal birth for the baby," she says.

McCrary remembers the hospital's nursing staff was less than supportive of her decision: "They proceeded to yell at me as I went into the bathroom to extract the gauze from my vagina."

Vaginal seeding is a controversial topic in the medical community, and while most medical professionals wouldn't yell at a patient like in McCrary's case, there certainly isn't universal support for the procedure. Victor González-Quintero, MD, MPH, specialist in maternal fetal medicine at Miami's Associates in Advanced Maternal Fetal Medicine is adamant that he would not recommend the process to patients until more research is done into its effectiveness.

"The fact that newborns may face better outcomes after vaginal delivery may not have anything to do with [exposure to vaginal bacteria] itself, there's just not enough data," he says. "More importantly, it could put babies at risk. We could be exposing newborns to infections if a mother is asymptomatic or we've failed to identify infections like Group B streptococcus, herpes, chlamydia, or gonorrhea during standard prenatal testing."

The authors of the BMJ editorial note that there isn't enough clinical research yet — they could find only one relevant study — to prove vaginal seeding provides any health benefits to newborns. Until there is more solid evidence, they write, health professionals should not perform vaginal seeding and should inform patients of the potential risks as well as provide other, more scientifically sound options that may improve the baby's microbiome.

"Encouraging breast feeding and avoiding unnecessary antibiotics may be much more important than worrying about transferring vaginal fluid on a swab," the authors conclude.

Still, there are doctors who support patients interested in seeding their cesarean-born babies. Eden G. Fromberg, DO, FACOOG, ABIHM, of Holistic Gynecology New York says that seeding is something she discusses in detail with her patients who are facing surgical birth.

"Given that acquisition of the microbiome during a cesarean delivery has been shown to involve microbial transfer from the skin cells of the operating room personnel rather than from the mother's vagina, and given that the baby's immune system is oriented for a lifetime by this earliest exposure, there are tremendous potential benefits to using this vaginal seeding technique for cesarean-born babies," she says.

What Drs. González-Quintero and Fromberg do agree on is the fact that expectant parents shouldn't make this decision without consulting their doctors first. While the majority of women fall into the it-certainly-can't-hurt camp, there are cases where choosing to share vaginal bacteria with a newborn could have unfortunate and serious repercussions. If seeding is on your birth plan, make sure your doctor knows about your decision so you can be tested for transferable infections accordingly.

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