Dominguez-Bello, M.G., De Jesus-Laboy, K.M., Shen, N., Cox, L.M., Amir, A., Gonzalez, A., Bokulich, N.A., Song, S.J., Hoashi, M., Rivera-Vina, J.I., Mendez, K., Knight, R., & Clemente, J.C. (2016). Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer. Nature Medicine 22(3), 250-253. Full study available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062956/
Jen: [00:22] Hello and welcome to the Your Parenting Mojo podcast. Today’s guest, Vanessa Merten wrote to me after she heard my podcast to telling me about her podcast and as soon as I listened to it, I knew we had to work together. Her show is called The Pregnancy Podcast and let me say right now that this is an altruistic episode for you, dear listeners, because I am not pregnant and not planning to get pregnant either, but when I listened to the pregnancy podcast, I realized that Vanessa is essentially doing the same thing that I’m doing in Your Parenting Mojo, but for the stage before the baby is born and just after, which is to say that she looks at a particular issue and examines it from all sides using scientific research as her guide, so while my listeners are probably here because they already have a child, I realize that many of you may be thinking about having another one. Maybe you didn’t have the time to do much research before your first baby or maybe you didn’t know there was research out there that could guide your choices, or maybe you did the research, but it was several years ago now and you’re not sure how things might’ve changed in the intervening years if so, the pregnancy podcast is for you. Welcome Vanessa. I’m so excited to have you on the show.
Vanessa: [01:45] Oh, I am a mom to my son Reef who is two; he’s just a few months younger than your daughter and when I was pregnant I felt like there was so much pressure to do what everybody else was doing and it was like, well, if everybody does things this way then this must be the right way to do things and like you, I’m very research minded and I really believe strongly in making informed decisions. So that mentality pretty much ruled my pregnancy and I just dove into as much research as I could find about everything and it really set me out on a different path than I had started from and made me make some different choices and…
Vanessa: [02:28] Well, I ended up doing a natural birth in a birth center which was different than every other person that I knew at the time. And it’s challenging. I think, you know, some parents that do choose to go that route. You have friends telling you, well that’s awesome, but you’re crazy. There’s absolutely no way I would consider that I’m getting an epidural as soon as I walk in the hospital… Which is completely fine. You know, there’s no, no one size fits all for birth.
Jen: [03:01] Yeah, I remember when I was doing the tour of one of the hospitals, all the mothers there were new mothers and we’re all, you know, natural birth is we’re going to do. And there was one mother who had had a baby before. He was new to the system and she was like, tell me what paperwork I need to sign to get the epidural as soon as I walk in the door and we’re looking at her like, what do you know that we don’t know?
Vanessa: [03:23] Yeah. So the more. But the more research I did on everything, you know, the more confident that I became in the decisions that I was making, even though they happen to be different than everything that my friends and family around me were doing. But it was hard to find good research and evidence that doesn’t have a bias behind it.
Vanessa: [03:45] You know, kind of like, like I think you do with your podcast. I just start out with, if I’m doing a topic on inducing labor, you know, I start off with, let’s go to the very basics like what is inducing labor, what are the different methods available and then go back and look at research for different methods and look at what there is showing evidence that yes, this is a possible thing or what are the possible side effects and just really trying to look at all sides of those issues.
Jen: [04:18] So in the podcast, how do you decide what topics to focus on? Because for some episodes I know you do a q and a format and you have the little short ones at about five minutes. And then you also have full episodes at about 20 minutes. So how, how do you sort of decide which topic you want to put into which type of episode?
Vanessa: [04:42] I love being able to help them get their questions answered and help them find research on questions that they have, but I can’t do 10 episodes a week. I wish I could, you know, there’s so much content out there, but it takes time and, and like your podcast, every episode I have the full episodes…it’s a master class. It’s very research intensive and, and that just takes time. So if it’s a question that applies to probably the majority of expecting moms and there’s a lot of content out there on it that I liked to do a full episode if it’s, you know, a mom has a question about, I have like an abnormality with my placenta and I’m not sure how that’s going to affect my birth. Then if it’s a specific question that maybe won’t apply to everyone, it still gives me an opportunity to answer that question and you know, maybe there’s another mom out there with the same question and that answer can kind of help her out too.
Vanessa: [05:42] Yeah, I do. I’m like, I am a little bit of a podcast junkie. The 40 Weeks, there’s just a five minute episode for each week of pregnancy. And it’s just kind of, you know, what’s going on with you, what’s going on with baby and, and then a tip for Dad at the end of that episode.
Jen: [06:01] Okay. And I should mention to my listeners that if you search The Pregnancy Podcast on iTunes, the 40 weeks prep podcast actually tends to be the first thing to pop up and that is static, is that right? You’ve, you’ve recorded those things and that doesn’t change, whereas you’re adding new episodes to The Pregnancy Podcast, right? Right. Yeah. So, um, so if you, if you search for the pregnancy podcast on itunes and you see that 40 weeks, then by all means go ahead and listen. But if you want to see the stuff that’s updated regularly, you have to just, I think scroll over to the right hand side and you’ll see the pregnancy podcast and it has a similar logo. So that should help you find it. So I think a lot of moms kind of start with the, you know, the typical What to Expect kind of sites and Baby Center because we don’t really know where else to look. Uh, so I’m curious as to what you think about the information that’s posted on those sites and whether you’ve noticed anything being promoted on their sites that maybe goes against some of the scientific research you’ve read?
Vanessa: [06:55] Yeah, I think sites like what to expect when you’re expecting and baby center. They do a good job of providing a lot of information on a lot of topics and, and they explained things in pretty simple terms, which is fine if that’s what you’re looking for, but I don’t think that they do a great job of really painting the complete picture and really diving into the research and evidence behind a lot of things. And I also don’t think they do a great job of really connecting all the pieces. You know, an example of this would be you have, you can read in one section about getting IV fluids during your birth. And that’s something that’s really common and then you know, and another section you’re reading about breastfeeding, well they’re not linking up that there’s a connection between the two and a few get IV fluids during your birth, your baby is going to be retaining some of those fluids, those fluids are going to be lost in the first 24 hours and it’s a possibility that it’s going to look to your care provider, like your baby is losing weight too rapidly and breastfeeding is not going well.
Vanessa: [08:00] And then suddenly they’re saying, you know, well maybe we should consider supplementing with formula and mothers just aren’t getting this information. So I think that that, those type of websites, they’re good for, you know, just a skim-the-surface kind of understanding of a lot of things going on with birth. But I don’t think that they do a great job of really connecting the pieces together well and, and giving parents a good idea of how everything pregnancy birth is really so interconnected and how one thing can affect another.
Jen: [08:34] Yeah. I learned that from your show, that specific piece of information. And, and that would have been very relevant to me. I had a natural birth but had IV fluids and yeah, my daughter lost a lot of weight in the first few days and the lactation consultants were pretty worried and we were struggling with latch as well. So maybe there was a secondary issue there too, but it’s definitely possible that it could have been just that she was losing some of the fluid that she got during the delivery.
Vanessa: [09:01] Yeah. And there’s, there’s been a lot of push to get the medical community to start looking at the 24 hour weight of the baby after birth. And you know, there is research that backs this up, but research, you know, even once it’s done for it to get out, to make changes, especially in the medical community, that does not happen overnight.
Jen: [09:25] I’m, I’m wondering also how often you found the scientific research that you read goes against common wisdom and the people that. The things that people just think are the way it is. What are some findings that have really surprised you?
Vanessa: [09:38] The findings that surprised me most are the ones that really go against what we’ve accepted is just part of kind of routine care. So, you know, we have ultrasounds which are amazing. It’s, it’s great technology; we can use ultrasound to diagnose things that we couldn’t decades ago, but it’s become this routine part of prenatal care and you have a lot of expecting moms getting multiple ultrasounds that aren’t necessarily medically indicated, and there’s quite a bit of research and some animal studies showing that there is potential for some negative effects from the ultrasounds. And I think what surprises me most is that, you know, these aren’t being talked about and they’re not challenging our current way of doing things.
Jen: [10:41] I had a lot of my pregnancy, I had a low lying placenta, so every time I went in and they want to take a look at it, see if things had lengthened out. So yeah, I had no idea that there’s such a thing as too many ultrasounds.
Vanessa: [10:54] Yeah. And, and like I said, you know, there is certain things where it is, it could be medically necessary if you have a low lying placenta, that’s definitely something that your care provider is going to want to keep an eye on. And you know, ultrasounds can be helpful in that. But you also have, I think a lot of expecting moms that every time they go in it’s, you know, well let’s see the baby, and they’re using it to check things like heartbeat that, that you don’t need an ultrasound to do that, you know, there are some other methods.
Vanessa: [11:35] Do and that, you know, for any intervention, a great question is what happens if we don’t do it, and I think, oh, this is going to escape me at the moment, but um, I do talk about kind of a line of questions like, okay, you know, what are all the outcomes if we do this? And then like you’re saying, what are the possible outcomes if we don’t do this? And then another good question to ask is, well, what if we wait, you know, if you’re talking about an induction, what if we wait a week or three days or you know, even when you’re in the middle of labor and they’re talking about doing a specific intervention, well let’s wait an hour. You know, what happens if we wait an hour? So I think those are, those are good questions to ask and maybe not some that, that expecting moms would think of.
Jen: [12:25] Yeah, yeah, for sure. I wouldn’t have thought of what if we wait one either and it, you know, it’s not to say that you always need to wait for a procedure, but it just forces the people around you to think, do we really need to do this thing right? Because it seems as though the conventional way of doing this as to, well, this is the next step to do. We stick the needle in and we burst the amniotic sac and that’s just what we do and nobody ever questions, well, what if we wait or what if we don’t do it? So yeah, we didn’t question those either. So, so for my listeners who already have a child, but you know, maybe you’re you’re pregnant again. And if so, congratulations. I’m curious as to some of the research driven so that you’ve seen that’s been published recently, maybe in the last couple of years, if, if my listeners have a toddler by now and I’m curious as to what has changed since the last time that they were pregnant that they really should keep in mind?
Vanessa: [13:20] One thing that I’m pretty fascinated with right now is just all the research that’s coming out on the gut microbiome and that seems to be just kind of exploding and we’re finding out that your gut health impacts so many other aspects of your overall health and we’re starting to find what kind of impact that’s also having our babies. There was a recent, a very, very small study that looked at how is Caesarian birth affecting the gut microbiome and flora of a newborn baby and what they’re finding is that, you know, a baby born by Cesarean that’s not going through the vaginal canal and picking up all those microbes, the flora in their gut is not as diverse as a baby that was born vaginally and, and they’re starting to look into, you know, what kind of effects can that have on the health of a newborn as they grow older and to childhood.
Vanessa: [14:21] And the more research that’s done on this kind of thing, you know, the more we’re looking at possible solutions for this. And in this one small study, they had actually taken a piece of sterile gauze and put it into the vaginal canal and then after the baby was born, via Caesarian, they just kind of swapped this gauze over the baby’s face and so that it would allow the baby to be colonized with these, these microbes from mom that they would have had had they had a vaginal birth. So, and you know, while this was small, hopefully this will kind of start paving the way for some more studies in this area and, and we can really get a better handle on how gut microbiome of a baby is really going to affect their health as, as they grow older and, and their health as they’re an infant as well.
Vanessa: [15:20] You know, a lot of this is, most of the research that’s been done on gut microbiome stuff hasn’t been focused on newborns. But most of it’s just focused on, you know, we’re looking at adults and how imbalances in the flora in your gut can affect things like inflammation or even serotonin production. And so I, I have not, this is a topic that I have not yet covered on the podcast, but I’m really looking forward to just really digging into this research and looking at where we can draw parallels to, to pregnancy and birth and where that kind of fit into into the pregnancy and birth model.
Jen: [16:08] So I’m curious, it seems like there’s so much research out there and I know that you kind of got into the podcast because you in a way kind of felt overwhelmed by the amount of information that that was out there. And so I’m wondering about how listeners should or can strike a balance between being informed and making informed decisions for yourself about what science says and about just being worried about everything and thinking is, is there some other major topic out there that I should be thinking about that I’m not thinking about? How do you personally strike that balance and how do you recommend others strike that balance?
Vanessa: [16:43] Yeah, that’s a tough thing. It’s so easy to get into information overload with all of the information that’s out there and you know, pregnancy is scary. There’s a lot of things that can happen, a lot of complications that can come up and there is going to be some things that are just out of your control. But I think that so much of the fear that comes and pregnancy is really fear of the unknown. So I think that the more you really learn and start educating yourself, the more competence that you build that you have a good idea of what’s going on and what to expect and what you want. And I think that that takes a lot of the worry away when you are informed about things and can make informed decisions.
Vanessa: [17:36] I would say if you don’t know what your options are, then you don’t have any. And you always have options, you know, even if your doctor’s recommending something, you have options because your midwife says, hey, you know, today we’re going to do this. That doesn’t mean that you don’t have options about it, so, but you know, you have to know what those options are to know what decisions you’re going to want to make.
Jen: [18:08] And even if you’re not sure what those options are, it seems as though there’s questions that you raised earlier, you know, what happens if we don’t do this and what happens if we wait. Um, even, even if you don’t know what the other options are that, that seems as though it could help your medical providers…make them explain to you what are some of your other options that maybe they wouldn’t have considered explaining to you otherwise.
Vanessa: [18:29] Such a huge advocate of asking questions. You know, I think oftentimes expecting parents are intimidated to ask questions from a doctor, you know, and, in the Western world doctors are kind of this authority figure and you really need to be your own advocate and you should never ever be intimidated or afraid or embarrassed to ask any question that you have.
Jen: [18:52] Mmm. So what will you do differently if, if, if you get pregnant again when you get pregnant again, I’m not sure which it is, but now that you know, so much more than you did the last time around, what will you do differently?
Vanessa: [19:04] If I were to get pregnant again, I would get a doula that was something that I knew about when I was pregnant, but I didn’t… I guess I didn’t really see the importance of that. And there’s, there’s been some interesting research showing that doulas actually decrease the risk that you would end up with Caesarian section. There’s some interesting research showing that they really are helpful, so I would definitely consider that. And the other thing, you know, I talked about the gut microbiome. I’d like to get a little more focused on like, fine tuning health and really taking a look at my health and vitamins and supplements and that kind of thing and really get that stuff dialed in.
Jen: [20:02] Yeah. Yeah. And, and I had no idea what was going to be like to have a baby and the fact that you’re, you’re pretty much kinda just focused on yourself. You know, you’re not even focused on what the doctors are saying that that conversation is going on with your partner. And it’s the Doula who knows what the options are and who can stand up for the things that you’ve already said are important and not say you’re not to say that if something is medically necessary that they’re going to say, no, you can’t do this, but that they will ask, you know, what if we wait, what if we don’t do it? Whereas your partner might forget and you may not even be hearing the conversation.
Jen: [20:41] Yep. Definitely found that so. Well, thank you so much for joining us. Vanessa. I have learned so much and I’m only sorry not going to get to practice. But I hope my listeners will be able to use this information so you can hear so much great research based information about pregnancy and birth and also the just after birth period by subscribing to the pregnancy podcast and you can find it at PregnancyPodcast.com Or on iTunes. Thanks again for sharing all your knowledge with us. Vanessa.
Also published on Medium.