Microbiome Diversity and Childbirth

​Probiotics are the "good" bacteria in and on our bodies. We have a symbiotic relationship with them. More and more research is pointing to the benefits and necessity of a healthy microcolony.

As it applies to labor and delivery, probiotics are extremely important, influencing not only the health and labor outcome of the mother, but the health of the infant into adulthood.

1. Aid in the digestion of food and the conversion and absorption of certain vitamins
2. Prevent infections that can cause premature rupture of membranes and early labor
3. Balance Group B Strep
4. Set the foundation for infant immunity

How Probiotics Aid in Digestion and Vitamin Conversion 

This is the probiotic claim to fame. There has been great attention given to the role of probiotics in digestive health, since, well, they are found in the digestive system. Probiotics, when in balance, keep the naturally occurring "bad" bacteria from over colonizing and creating problems such as inflammation, gas, bloating, diarrhea, constipation, etc... But, did you know that probiotics play a big role in the breakdown of vitamins in our food?

Many of the vitamins we have talked about being essential for the hormones and processes of labor and delivery are not usable in their natural form. They must be broken down or changed into a form that our body can utilize. 

Vitamin K is a great example of this process and the importance of the need for healthy gut bacteria. 

There are 2 naturally occurring forms of Vitamin K, simply named K1 and K2. 

• K1: is the form found in plants like parsley, kale, and spinach
• K2: is found in animal products like organ meats, grass fed butter, and pasture raised eggs, and in fermented foods (bacteria fermented...hint hint)

K1 is pretty useless in the body as is (It does play a partial role in the formation of blood clotting factors, but no other functions), and actually only a fraction of the K1 found in plants can be absorbed. The K1 that is absorbed is stored in your Liver for a time of need. It is then CONVERTED to K2 to be used. K2 is the usable form of K1. How is K1 converted to K2....BACTERIA! There are two ways to use bacteria to convert K1 into K2

1. Eat bacteria cultured foods such as sauerkraut, kimchi, miso, and tempeh: the naturally occurring bacteria break down the plants and change the K1 into K2.
2. Have a healthy gut flora so your own digestive bacteria can break down the K1 found in the vegetables into the usable K2.

FYI: the Vitamin K injection given to infants is a synthetic form of Vitamin K1. 

Probiotics to Prevent Infections

Our probiotics are the first line of defence for our immune system. In fact 70-80% of our immune system is found in the gut. Not only do the bacteria directly attack and consume invading microorganisms, they also digest the fiber in our food to form short chain fatty acids which are then an energy source for the cells that line our digestive system and prevent invaders from passing into the blood (including the lymph cells in the small intestines)...isn't our body amazing!

What does this have to do with the Amniotic Sac? Actually quite a bit. We talked early about the need for antioxidant Vitamin C/E to prevent elevations in cytokines that increase inflammation and cause premature rupture of membranes. Probiotics play a similar role in the vagina. The probiotics of the vagina have a job of preventing invading bacteria from making their way up into the uterus and causing damaging and inflammation in the amniotic sac that may lead to premature labor.

Since we are talking about infections, I think it would be good opportunity to jump into the Group B Strep issue. 

What is Group B Strep?

Group B strep is a common and normal bacteria of the digestive system. It is passed from mother to daughter and if your mother was positive, you are most likely positive as a carrier. (25% of women are carriers). Being a carrier doesn't mean you have an STD, or you have a disease, all it means is that your body carries this bacterium in your normal flora.  

What's the Issue with Group B Strep?

So, here is the deal....In women who are carriers who have healthy flora, the GBS (Group B Strep) and probiotics are balanced. In most women it is harmless and is just a normal part of the flora balance. In women who are carriers who have unhealthy flora, the GBS becomes overabundant. This overabundance of GBS can cause complications in labor (such as premature rupture of membranes, or preterm labor), but the biggest worry is that of the health of the newborn. 

From what I have read, it takes about 12 hours for the bacteria to migrate up into the sac and colonize. If the rupture of membranes occurs during labor, the risk of infection is significantly reduced. The risk to the newborn is significantly higher in those who were not aware that their membranes had ruptures (leaking fluids), or had a rupture of membranes without onset of labor and did not receive medical treatment. GBS in newborns can cause Sepsis (infections of the blood), pneumonia, and meningitis. All very serious. 

What can you do?

The best thing you can do for the prevention of GBS overgrowth is to keep your good gut bacteria happy. Once you test positive for GBS during pregnancy, medical staff will treat you positive throughout, regardless of subsequent testing...and here is why. As a carrier, if you ever test positive you are a carrier, your levels fluctuate based on the balance of your flora. It is medically safer to assume your GBS is overgrown at delivery than to assume it is not and risk the complications. By keeping your natural bacteria balance prior to the GBS test and maintain balance before labor and delivery will decrease your chances of testing positive or having an overgrowth during labor. 

Also, be aware of your body. If the amniotic sac is intact prior to onset of labor, and labor is short, your chances of newborn complications is small. If you have rupture of membranes and delayed onset of labor and a longer labor, the chances of newborn complications rises. 

Standard Hospital Care for GBS

The standard of care is to administer antibiotics during labor to decrease the amount of GBS present at the birth of your baby. This opens up another round of issues. The antibiotics used not only decrease GBS, but also the good probiotics of your system. Your baby will be born without the access to your natural probiotics, making it necessary for you and your baby to supplement after birth.

Vaginal Probiotics Set the Foundation of Infant Immunity

These naturally occurring bacteria cover your baby as they exit the womb. This is your baby's first probiotic inoculation. Research shows that babies born via cesarean do not receive this immune foundation and are prone to immune issues such as asthma, allergies, obesity, and many other long term health complications. All because they were not exposed to bacteria at birth.

When born, infants have a very limited about bacteria on and in their bodies. When a baby is born vaginally, they are covered in the mother's flora, and thus the foundation of their own flora begins. These bacteria will develop over the next several week, and will also grow in diversity with breastfeeding.

If a baby is born to a GBS mother who used antibiotics during labor, or via cesarean, supplementing both mother and baby becomes important to re-establish and establish healthy bacterial growth and prevent life-long complications. 

Meal Plan #6

Breakfast #6: Plain Raw-Goat Milk Yogurt with Slices Almond and Wild Raspberries

If you are looking for a local source of raw goat milk yogurt, I know a guy! It's so good, without that scary, gamey taste most people associate with goat's milk. 

Lunch #6:  Two Egg Frittata with Leftover Veggies and Salsa

I have this super cute, little, cast iron skillet that is just perfect for making two egg frittatas. Which is the perfect quick way to use leftover veggies. In this case I had some peppers and onions, and some bacon sauteed kale. 

Dinner #6: Coconut Curry Chicken Soup

Homemade Chicken Broth is a must when getting ready for labor and delivery. The hyaluronic acid, minerals, fats, cholesterol, and vitamins are abundant and easy to assimilate. 

Miss a Part in the Series?

Planning Nutritionally for Labor and Delivery Part 1 - Biology of Labor
Planning Nutritionally for Labor and Delivery Part 2 - Oxytocin "the Love Hormone"
Planning Nutritionally for Labor and Delivery Part 3 - Estrogen and Progesterone
Planning Nutritionally for Labor and Delivery Part 4 - Cervical Ripening
Planning Nutritionally for Labor and Delivery Part 5 - More Than Just Progression

To Contintue...

Planning Nutritionally for Labor and Delivery Part 7 - Top 10 Foods for Labor and Delivery