Asthma, Vaginal Delivery and American Births
Studies Show Lots of Things
I read somewhere that the two most dangerous words for your health are: "studies show." Variations would be "studies report" and "data shows." Why are these dangerous? Because there are all kinds of studies and sometimes they steer good judgment a little too hard. Because far too often, their results are impractical and cause people fear. Sometimes, however, they're spot on target, change medical practice for the better and support good old common sense.
I read this week about new studies reported by three journals show that how, when and where you deliver a baby can profoundly affect whether your child will be asthmatic. The American Journal of Respiratory and Critical Care Medicine says having a child in the fall increases their chances of getting a winter-borne respiratory illness that will predispose them to asthma. The journal Thorax reports that having your child by C-section also bumps up the odds of developing asthma because vaginal delivery primes the immune and respiratory systems to develop a healthy airway. The Journal of Asthma says children born in the US are more likely to develop asthma than children born outside the country because of the sterile conditions we use in American delivery rooms. Apparently, babies in developing countries encounter more infections and may be better equipped to withstand less serious assaults associated with asthma like mold and dust mites.
OK, what the heck are we supposed to do with information like this? I mean on a practical, living-in-America kind of way. Here are my thoughts. It's a good thing the report about fall babies came out this week because now, women of childbearing age can avoid having sex until about, oh, let's say, March and they won't conceive a fall baby. It's a particularly good thing I didn't know about this when my son was conceived after a house-bound New Year's Eve. Poor kid was born in September. Dang. He's fortunate he didn't inherit my asthma gene (a strong one in my family) despite his poorly timed birth.
And how about that study about kids born in America versus those born outside the country? Sterile versus non-sterile deliveries? Uh, what can I say? You'd better book your flights, Ladies. We don't exactly aim for perfect sterility in normal vaginal deliveries at the hospital. Believe me, we keep it clean but when you think it through, just how germ-free can we keep your hind end? Not very. We use sterilized delivery tools, drapes and gloves. Some doctors still wear masks and sterile gowns but not all. Most of the time, they wear the sterile bathrobe-type clothing that comes in the delivery pack to keep their clothes clean. Deliveries are messy. Apparently, that's a good thing for babies. They start developing strong immune systems straight out of the shoot.
That point about C-sections has been around for a while now. There have been several studies that support the theory that C-section babies develop more asthma in their lifetime than vaginally delivered babies. Again, think about that hind-end of yours. When babies are squeezed through the birth canal (AKA vagina), they're exposed to all kinds of germs—good ones that colonize their mouths, noses and respiratory tracts with bacteria. When you deliver a baby by C-section, especially in planned or early labor cases where baby never made it into the birth canal; they don't get that exposure. The studies show they're 80% more likely to develop asthma than their vaginally-born nursery-mates. This is an argument for thinking it through carefully before you sign on for a C-section. When a C-section is necessary—there's no better way to get a baby out of trouble and safely into its mother's arms. I can't count the number of emergencies that were averted or saved in the operating room by skilled obstetricians. I'm so grateful we have that ability. On the other hand, there sure are a lot of C-sections these days. We rarely do vaginal births after Cesarean anymore. We do a lot more C-sections nowadays than assisted vaginal births using vacuums and forceps. We do a lot more scheduled C-sections and it seems like the number done for convenience may be climbing. Is it a coincidence that the asthma rate in America is climbing right along with the C-section rate? It's a darn good question.
Now, back to good old common sense. Studies show lots of things. You can find a study to support almost anything it seems. Common sense says: do your best and accept what comes. Do everything you can to deliver a healthy baby to a healthy Mama. If you conceive a child whose birth will come next fall—good for you. It's a lovely time of year to cozy up with a newborn. Think of how much fun next Christmas will be. Are you planning on having your baby in an American hospital? Excellent! We do a great job bringing healthy children into the world. Our nurses are skilled, compassionate and supportive. Our doctors and midwives are top-notch. It's a good place to be and you're lucky to be here. About those C-sections: if you need one, you need one. If you don't, think about it.
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