Creating Optimal Birth Space

The environment in which we live and move and have our being is critical to our physical, mental, spiritual and social functioning. More and more understanding is emerging about how the environment plays a pivotal role in all aspects of our lives. From mice to (wo) men, science is demonstrating that the body's neural network is "plastic", that genes are not destiny and that the "environment" is an integral part of how living creatures function and develop. Every physiological interaction and behaviour, from the way genes are expressed in the sperm and the ovum to our health and experience across the lifecycle depends upon the environment. The environnment gives feedback which will be either nourishing and provide the stimulus to function well and grow or hostile, which disrupts our functioning, leading to disease, distress and decay.

Recognition of the way the environment is integral to optimal functioning is expanding our understanding of the role of maternity care in providing optimal environments for childbearing women. The science is also demonstrating why woman centred care, facilitating the fulfilment of woman's choices and incorporating women's rights into maternity care are so much a part of optimising outcomes for women, their babies, their intimate relationships and society in general.

My friend and colleague, the wonderful Maralyn Foureur, Professor of Midwifery at the University of Technology of Sydney (UTS) presented on this topic at the recent homebirth conference in New Zealand.  Maralyn is heading up a research team exploring birth space and has attracted a highly prized NHMRC grant for this work. 

Click the link below and it will take you to the slide share of her presentation

Creating Optimal Birth Space

I think you will enjoy and get a lot out of her research.

Birth and Bugs

Note: for some reason the links aren't showing up in this post. Just run your cursor over the words and they will show as a purple colour. I can't fix this glitch, not sure why! Sorry.

Mumma and babe

Some interesting posts about the importance of the way babies are born and the bacteria they are exposed to through the birth process are emerging in cyberspace. The information is not only interesting, it helps to inform our practice as midwives and enables parents to understand one of the many reasons why there is a concerted move in both midwifery circles and government agencies to turn the tide more towards normal birth. Concerns are being raised that environmentally triggered changes to immune cells of babies born by caesarean section are predisposing those babies to be susceptible to immunological diseases such as diabetes and asthma in later life.

A blogger has explained the importance of our exposure to bugs at birth this way.

and a teacher of molecular biology at Princeton University, Bonnie Bassler, explains how bacteria talk to each other chemically. Bonnie informs us that we are composed of 10x more bacteria cells than human cells!

This information is a powerful addition to the accumulating evidence about normal, natural, unhindered, supported birth being best for mother and baby.

Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring

The way that our physiology switches genes on or off in response to environmental circumstances/triggers/cues, a process now studied as 'epigenetics' or 'above the genes' is becoming increasingly understood. The way that stressors impact our lives, our genetic expression and our immune system is becoming more and more recognised and obvious as scientists seek to understand the role of the environment in disease profiles. The significance of the prenatal experience in setting the foundations for health and wellness or disease is now recognised as a reality for humans as well as other animal species.

What scientists are discovering as they study the role of the prenatal environment in health and disease, is that high levels of maternal stress during the prenatal period is associated with impaired immune modulation. This study gives further credence to the Barker hypothesis that the prenatal experience is programming the infant's physiology, including the immune system to respond to the environment it will be born into. In the case of children whose mothers experience chronic and high stress levels, they have immune systems that are more vulnerable and more highly triggered by adverse environmental factors.

"In the Urban Environment and Childhood Asthma Study, the investigators evaluated associations among prenatal maternal stress and cord blood mononuclear cell (CBMC) cytokine responses among 557 families in Boston; Baltimore, Maryland; New York City; St. Louis, Missouri, and other cities. Each child had a parent with history of asthma or allergy".

Cytokines are messenger molecules with a complex range of interweaving, intersecting pro inflammatory and anti inflammatory functions.

"This is the first study in humans to show that increased stress experienced during pregnancy in these urban, largely minority women, is associated with different patterns of cord blood cytokine production to various environmental stimuli, relative to babies born to lower-stressed mothers," lead author Rosalind Wright, MD, MPH, associate physician at Brigham and Women's Hospital in Boston, Massachusetts, said in a news release.

The obvious answer is take care of pregnant women. Reduce the environmental stressors that pregnant women have to negotiate on a day to day basis. Poverty, violence, poor nutrition, unwanted pregnancies, lack of preconceptual care, lack of meaningful, supportive care during pregnancy and birth etc are all environmental risk factors with huge implications for the health and wellbeing of mothers and their babies.

Midwifery care that is provided in a one to one relationship is very beneficial for helping a woman defuse her stress levels. As a woman feels safe with her midwife and as trust builds, discusses her fears, problems and life circumstances, emotional stress is releases and solution generating can begin. Our government needs to heed these studies and provide better care for pregnant women if they truly want better and healthier societies.



Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring

Study finds genetic link between misery and death

Specifically, Cole analyzed transcription factor binding sequences in a gene called IL6, a molecule that is known to cause inflammation in the body and that contributes to cardiovascular disease, neurodegeneration and some types of cancer.

"The IL6 gene controls immune responses but can also serve as 'fertilizer' for cardiovascular disease and certain kinds of cancer," said Cole, who is also a member of UCLA's Jonsson Comprehensive Cancer Center and UCLA's Molecular Biology Institute. "Our studies were able to trace a biochemical pathway through which adverse life circumstances — fight-or-flight stress responses — can activate the IL6 gene.

Interleukin-6 (IL-6) is a protein that in humans is encoded by the IL6 gene.

IL-6 acts as both a pro-inflammatory and anti-inflammatory cytokine - an immune system messenger molecule. IL-6 is relevant to many disease processes such as diabetes, atherosclerosis, systemic lupus erythematosus, prostate cancer and rheumatoid arthritis. Advanced metastatic cancer patients have higher levels of IL6 in their blood.
Cytokines are regulatory signaling proteins, taking messages from cell to cell and influencing the behaviour and activity of the cells. Their pro-inflammatory behaviour is implicated in many of the processes that plague pregnant women, causing havoc for them and their babies.

This study is very exciting. Such clear linking of stress response and cytokine activation as described by these researchers is essentially providing more evidence that pregnant women need environments which are calm, relaxed, nurturing and supportive. Midwives are the obvious people to support, nurture and ensure calm and relaxed surroundings as they work with women to normalise their experiences of change on the journey to becoming a mother.

1. Kristiansen OP, Mandrup-Poulsen T (December 2005). "Interleukin-6 and diabetes: the good, the bad, or the indifferent?". Diabetes 54 Suppl 2: S114–24. PMID 16306329.
2. Dubiński A, Zdrojewicz Z (April 2007). "[The role of interleukin-6 in development and progression of atherosclerosis]" (in Polish). Pol. Merkur. Lekarski 22 (130): 291–4. PMID 17684929.
3. Tackey E, Lipsky PE, Illei GG (2004). "Rationale for interleukin-6 blockade in systemic lupus erythematosus". Lupus 13 (5): 339–43. PMID 15230289.
4. Smith PC, Hobisch A, Lin DL, Culig Z, Keller ET (March 2001). "Interleukin-6 and prostate cancer progression". Cytokine Growth Factor Rev. 12 (1): 33–40. PMID 11312117.
5. Nishimoto N (May 2006). "Interleukin-6 in rheumatoid arthritis". Curr Opin Rheumatol 18 (3): 277–81. doi:10.1097/01.bor.0000218949.19860.d1. PMID 16582692.
6. "Cancer Patients Typically Have Increased Interleukin-6 Levels". American Society of Clinical Oncology 2006 Annual Meeting, Abstracts 8632 and 8633. Medscape.com. 2006-06-26. http://www.medscape.com/viewarticle/537309.

Study finds genetic link between misery and death

Dirty tricks of the egg and sperm race - 24 February 2010 - New Scientist

The title of this article about gene expression from New Scientist is misleading. Not so much 'dirty tricks' but fascinating negotiations! New insights into how genes express and are modified by environmental factors, known as the field of 'epigenetics' provide provide a better understanding of how we become who we are.

"The imprinted genes include several with a role in embryo growth and development, most of which are also expressed in the brain, meaning that key traits like body size, cognitive ability and personality might be moulded by epigenetic inheritance".

Dirty tricks of the egg and sperm race - 24 February 2010 - New Scientist

The Reinvention of the Self § SEEDMAGAZINE.COM

"Elizabeth Gould overturned one of the central tenets of neuroscience. Now she’s building on her discovery to show that poverty and stress may not just be symptoms of society, but bound to our anatomy".

Brilliant article about the role of the environment in making us who we are:

"Subsequent experiments have teased out a host of other ways stress can damage the developing brain. For example, if a pregnant rhesus monkey is forced to endure stressful conditions—like being startled by a blaring horn for 10 minutes a day—her children are born with reduced neurogenesis, even if they never actually experience stress once born. This pre-natal trauma, just like trauma endured in infancy, has life-long implications. The offspring of monkeys stressed during pregnancy have smaller hippocampi, suffer from elevated levels of glucocorticoids and display all the classical symptoms of anxiety. Being low in a dominance hierarchy also suppresses neurogenesis. So does living in a bare environment. As a general rule of thumb, a rough life—especially a rough start to life—strongly correlates with lower levels of fresh cells.
Gould’s research inevitably conjures up comparisons to societal problems. And while Gould, like all rigorous bench scientists, prefers to focus on the strictly scientific aspects of her data—she is wary of having it twisted for political purposes—she is also acutely aware of the potential implications of her research".

The environment shapes us, from the very beginning to the very end.

"...As Nottebohm has said, “Take nature away and all your insight is in a biological vacuum.” Nottebohm discovered neurogenesis in birds learning to sing in their natural habitat". If he'd studied birds in cages, they would have been too stressed to sing and therefore wouldn't have grown new neurons.

The Reinvention of the Self § SEEDMAGAZINE.COM

The implications for midwifery work with childbearing women is that midwives create the right environment within which women can explore becoming mothers in an optimal way.

Probing Question: Do emotions influence heart health?

Probing Question: Do emotions influence heart health?

"Can positive emotions like love, friendship and social connectedness improve health? It seems that way, suggests McDanel. Many studies have shown that patients who have caring support networks during health crises have better outcomes than those who do not, she said. A decade-long study on elderly Australians found that those with larger networks of friends were found to be 22 percent less likely to die during the study period than those with fewer friends.
"Friendships and supportive social networks can definitely help people through times of sickness or emotional hardship," McDanel said. "We have to treat people with a holistic approach, treating their physical maladies, improving their diet and exercise, but also working on their emotions and giving them the tools to manage them better."
Reducing stress, anger and loneliness, she said, is a recipe for good health"

Just goes to show, we need to be there for each other and be good to each other. Support and kindness are life saving.

Medical News: Depression During Pregnancy Linked to Kids' Behavior Problems - in Psychiatry, Depression from MedPage Today

A study of the children of 120 disadvantaged mothers from South London, reported in the January/February issues of Child Development, provided more evidence of the compelling need to take care of childbearing women and in particular, to provide support for disadvantaged and marginalised women, who were more likely to be depressed and have experienced conduct problems themselves as children. Researchers found that children whose mothers were depressed were twice as likely to display antisocial behaviour than those whose mothers weren't depressed.

Medical News: Depression During Pregnancy Linked to Kids' Behavior Problems - in Psychiatry, Depression from MedPage Today

The researchers "explored several potential mechanisms for the link between maternal depression and a child's behavior problems:

• Direct effects on the fetus from biological correlates of the mothers' depressive symptoms
• Depression in pregnancy as a sign of environmental adversity
• Re-exposure to maternal depression after birth
• Indirect effects of depression on the developing fetus driven by mothers' smoking, drinking, and drug taking during pregnancy
• A genetic explanation whereby women who experience depression in pregnancy may also have a greater genetic risk for antisocial behavior, which they pass on to their offspring

Hay and her colleagues noted that these explanations are not necessarily mutually exclusive".

As the effect of the social environment upon the individual becomes more widely recognised and the way the building of a healthy sense of self in a baby/child is inextricably linked to the presence of a moment by moment, congruent, consistent, warm, responsive interactive relationship with the mother, it is no longer possible to ignore the responsibility of society to help childbearing women in every way possible. Apart from addressing basic economic necessities, a fundamental and important capacity building initiative is to provide one to one midwifery care. The provision of a trusting relationship with a known midwife in a continuity of care model, supports pregnant women's growth and development, providing the opportunity for early identification of potential problems and instituting remedial action and targetted solutions before the problems begin.  Authentic midwifery care, education, good nutrition, exercise and as already  noted, acupuncture all work together to alleviate and minimise depression and the associated problems with depression for childbearing women and their children.  Providing adequate resources for intervention in the beginning of life is an excellent public health strategy as it avoids the huge financial and societal cost of antisocial behaviour later on.

Ancient remains put teeth into Barker hypothesis from PhysOrg

"The Barker hypothesis is named after epidemiologist David Barker, who during the 1980s began studying links between early infant health and later adult health. The theory, also known as the Developmental Origins of Health and Disease Hypothesis (DOHaD), has expanded into wide acceptance.

As one of the founders of the field of bioarcheology, Armelagos studies skeletal remains to understand how diet and disease affected populations. Tooth enamel can give a particularly telling portrait of physiological events, since the enamel is secreted in a regular, ring-like fashion, starting from the second trimester of fetal development."

Da Vinci

Disruptions in the formation of the enamel, which can be caused by disease, poor diet or psychological stress, show up as grooves on the tooth surface.


Ancient remains put teeth into Barker hypothesis

Sweet! -- sugar plays key role in cell division

Scientists seeking to understand the complex interactions involving hundreds of proteins that enables a human cell to split into two, have found a layer of regulation, that up until now has been invisible, although they were aware in 2005 that sugar helped to control cell division.

http://www.physorg.com/news6643.html

A sugar-based signaling pathway has been found that works independently and seems to be the trigger for the phosphorylation signaling system, which has always been thought to be 'the' pathway that underpinned human cell division processes

Sweet! -- sugar plays key role in cell division

Ant feeding on sugar crystal Wikipedia

The discovery of the sweet switch is considered to be "paradigm-shifting in terms of signaling. Signaling is how a cell perceives its environment, and how it regulates its machinery in response to stimuli. The new sugar switches reveal that the cellular circuitry is much more complex than previously thought".

Ah yes, our biology, physiology and entire being is fascinating! Layers upon layers of interaction are being discovered - we are not a 'done deal' by any means.

To the scientists:

"Because these previously unrecognized sugar switches are so abundant and potential targets of manipulation by drugs, the discovery of their role has implications for new treatments for a number of diseases, including cancer".

However, what about the role of something incredibly simple, like good low GI (glucose index) nutrition to prevent the signaling switch being corrupted in the first place?

Low GI foods

 

Recipes

http://www.lowcarbiseasy.com/aboutlowcarb.htm#why

 This information is vitally important for couples wanting to have a baby. Nutrition in one of the key environmental contributors to a healthy pregnancy that couples can take control of before they get pregnant. We know how vitally important optimal sugar control is to a healthy baby's anatomy and development.

Medical News: SMFM: Gene Variants Linked to Preterm Labor - in Meeting Coverage, SMFM from MedPage Today

Fascinating article

Medical News: SMFM: Gene Variants Linked to Preterm Labor - in Meeting Coverage, SMFM from MedPage Today

"Some women and fetuses carry gene variants that predispose them to the early onset of labor," Romero said.

The question we need to be asking is "what turns these gene variants 'on'?" and how can we keep them turned 'off'.

My hunch is that CRH is key to the inflammatory processes that do things to genetic switches.

What gets CRH fired up?

Embodied reactions (both conscious and other than conscious) to environmental stressors!

Hmm. Ina May Gaskin's Farm statistics are interesting and I had to put this article here to illustrate my thinking explained below.

Ina May Gaskin, Bonny Reid and her son

http://www.guardian.co.uk/lifeandstyle/2009/sep/26/natural-birth-expert

My theory and I know there is a lot of work to be done to 'prove' this 'scientifically', is that this is where one to one midwifery work is so beneficial. Authentic midwifery care, such as provided by midwives like Ina May Gaskin is an 'anxiolytic'. The kindly, loving relationship with a midwife the woman knows and trusts, helps a woman to stay calm, relaxed and feeling loved and through conversations and information sharing encourages the woman to eat well, exercise appropriately and minimise environmental toxins of all kinds - all of which serves to keep CRH stable and therefore physiology stable for optimal growth and functioning. My take on why the incidence of all that plagues pregnant women and their childbearing experience, such as preterm labour, pre-eclampsia, gestational diabetes, desultory labour etc ad infinitum, is lessened with good, one to one midwifery care.

YouTube - (Baby's perspective) barnets perspektiv!

Ever wondered what it is like to be baby looking out at the world from inside a pram? Wondered what it is like to be a baby being carried? This short video demonstrates the difference. The language is not English, but for those English speakers, the visual portrays the message brilliantly.



YouTube - Barnets perspektiv!

YouTube - Controlling the Brain with Light (Karl Deisseroth, Stanford University)

Optogenetics: controlling brain cells with lasers
New Scientist Story
7th January 2010 by Ewen Callaway

http://www.newscientist.com/article/dn18353-optogenetics-controlling-brain-cells-with-lasers.html

Brain cells can be switched on and off like light bulbs using newly identified microbial proteins that are sensitive to the colour of laser light.

The discovery is the latest in the fast-moving field of optogenetics, which has already given researchers unparalleled control over brain circuits in laboratory animals. The technology may lead to treatments for conditions such as epilepsy, Parkinson's disease and blindness. New Scientist explains the science and its promise.

If you have the patience to sit and watch this video, you will be amazed by what is happening with biotechnology and psychiatry. Great possibilities for much of what ails humanity.

What's this story got to do with birth and midwifery?  Psychiatry seeks to fix brains once they are broken.  The fields of perinatal psychology and epigenetics are explaining how prenatal programming sets the stage and the foundations for many diseases in adulthood.  Depression being one of the diseases that are increasingly linked to prenatal experiences of one kind and another, particularly those to do with elevated hypothalamic, pituitary adrenal axis stimulation in pregnancy (aka the stress response system).

Pregnant women feel better, that is, have lower circulating cortiosteroids (stress hormones) when they feel in control, have choices and feel listened to, valued and respected by their caregiver.  They are more likely to go to term, birth well and breastfeed well . They are also less likely to get gestational diabetes, hypertension and their babies are less likely to need nursery admission.  Midwives are the maternity care specialists who provide the sort of care that women want.  Long term relationships between mothers and babies are better with midwifery care, women feel more satisfied and depression rates are lower.  My take on this is that one to one midwifery care helps by supporting women to feel good, eat well, get enough rest, avoid toxins etc thus giving brains the best opportunity to be built right from the beginning.

YouTube - Controlling the Brain with Light (Karl Deisseroth, Stanford University)

Preterm babies grow better with Mozart's music

Gone are the days when babies were thought to be 'blank slates' requiring only sleep, clean nappies, warmth and food.


Advances in neuroscience demonstrate that babies need much more than cursory attention to their basic physical needs. Babies from birth, whatever their gestation, require love, sensory stimulation including movement, skin to skin experience with their mothers and the opportunity to engage eye to eye with their mothers. Babies are sensitive, social and interactive; constantly seeking to engage; adjusting, learning and developing according to environmental cues, feedback and experiences.

The environmental needs of babies who are born prematurely require thoughtful consideration as they are often in nurseries, handled by strangers even though they are generally kind and well meaning and subject to painful and unpleasant stimuli.

Exciting work, exploring the needs of premature babies is leading to brilliant discoveries by pioneers such as Dr Nils Bergman, who was the first to highlight the tactile needs of premature babies and developed kangaroo mothercare, or skin to skin baby wearing for premature infants and their mothers.

Dr Bergman demonstrated that premature babies who had 'kangaroo care' stabilise better and faster, cry less, fuss less, grow better and have enhanced brain development. Mother/baby bonding is improved too.

http://www.kangaroomothercare.com/


The recognition that babies are people too and thrive in an enriched environment has had another boost.

A new study carried out by Dr. Dror Mandel and Dr. Ronit Lubetzky of the Tel Aviv Medical Center affiliated with Tel Aviv University's Sackler School of Medicine has found that pre-term infants exposed to thirty minutes of Mozart's music in one session, once per day expend less energy -- and therefore need fewer calories to grow rapidly -- than when they are not "listening" to the music.
"It's not exactly clear how the music is affecting them, but it makes them calmer and less likely to be agitated," says Dr. Mendel, a lecturer at Tel Aviv University.
In the study, Dr. Mandel and Dr. Lubetzky and their team measured the physiological effects of music by Mozart played to pre-term newborns for 30 minutes. After the music was played, the researchers measured infants' energy expenditure again, and compared it to the amount of energy expended when the baby was at rest. After "hearing" the music, the infant expended less energy, a process that can lead to faster weight gain.
A "musical environment" for preemies
When it comes to preemies, one of the main priorities for doctors is to get the baby up to an acceptable body weight so he or she can be sent home. At the hospital, preterm babies may be exposed to infections and other illnesses, and a healthy body weight keeps them immune to other problems in the future.
While the scientists are not sure what occasioned the response, Dr. Mandel offers one hypothesis. "The repetitive melodies in Mozart's music may be affecting the organizational centers of the brain's cortex," he says. "Unlike Beethoven, Bach or Bartok, Mozart's music is composed with a melody that is highly repetitive. This might be the musical explanation. For the scientific one, more investigation is needed."
The study came about through an international project led by the U.S.-based consortium NIDCAP, whose goal is to create a set of standard practices to optimize the health and well-being of neonates. A number of environmental effects, such as tactile stimulation and room lighting, are already known to affect the survival and health of these very susceptible babies.

A sonata a day keeps the doctor away

Wonderful to see this work steadily improving the lot of premature babies and their mothers. However, we need to also focus on preventing prematurity as premature babies have extra risks and potential burdens to deal with as they grow outside the womb. One to one midwifery care with a midwife who respects, listens and cares for the individual woman provides a space place for the woman to explore becoming a mother; process her stressful feelings and develop self confidence. In such a capacity building environment, stress hormones are diminished because women feel valued and in control; inflammatory processes are not triggered and babies grow better and to term.

Aging well starts in womb, as mom's choices affect whole life - USATODAY.com

During the crucial "window of opportunity" before birth and during infancy, environmental cues help "program" a person's DNA, says Alexander Jones of Great Ormond Street Hospital in London and the University College of London Institute for Child Health. This happens through a delicate interplay of genes and the environment called epigenetics, which can determine how a baby reacts for the rest of its life, Jones says.

Through epigenetics, chemical groups attach to DNA. Although they don't change the order of the genes, the chemical groups can switch those genes on or off, Jones says.

Many things, such as chemical contaminants, can cause epigenetic changes. So babies exposed in the womb to synthetic hormones may begin responding abnormally to the natural hormones later made by their own bodies, says Hugh Taylor of Yale University School of Medicine".

"Babies and children also can develop abnormal reactions to stress, says Jack Shonkoff of Harvard University, co-author of a June paper on early influences in health in The Journal of the American Medical Association.

In the short term, reacting to typical, everyday difficulties can help people develop a healthy response to stress.

But persistent, "toxic" stress — such as neglect or extreme poverty — may program a child's nervous system to be on perpetual high alert. Over time, this can damage the immune response and lead to chronic ailments, such as heart disease and depression, the study says.

Aging well starts in womb, as mom's choices affect whole life - USATODAY.com

Wonderful to see the scientific literature on prenatal programming and epigenetics making into the mainstream arena. People who are thinking about becoming parents will find this information critical to their decision making. I wrote about preconceptual and pregnancy work in the book "Birth Territory and Midwifery Guardianship". For anyone who wants to learn more, they may find the book very useful.

Preconceptual counselling with a midwife is a big step in the right direction to managing the complexities of modern life and becoming a parent. Every parent wants the best for their children. This information helps them do take responsibility, seek out support and information before they get pregnant, then take the steps necessary to ensure a 'head' and 'heart' start for their child.

How Childhood Trauma Can Cause Adult Obesity - Yahoo! News

"Early adverse experience can disrupt the body's metabolic systems," says Shonkoff. "One of the cornerstones of biology is that our body's systems when they are young are reading the environment and establishing patterns to be maximally adaptive."
Researchers also posit that high levels of stress hormones caused by Adverse Childhood Experiences, known as ACEs can wear down the body over time. A temporary spike in blood pressure in response to a stressful event may be useful to power an adaptive fight-or-flight response, but over the long term constant high blood pressure could raise a person's risk for heart attack and stroke. Studies have also found that consistently elevated levels of stress hormones, like cortisol, can lead to permanent damage in certain brain regions linked to depression.
Recently, scientists have discovered that these changes can themselves be passed down from one generation to the next - a burgeoning new area of study called epigenetics. Such research may have significant and long-term implications for the prevention of obesity, addiction and other illnesses related to early life stress. After all, reducing childhood exposure to trauma in one generation may further benefit that generation's children and grandchildren.
If, for instance, a modern child's early life experience - in the womb and during the first five years, particularly - is constantly stressful, it would be incredibly energy-consuming, says Dr. Bruce Perry, senior fellow at the ChildTrauma Academy. "If your genes get the message that you are entering a stressful world, it makes complete adaptive sense to take the existing metabolism and tune it up to deposit fat and store energy to prepare for what the body is expecting will be a challenging and stressful life," he says".

How Childhood Trauma Can Cause Adult Obesity - Yahoo! News

Epigenetics is one of the fields of science that is demonstrating the importance of one to one midwifery care throughout the childbearing period for women and their families. Unmitigated stress leads to genetic, inflammatory and physiological changes that can be permanent. Homeostasis is disrupted and a process called Allostasis is triggered. Allostasis is when body systems are upregulated to cope with unrelieved stress and stress hormones.

Genes

When women feel cared about and valued and have a midwife to talk to about the day to day, moment to moment anxieties, fears and challenges that life and pregnancy brings, their stress response is dampened and their connection response is triggered. Discussing feelings, nutrition, exercise, relationships and changes with a midwife who cares and is interested is capacity building.

The human brain may contain up to one trillion neurons. These nerve cells are interconnected, as shown in this microscopic image, so that they can transmit electrical impulses—and information—to other cells. Image by 3D4Medical.com/Getty Images: National Geographic

When women feel in control, their stress hormones are down, their wellbeing hormones are up and they feel better about themselves. When women are informed and feel in control, they are more likely to do the self care things that help grow healthy babies.

Obstetricians attitude to delayed cord clamping

Obstetricians attitude to cord clamping

Midwives who work with women in a one to one relationship based way with childbearing women weren't at all surprised when researchers found massive benefits with leaving the cord alone after birth for the newborn. Midwives working with women they know are also very aware of the benefits to the mother of leaving the cord alone after birth. Mainstream maternity care has yet to recognise or discover that aspect.

Photo from Wikipedia

Now that current evidence indicates that leaving the umbilical cord to pulsate for at least 3 minutes after birth confers many benefits to newborns, recommendations have been made to change established hospital practice and leave the cord to pulsate. Benefits for the baby from the extra minutes of blood transferred from the placenta include: stem cells, optimal lung and cerebral perfusion, increased number of red blood cells, appropriate blood volume transfer and placentally transferred oxygen during those precious moments as the baby switches from intra to extra uterine life and circulation; reduced rate of sepsis, reduced rates of intraventricular haemorrhage and reduced rates of necrotising enterocolitis.

Two intrepid researchers, both consultant obstetricians, sought to discover whether obstetricians have changed practice in regards to cord clamping in light of the new insights about the value of cord blood to the infant following birth.

Doctors Ononeze and Hutchon‌ said in their article in the Journal of Obstetrics and Gynaecology (2009)

"Questionnaires were given to obstetricians from 43 different units in UK, other EU countries, USA, Canada, Australia etc. There was a 100% responserate. 53% adopted the recommendation only occasionally whereas 37% have never. Difficulty with implementation in clinical practice was the main reason for failure to adopt recommendation. Unawareness of the evidence of the benefits of delayed cord clamping was the reason in half of the non-compliant group".

Interesting that so many obstetricians a) didn't know about the benefits of leaving the cord to pulsate after birth and b) didn't believe the evidence and c) found it difficult to do in practice. The researchers disagreed leaving the cord to pulsate was difficult in practice, so we can only assume it is because the doctors were not prepared to wait those few minutes.

Given that evidence informed practice is touted at every opportunity in contemporary health care, it is very surprising that our medical colleagues are not up to date and can't find ways to put evidence to work for the better health of babies.

"There is no consensus amongst medical and midwifery staff as to when to clamp the cord following delivery of the newborn. The tradition in obstetric practice is to clamp the cord immediately after birth".

The lack of consensus in timing of cord clamping may well exist in the system that approaches birth as a moving conveyor belt experience in a factory, however those of us who work in relationship based practice are agreed that the best time to cut the clamp and cut the cord depends upon the mother's thinking about how to manage her placenta. For those women who want to leave the baby and placenta attached, then the cord is never clamped and cut. The cord falls off the baby's umbilicus in it's own time. For others, they choose to birth their placenta, then clamp and cut it. Once women understand the process of third stage, they choose to manage it themselves and do very well.

Fabulous to see these two obstetricians doing such great work. Their perspective and honesty is commendable.

Journal of Obstetrics and Gynaecology. 2009 Apr;29(3):223-4.

The Disappearing Male

 Michael Mendezza from Touch the Future shared this information about the effect of environmental toxins on male fetuses and fertility. Artificial chemicals in the environment have increased from less than 100 in the early 1900's to over 86,000 now. The video below explains that 85% of those chemicals have not been evaluated for safety for human babies.
  Michael encourages us to get informed. The following came from Michael's newsletter. 

Download and read the complete interview with Peat Myers, Chief Executive Officer of Environmental Health Science, one who has been involved with the science behind this issue since it began. He describes with profound clarity how hormones bind with DNA which trigger protein expression - and how chemicals that mimic hormones, in this case estrogen, are altering human development around the world - it is excellent.
 From the video site:   "The Disappearing Male is a CBC documentary about one of the most important, and least publicized, issues facing the human species: the toxic threat to the male reproductive system. The last few decades have seen steady and dramatic increases in the incidence of boys and young men suffering from genital deformities, low sperm count, sperm abnormalities and testicular cancer. At the same time, boys are now far more at risk of suffering from ADHD, autism, Tourette's syndrome, cerebral palsy, and dyslexia. The Disappearing Male takes a close and disturbing look at what many doctors and researchers now suspect are responsible for many of these problems: a class of common chemicals that are ubiquitous in our world. Found in everything from shampoo, sunglasses, meat and dairy products, carpet, cosmetics and baby bottles, they are called "hormone mimicking" or "endocrine disrupting" chemicals and they may be starting to damage the most basic building blocks of human development".  Bisphenol A is a synthetic oestrogen that affects cell differentiation in the fetus, having a particularly troublesome effect on male fetuses/babies. 

What is Bisphenol A? Bisphenol A is a chemical commonly used in the manufacture of clear polycarbonate plastic. It is one of the top 50 products produced by the chemical industry, generating revenues in the order of $6 million per day in the United States, Europe, and Japan alone. Global bisphenol A production exceeds 6.4 billion pounds per year.
How pervasive is it? Most people reading this will have come into contact with bisphenol A at some stage in their life. A study by the United States Centers for Disease Control and Prevention found that 95% of Americans have detectable levels of bisphenol A in their bodies. Researchers also found that the median level of bisphenol A in humans was substantially higher than the level that causes adverse effects in other animals.
Where is it found? Bisphenol A is commonly found in a range of polycarbonate plastic products, including most plastic baby bottles. It is also found in the following:

• children’s toys
• dental sealants
• epoxy lining of food and beverage cans
• reusable drink containers
• microwavable food containers
• electronic equipment
• sports helmets
• eyeglass lenses

What can we do? Given that bisphenol A has been found to alter cell behaviour even at very low levels – in the parts per trillion – the safest approach is to avoid using products containing it altogether. This is especially important during pregnancy and infancy.

Breastfeeding babies is best, the baby's mother however, needs to avoid bisphenol A containing products. If a mother is bottle feeding her baby, then ensuring the bottles and teats that are used are made of products that do not contain bisphenol A is important.

You may also like to watch a brief ABC report on Bisphenol A and newborn health.

References
vom Saal, F.S. and Welshons, W.V. Large effects from small exposures: II. The importance of positive controls in low-dose research on bisphenol A. Environmental Research, Online November, 2005. doi:10.1016/j.envres.2005.09.001.
vom Saal, F.S. and Hughes, C. An extensive new literature concerning low-dose effects of bisphenol A shows the need for a new risk assessment. Environ. Health Perspect. 113:926-933, 2005.
Gibson, R.L. Toxic Baby Bottles. Scientific Study finds leaching chemicals in clear plastic baby bottles. Environment California Research & Policy Center. Feb 2007

Study shows how gene action may lead to diabetes prevention, cure

Exciting developments in the field!

"A gene commonly studied by cancer researchers has been linked to the metabolic inflammation that leads to diabetes.

Understanding how the gene works means scientists may be closer to finding ways to prevent or cure diabetes, according to a study by Texas AgriLife Research appearing in the Journal of Biological Chemistry.
"Because we understand the mechanism, or how the gene works, we believe a focus on nutrition will find the way to both prevent and reverse diabetes," said Dr. Chaodong Wu, AgriLife Research nutrition and food scientist who authored the paper with the University of Minnesota's Dr. Yuqing Hou.
Wu said the research team will collaborate with nutritionists to identify what changes or supplements in a diet will activate the gene to prevent or stop the progression of diabetes".
Nutrition folks! Nutrition, nutrition, nutrition.

And.

Manage your stressors! Turn on the parasympathetic nervous system pathways, keep your nervous system happily calibrating back to a calm, relaxed state and ensure the disease carrying genes are kept switched off; while switching on and keeping on the genes that keep us well.

The role of inflammatory processes in much of what ails us, including premature labour, pre-eclampsia and diabetes - scourges for childbearing women and their babies, is becoming more and more widely recognised.

Inflammatory processes are switched on by numerous environmental factors such as chronic stress (aka cortisols etc), poor nutrition, toxins, lack of exercise and stasis of lymph fluid; feelings generated by social isolation and not feeling/being valued or loved and/or being in a hostile environment to name a few 'biggies'.

Exercise, relaxation, good nutrition, being surrounded by loving people and the ability to talk about what is important to you and bothers you, while being listened to and respected are all environmentally controllable elements which contribute to optimal psychophysiological functioning.

No wonder one to one midwifey care is associated with better heath outcomes for women and babies.


Study shows how gene action may lead to diabetes prevention, cure

‘Survival of the Kindest’ – Sympathy is Strongest Human Instinct

“Because of our very vulnerable offspring, the fundamental task for human survival and gene replication is to take care of others,” said Keltner, co-director of UC Berkeley’s Greater Good Science Center. “Human beings have survived as a species because we have evolved the capacities to care for those in need and to cooperate. As Darwin long ago surmised, sympathy is our strongest instinct.”

Empathy in our genes

Keltner’s team is looking into how the human capacity to care and cooperate is wired into particular regions of the brain and nervous system. One recent study found compelling evidence that many of us are genetically predisposed to be empathetic".


‘Survival of the Kindest’ – Sympathy is Strongest Human Instinct