Supporting a Healthy Pregnancy – Health from the Ground Up #2

In our last article in the Health from the Ground Up series, we talked about the importance of genetics to our health and how genetic predispositions can be overcome. Next, we move on to another foundational principle: how parental health choices affect fetuses.

C-Sections and the Baby’s Microbiome

How a baby is born has profound effects on their microbiome. The largest study yet conducted on this topic was published in 2019. It found that children born through the vaginal canal carry different microbes than those delivered by caesarean section (C-section); newborns delivered through caesarean section tended to lack strains of gut bacteria found in healthy children and adults, and instead carried microbes more common in hospital environments.

The gut flora promotes normal gastrointestinal function, protects against infection, regulates metabolism, and is crucial to immune function. Babies born via caesarean may have increased susceptibility to gut infections, asthma, and allergies later in life.

C-sections are absolutely appropriate in some situations and help save lives, but in many cases they may be inappropriate. In the US, about a third of births are C-section, and rates have been increasing—but some in the scientific community believe this is higher than it should be. The World Health Organization estimates that C-sections are necessary only 10-15 percent of the time. One reason for so many more non-indicated C-sections is economic: doctors are paid (about 15 percent) more for them than vaginal births. In fact, when doctors are paid more for C-sections relative to vaginal births, C-section rates increase; when that gap is closed, C-section rates decline. 

Studies have also found that C-sections spike around morning, lunchtime, and the end of the day, suggesting that doctors are responding to scheduling pressures (eating lunch, scheduling office hours, or going home) rather than clinical need.

C-sections also come with risks both to the mother and the baby.

If you do have a birth by C-section, consider using a high-quality infant probiotic to support the baby’s gut health. 

Epidurals and Pitocin

Epidurals are commonly used during childbirth for pain relief. They involve an injection of a local anesthetic, which is derived from cocaine, into the “epidural” space of the spine. There are risks associated with epidurals. They interfere with hormones of pregnancy and childbirth. For example, epidurals reduce oxytocin production, which during birth means that a woman can miss out on the final, powerful contractions of labor and must instead use her own effort. Epidurals can interfere with a woman’s ability to work with her contractions, which can stall labor and lead to the administration of Pitocin, a synthetic version of oxytocin, to induce labor. Pitocin is known to increase the likelihood of a c-section.

Epidurals can also lengthen labor, increase the risk of C-section by 2.5 times, increase the likelihood of induction with synthetic oxytocin, and increase the chance of pelvic floor problems in mothers after birth, to name a few of the side effects.

Epidurals can also have effects on the baby; drugs delivered by epidural enter the baby’s bloodstream at equal or higher levels than those found in the mother. Some studies have found deficits in newborn abilities that are consistent with the toxicity of drugs used in epidurals; these drugs can also adversely affect the newborn immune system.

The best way to avoid some of the complications discussed above is to opt for a natural childbirth—a birth without the typical medical interventions and drugs. This often happens in a home setting, but natural births also take place in hospitals. Midwifes and doulas often facilitate natural deliveries. Midwifes provide medical care and support during pregnancy, birth, and the postpartum period; doulas provide emotional and physical support during these periods. They help with the techniques that are helpful during natural childbirth like touch, massage, and breathing.

Pregnant women should discuss these issues with their doctors and educate themselves about the risks and benefits to using epidurals during birth.

Mental Health

Research is now showing the profound effect a pregnant mother’s mental health has on an unborn child.

• Studies have linked a pregnant woman’s exposure to traumatic events as well as chronic and common life stressors to significant alterations in children’s neurodevelopment (autism, affective disorders, and reduced cognitive ability).
• Elevated levels of antenatal (pre-birth) depression and anxiety are associated with poor emotional judgment in young children and increase risk for neurodevelopmental disorders.
• Parental psychological stress during pregnancy has been associated with difficult child temperament at 12 months postpartum.
• The impact of antenatal depression and anxiety have also been shown to extend later into a child’s life, leading to attention deficit disorder (ADHD) symptoms in 8–9-year-old children.
• A recent meta-analysis suggested that psychological stress and mental illness influence a child’s emotional, cognitive, and behavior development as well as impacting birth outcomes and physical growth.

The father’s health also impacts the child’s health:

• Growing research suggests that a man’s diet, drinking, smoking, and age may contribute to birth defects, autism, obesity, mental illnesses, and other problems in their kids.
• Depression in fathers during the postnatal period was associated with adverse emotional and behavioral outcomes in children such as oppositional defiant disorder.
• Another study found that chronic illness on the father’s side puts newborns at greater risk for issues such as preterm birth, low birth rate and other conditions that require admittance to the neonatal intensive care unit.

Some of these effects have to do with epigenetics. Age and unhealthy habits change our genes, and these changes can then be passed on to our children. A man’s obesity may affect his genes in a way that predisposes his children toward obesity.

For mothers, the damaging effects of depression and stress expose infants to cortisol, the primary stress hormone. One study found that prenatal cortisol exposure negatively predicted cognitive ability in the infant.

Diet

• Research has indicated that a mother’s consumption of a western-style diet high in refined carbohydrates and processed foods was linked with her child developing obesity and diabetes.
• Maternal high sugar diets, especially those high in sweetened beverages, have been linked with poorer childhood cognition.
• Animal studies have found that maternal low-protein diets can lead to prostate cancer in offspring later in life.
• One study found that low maternal HDL cholesterol was associated with an increased risk for ADHD in their children.

There is no one-size-fits all diet that pregnant women should adhere to. Eating whole foods, plenty of vegetables and fruits, and limiting pro-inflammatory foods seems to be the best bet. The inflammatory index links specific foods to markers of inflammation, like IL-1β, IL-4, IL-6, IL-10, TNF-α and C-reactive protein. Trans-fat is the most pro-inflammatory food, and things like tea, berries, ginger, and omega-3-rich fish are among the most anti-inflammatory foods. Studies have shown that higher early-pregnancy inflammatory index scores are associated with higher odds of being overweight or obese in late-childhood.

Environmental Exposures

While exposures to a variety of environmental contaminants is bad for overall health, it is especially bad during pregnancy. Note that many of these exposures have been linked with lower birth weights; research has found that the biggest predictor of cardiovascular disease later in life wasn’t smoking or other lifestyle factors, but an individual’s weight at birth.

• Lead, mercury, nickel, and manganese have been associated with poor reproductive outcomes. Some integrative experts recommend getting tested for heavy metals before a pregnancy and doing a supervised detox if need be.
• Exposure to air pollution has been associated with congenital birth defects and low birth weight.
• A recent study found that pregnant women who were exposed to chemical compounds known as phthalates during pregnancy had an increased risk of preterm birth. They also have been found to decrease penis size and anogenital (anus to penis) distance in newborns. Phthalates are used to make plastic softer and are found in many consumer products. Avoiding processed foods that come in plastic containers, selecting fragrance-free products or those labeled as “phthalate free” are some ways to avoid phthalates.
• Exposure to glyphosate, the active ingredient in the Roundup herbicide, is significantly associated with preterm births.
• Prenatal exposures to environmental tobacco smoke, air pollution (PAH), and pesticides affect fetal growth and neurodevelopment.
• Researchers have shown that exposure to endocrine disruptors during pregnancy can lead to medium and long-term health problems for both the mother and the fetus. The placenta regulates maternal physiology and fetal development, producing the hormones necessary for pregnancy. Any alteration in its function affects the health of both the mother and the child. A malfunctioning placenta can lead to complications later in life such as diabetes, obesity, and other chronic illnesses. Here are some ways to avoid endocrine disrupting chemicals.
• Antineoplastic cancer drugs, BPA, formaldehyde, and solvents are linked with infertility and miscarriage.

Supplements

Keeping your developing baby healthy isn’t just about avoiding exposures. Healthy fetal growth can be supported by some key supplements:

• Omega-3s: One study found that women who had low blood levels of omega-3 fatty acids during early pregnancy have birth to children who had smaller brain volumes of grey and white matter at age 9-11.
• Folate: a small amount of folate added to a prenatal multivitamin can substantially cut the risk of neural tube defects and spina bifida. In fact, ANH-USA’s first lawsuit was the landmark case of Pearson v. Shalala—and because we won, there is now widespread public knowledge about the importance of consuming enough folate during pregnancy to prevent neural tube defects.
• Vitamin D: A 2019 review concluded that vitamin D deficiency was related to higher risk of maternal complications (including preeclampsia, impaired glucose tolerance, and caesarean section rate) and neonatal complications (low birthweight, neonatal hypocalcemia seizure, and impaired skeletal, lung and immune development).

There are a few “no-brainers” that most doctors will tell you about to protect the health of a developing fetus:

• Avoid secondhand smoke.
• Limit caffeine intake. Caffeine is a stimulant that can increase heart rate and blood pressure, which is not recommended during pregnancy.
• Avoid raw meat in dishes like sushi, which can increase changes of bacterial infections.
• Avoid alcohol. Babies cannot process alcohol well, and exposure to alcohol seriously affects their development. Drinking alcohol during pregnancy increases the risk of miscarriage, premature birth, and low birth weight; it can also affect your baby after they are born.

This can seem like a lot to think about during pregnancy, which is already difficult enough. But the takeaways can be boiled down to a few simple principles: eat a diet of whole foods and avoid refined and processed foods; take measures to manage and reduce stress; and try to reduce exposures to environmental pollutants—for example by filtering your water and avoiding takeout and other foods that come in plastic or Styrofoam containers.