There was a fascinating documentary in the Horizon strand on BBC Two last night which investigated the theory that childhood allergies and asthma are caused by lack of exposure to a range of micro-organisms. The standout was this part of the theory:
Scientists believe the bacteria that babies are exposed to in the birth canal somehow help protect them from allergies, and the rise in Caesarean births may be making children more allergic.Babies born by c-section do not get exposed to these bacteria - which change in the woman's birth canal in preparation for vaginal delivery - but a completely different range within the hospital's maternity unit. Other factors in providing babies with the full range of the "good" organisms are breast feeding and the greater time spent indoors compared to earlier generations.
While not explaining the theory, this US childbirth site explains the observations around c-section births.
Babies born by cesarean section are more likely to have breathing problems and to develop several chronic diseases: childhood-onset diabetes, allergies with cold-like symptoms, and asthma in childhood and beyondI came to that site while looking for the rates of birth by c-section in the USA to compare to the approximately 25% in the UK. The site goes into some of the reasons why the rate in America higher at over 30%, including some pretty worrying comments about doctor's practices in not promoting it however this was the real kicker:
Many health professionals are feeling squeezed by tightened payments for services and increasing practice expenses. The flat "global fee" method of paying for childbirth does not provide any extra pay for providers who patiently support a longer vaginal birth. Some payment schedules pay more for cesarean than vaginal birth. Even when payment is similar for both, a planned cesarean section is an especially efficient way for professionals to organize their hospital work, office work and personal life. Average hospital payments are much greater for cesarean than vaginal birth, and may offer hospitals greater scope for profit.(For clarity, rates vary across the UK and "efficiency" is often given as a reason why individual health areas have much higher rates than others.)
So by directly or indirectly encouraging c-section births, the US "health" system is contributing to ill health. From NBC News:
Allergies triggered by food or the environment have risen sharply in U.S. children in recent years, especially among more affluent families, according to a large government study. The "epidemic" rise in allergies, as one expert describes it, is of concern because it increases the risk of potentially fatal respiratory diseases or disfiguring skin conditions that could require long-term care.Higher income groups would instinctively appear to have greater numbers of doctor-directed births. Studies also show that foreign born children living in the USA have lower rates of allergies than those born in the USA. After living in the "hygenic" conditions in the USA, their resistance to allergies lowers.
The latest data, released on Thursday by the Centers for Disease Control, showed the prevalence of food allergies increased in children under age 18 from 3.4 percent in 1997 to 5.1 percent in 2011. Skin allergies rose from 7.4 percent to 12.5 percent in the same time period.
Maybe doctors who are keen on slicing into women's uterises should remember the Hippocratic oath:
I will use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep themLet me make it clear, there are good reasons why some women have to give birth in this way however the factors listed by childbirthconnection.com have nothing to do with these. Very careful prescribing of antibiotics in early childhood is also important. As important though is that parents allow their children to be exposed to a whole range of different organisms especially in their first year. The adage that a bit of dirt does you good seems to be more than an old wife's tale. The simplest way is often just to go outside - posh nannies used to take their charges out on daily walks in their pram come rain or shine. (Nannies used to do a lot of other things I would NOT endorse - a teaspoon of alcohol or holding the child over an unlit town gas burner is definitely frowned upon as a way of getting them off to sleep). "Fresh air" even in the middle of polluted cities was recognized as "good for baby" - in the USA there was a fashion to hang baby cages from windows of tenement buildings to enable this, even Eleanor Roosevelt had one!