The Effect of Natural Birth Compared to C-Section Delivery on Improvement of Infant Gut Health

TheEffect of Natural Birth Compared to C-Section Delivery on Improvementof Infant Gut Health

ChapterI: Introduction

Statementof the problem

Theadult human gut is abundantly filled with billions of bacteria thatfacilitate proper digestion and help in guarding against pathogens.However, an infant`s belly is virtually lacking microbes. Usually, anewborn`s first exposure to friendly bacteria happens during thepassage down through the mother`s vaginal canal during natural birth[ CITATION Gre15 l 1033 ].During a natural birth process, the infant is usually covered inbacteria, and some get ingested in the process. The newborn picks upmore bacteria from the mother through breastfeeding. In this process,the infant`s gut start to be populated with advantageous bacteriathat also play a significant role in the advancement of the baby`simmune system.

However,an infant delivered by C-section usually bypasses this crucial phaseof initial bacteria dunking. Additionally, women who undergo cesareandelivery usually delay breastfeeding in addition to being givenantibiotics to prevent infections in the incision. Health expertshave long been suspecting that different forms of bacteria maycolonize cesarean delivery infants compared to other infants [ CITATION Gre15 l 1033 ].In the recent past, few types of research have been done on theeffects of virginal delivery compared to cesarean delivery on theimprovement of infant gut health. This study is aimed at filling thisresearch gap by providing additional evidence on the subject matter.

Purposeof the study and justification of the problem

Thepurpose of the study is to provide an understanding of therelationship between natural birth and C-section in infant gut healthregarding the probiotic bacteria. An illustration of the implicationsof the maternal nutritional state is essential in dictating theoverall health of the infant [ CITATION Chr15 l 1033 ].The mother serves as the primary sourceof nutrients to the infant. The infant absorbs the foods she takesthrough channels including breastfeeding. However, in assessing thenutritional status of the mother, it could be essential to monitorthe infant`s health status since that would provide informationregarding the maternal nutrition [ CITATION Bhu13 l 1033 ].Recent studies have focused on understanding the difference betweenvaginal and caesarean births regarding increasing the newborn`s gutbacteria [ CITATION Aza13 l 1033 ].

Researchersacknowledge the fact babies who have been born through the birthcanal benefit from the first dose of microbes essential for theirgut. Studies illustrate that mothers pass the beneficial bacteria tothe babies as they go through the birth canal. The importantbeneficial bacteria likely to be passed to the new-born areLactobacillus [ CITATION Grz12 l 1033 ].The bacteria are essential in facilitating the breakdown of lactosethat is available in milk to provide energy to the host. Further, itis determined that Lactobacillus colonizes at the mother`s vagina asshe approaches the day of delivery. The passage of such bacteria canprobably be associated with the fact that the baby will solely bedepending on breast milk[ CITATION Grz12 l 1033 ].Because of the same, it becomes essential that it has the capabilityto digest the breast milk. However, there is the need for conductingadditional research on the relationship between virginal and cesareandelivery and improved gut health of an infant which justifies theneed for conducting this research.


Childrenborn through the natural birth benefit from improved gut health ascompared to those of the C-section.


  1. What are benefits of virginal delivery over cesarean delivery to the infant?

  2. What is the effect of cesarean delivery on the gut health of an infant?

  3. Is there any connection between cesarean delivery and chronic conditions such as type 1 diabetes and asthma?

ChapterII: Review of the literature

Comparisonof natural birth and Cesarean delivery (CD)

Duringnatural delivery, the contact with intestinal flora and maternalvaginal is usually significant for the start of an infant`scolonization. During a cesarean delivery, this direct contact isusually absent, and the non-maternally developed environmentalbacteria play a crucial role in infants` intestinal colonization.Studies indicate that the composition of the first human microbiotacan have long-lasting effects on the intestine in infants who arebreast feeding. For instance, Grześkowiak, et al. indicated that theprimary gut flora in babies born by CD might be disturbed up to sixmonths after birth.

Recentstudies have also provided a comprehensive look at the early phasesof a human body`s colonization by microbes [ CITATION Gre15 l 1033 ].Infants born through the natural birth process tend to be colonizedpredominantly by Lactobacillus, while babies born through theC-section tend to be colonized by a collection of possibly pathogenicbacteria mostly found in hospitals and on the skin, such asAcinetobacter and Staphylococcus, which shows that infants born bycesarean delivery are colonized with skin flora in place of thevaginal type of bacteria. Previous studies have also shown thatbabies born by CD are at high risk of food allergies, type 1diabetes, asthma and celiac disease[ CITATION Gre15 l 1033 ].These infants are also faced with increased risk of obesity, which isseemingly related to the mix of gut bacteria that usually help indigestion of food and nutrients absorption from the intestines.

Thegut microbiota and the delivery mode

Inbabied born through vaginal delivery, the bacteria designated for thegut microbiota usually originate mainly in the rectum and maternalbirth canal. Once these bacteria are ingested by the infant, theytravel through the baby`s stomach and colonize the lower and upperintestine, a complicated process that builds up quickly. Infants bornthrough cesarean delivery, especially cesareans done before laborcommences, do not usually encounter the bacteria of the maternalrectum and birth canal [ CITATION Grz12 l 1033 ].Instead, bacteria from the hospital environment and the skin rapidlypopulate the bowel. Consequently, the bacteria that inhabit the lowerintestine following cesarean delivery may be significantly differentfrom those found in a newborn delivered through a natural birthprocess.

Developmentof an infant`s immune system

Thefirst steps in the development of immune system usually occurs at thetime when the core microbiota is formed, and the gut bacteria usuallyplay a significant role in the process [ CITATION Joh12 l 1033 ].In days following birth, the newly arrived gut bacteria induce theinfant to produce white blood cells as well as other immune systemcomponents such as antibodies which are directed at disease-causingmicroorganisms. The microbiota bacteria also help the infant`s immunesystem to tolerate their presence[ CITATION Joh12 l 1033 ].However, in a cesarean delivery, the fledging immune system isusually confronted with often-hostile bacteria such as Clostridiumdifficile, an often-troublesome pathogenic bacterium that can lead tosevere diarrhea. Available data indicate that atopic illnesses appearmore often in newborns after CD than after natural birth process[ CITATION Joh12 l 1033 ].Therefore, the composition of enteric microbiota in days after birthseems to be an essential factor for achieving and sustaining goodhealth in months and years to come.

Significanceof the proposed research

Infanthealth remains to be a contemporary issue that needs to be addressed.The determination of whether or not natural birth helps inimprovement of their health is essential. A comparison of the twomodes of delivery will help guide in nursing practice and encouragemothers on the best option of delivery. The study will help parentsand physicians realize that their decisions about the mode ofdelivery can have significant impact on their newborn`s gut healthand this can have possibly lifelong effects on the baby`s health.

ChapterIII: Research proposal

Populationand sample

Thepopulation to be sample will comprise of women who recentlydelivered. Samples will be selected randomly from two strata of womenwho delivered through a natural birth process and the cesareandelivery.


Astratified sampling procedure will be used followed by a selection ofa simple random sample from the groups. The population will begrouped into two, comprising of women who delivered through theC-section and virginal delivery. Random samples of 50 from each groupwill then be selected for purposes of the study.


Thisdescriptive study will be done by conducting a survey as part of theresearch to aid in the collection of relevant data for purposes ofthe study. Data will be gathered using structured questionnairesfrom the research participants for further analysis andinterpretation.

Typeof data to be gathered and data collection instruments and procedures

Qualitativedata will be gathered in the study about the newborns` gut health.Thus, the type of data to be collected is qualitative. Questionnaireswill be used as the data collection instruments, and the participantswill take part in a survey in which the questionnaires will beadministered. Data will be collected from a total of at least 100women. Consideration will be given for mother`s diet history the weekthey gave birth to their child. The questions will be asked in theform of a survey. The answers provided by the mother will becorrelated with the observations made on the infant to determinetheir overall health. It would be possible to understand thecorrelation between the natural birth and C-section mode of deliveryon infant gut health.

Methodsof data analysis

Theinfants` gut health will be examined and analyzed and compared withthe mode of delivery used by their parents. This will help informulating viable inferences about the effects of natural birthcompared to cesarean delivery on the improvement of gut health oninfants.


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Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S., . . . Black, R. E. (2013). Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet, 452-477.

Christian, P., Mullany, L. C., Hurley, K. M., Katz, J., &amp Black, R. E. (2015). Nutrition and maternal, neonatal, and child health. Seminars in perinatology (pp. 361-372). Elsevier.

Gregory, K. E., LaPlante, R. D., Shan, G., Kumar, D. V., &amp Gregas, M. (2015). Mode of Birth Influences Preterm Infant Intestinal Colonization With Bacteroides Over the Early Neonatal Period. Advances in Neonatal Care, 386-393.

Grześkowiak, Ł., Grönlund, M.-M., Beckmann, C., Salminen, S., von Berg, A., &amp Isolauri, E. (2012). The impact of perinatal probiotic intervention on gut microbiota: double-blind placebo-controlled trials in Finland and Germany. Anaerobe, 7-13.

Johnson, C. L., &amp Versalovic, J. (2012). The human microbiome and its potential importance to pediatrics. Pediatrics, 950-960.