"The outcomes of maternity care and maternity care interventions have traditionally focused on important short-term outcomes such as perinatal mortality, newborn morbidity (e.g., measured by Apgar score, cord blood analysis, and/or admission to advanced care), and certain maternal outcomes. There is increasing recognition, including from other frameworks, that exposures during the highly sensitive perinatal period may have implications for longer-term health and well-being" (Buckley, 2015).
Let's take a look at the a few of the other frameworks mentioned in the report by Buckley, and why they should be taken into consideration when looking at the hormonal physiology of labor and delivery.
One framework, entitled Fetal Origins of Adult Disease (FOAD), has now branched out into the peri- and post-natal periods, looking at the developmental origins of health and disease (DOHaD). It recognizes that "a stimulus or insult at a critical period of development has lasting or lifelong effects" and now considers the newborn to be equally vulnerable. Research shows fetal programming is a mechanism to optimally adapt the infant for future environments and effects. Studies in the biochemical process of epigentics, which turn genes on and off, have found "increased DNA methylation, a marker of epigenetic changes, in human newborn tissues following cesarean compared with vaginal births" (Buckley, 2015), as well as adult animal behavior and brain function when comparing vaginal and surgical births, and increased stress responses and increased risks of certain adult diseases in infants born surgically (asthma, allergies, Type 1 diabetes, overweight and obesity, and celiac disease).
Out of the multitude of epigenetic programming research has risen the EPIIC hypothesis: epigenetic impact of childbirth, which suggests that "physiological labor and birth have evolved to exert eustress (a healthy positive form of stress) on the fetus, and that this process has an epigenomic effect on particular genes...Reduced or elevated levels of cortisol, adrenalin, and oxytocin produced during labor may lead to fetal epigenomic remodeling anomalies which exert influence on abnormal gene expression. This reprogramming could manifest in a range of non-cummunicative diseases and biobehavioural problems in the neonate and into adulthood" (Buckley, 2015).
The microbiome is an area of intense study and research at this time. In fact, there are hospitals and birthing centers around the world that are using vaginal secretions at birth to "seed" the neonate born surgically, who has had no direct contact with the birth canal. This assists with the appropriate microbes introduced to the infant for establishing appropriate microbiomes throughout their internal and external systems.
Few medium- and long-term studies have been done on the impacts over time of the maternity care provided during the birth process. Buckley notes, "Markedly missing from current research are high-quality studies of the impact of perinatal interventions on medium-term outcomes such as breastfeeding success and duration, maternal-infant attachment, maternal emotional well-being, and other hormonally-mediated salutogenic outcomes" (2015).
Lastly, Buckley makes an excellent case for questioning total reliance on evidence-based health care, in that there is:
"Because of these limitations, the use of evidence-based health care may be an insufficient safeguard for maximizing benefits and minimizing harms in the mothers and babies in relation to maternity care" (Buckley, 2015).
Very stimulating and though-provoking information is provided in the extensive and well-researched Buckley report. It causes me to wonder what we have done in years past, and what we currently do for childbirth....what will be the outcomes in decades and centuries to come? Hmmm.
Buckley, S. J. (2015). Hormonal physiology of childbearing: Evidence and implications for women, babies, and maternity care. Downloaded from http://childbirthconnection.org/pdfs/CC.NPWF.HPoC.Report.2015.pdf
When you visit the Site, we automatically collect certain information about your device, including information about your web browser, IP address, time zone, and some of the cookies that are installed on your device. Additionally, as you browse the Site, we collect information about the individual web pages or products that you view, what websites or search terms referred you to the Site, and information about how you interact with the Site. We refer to this automatically-collected information as Device Information."
We collect Device Information using the following technologies:
Additionally when you make a purchase or attempt to make a purchase through the Site, we collect certain information from you, including your name, billing address, shipping address, payment information (including credit card numbers), email address, and phone number. We refer to this information as "Order Information."
We use the Order Information that we collect generally to fulfill any orders placed through the Site (including processing your payment information, arranging for shipping, and providing you with invoices and/or order confirmations). Additionally, we use this Order Information to:
We use Student Access Information to provide accurate tracking to Users and Clients on completion and use of the courses, as well as for analysis on how to improve our services.
We use the Device Information that we collect to help us screen for potential risk and fraud (in particular, your IP address), and more generally to improve and optimize our Site (for example, by generating analytics about how our customers browse and interact with the Site, and to assess the success of our marketing and advertising campaigns).
We share your Personal Information with third parties to help us use your Personal Information, as described above. For example, with your employer who needs to verify your completion or progress of your studies. We also use Google Analytics to help us understand how our customers use the Site--you can read more about how Google uses your Personal Information here: https://www.google.com/intl/en/policies/privacy/. You can also opt-out of Google Analytics here: https://tools.google.com/dlpage/gaoptout.
Finally, we may also share your Personal Information to comply with applicable laws and regulations, to respond to a subpoena, search warrant or other lawful request for information we receive, or to otherwise protect our rights.
As described above, we use your Personal Information to provide you with targeted advertisements or marketing communications we believe may be of interest to you. For more information about how targeted advertising works, you can visit the Network Advertising Initiative's ("NAI") educational page at https://www.networkadvertising.org/understanding-online-advertising/how-does-it-work.
You can opt out of targeted advertising by:
Additionally, you can opt out of some of these services by visiting the Digital Advertising Alliance's opt-out portal at: http://optout.aboutads.info.
Please note that we do not alter our Site's data collection and use practices when we see a Do Not Track signal from your browser.
If you are a European resident, you have the right to access personal information we hold about you and to ask that your personal information be corrected, updated, or deleted. If you would like to exercise this right, please contact us through the contact information below.
Additionally, if you are a European resident we note that we are processing your information in order to fulfill contracts we might have with you (for example if you make an order through the Site), or otherwise to pursue our legitimate business interests listed above. Additionally, please note that your information will be transferred outside of Europe, including to Canada and the United States.
When you place an order through the Site, we will maintain your Order Information and Student Access Information for our records unless and until you ask us to delete this information. We are required to keep course completion records for at least 5 years in order to comply with certain accreditation requirements.
For more information about our privacy practices, if you have questions, or if you would like to make a complaint, please contact us by e-mail at email@example.com or by mail using the details provided below:
5890 Monkland Avenue, #16, Montreal, QC, H4A 1G2, Canada
Last Updated: September 2018