Primal Health Research Perspecitve on C-sections/interventions and autism

I posted the excerpt below on my Healing and Preventing Autism Naturally Group but thought you all might enjoy this article too!

 

If it is already posted somewhere else on here, just let me know and I'll delete it :)

 

http://www.wombecology.com/caesareans.html

 

EXCERPT:

 

"My interest in autism started in 1982, when I met Niko Tinbergen, one of the founders of ethology, who shared the Nobel prize with Konrad Lorenz and Karl Von Frisch in 1973. As an ethologist familiar with the observation of animal behaviour, he studied in particular the non-verbal behaviour of autistic children. As a "field ethologist" he studied the children in their home environment. Not only could he offer detailed descriptions of his observations, but at the same time he listed factors which predispose to autism or which can exaggerate the symptoms(12).

He found such factors evident in the period surrounding birth: induction of labour, "deep forceps" delivery, birth under anaesthesia, and resuscitation at birth. Interestingly this pioneer introduced the variable ‘labour induction’. When I met him he was exploring possible links between difficulty in establishing eye-to-eye contact among autistic children and the absence of eye-to-eye contact between mother and baby at birth. The work of Tinbergen (and his wife) represents the first attempt to explore autism from a "primal health research" perspective.

It is probably because I met Niko Tinbergen that I read with special attention, in June 1991, a report by Ryoko Hattori, a psychiatrist from Kumamoto, Japan.(13) She evaluated the risks of becoming autistic according to the place of birth. She found that children born in a certain hospital were significantly more at risk of becoming autistic. In that particular hospital the routine was to induce labour a week before the expected date of birth and to use a complex mixture of sedatives, anaesthesia agents and analgesics during labour. This study could not dissociate the effects of labour induction and the effects of drugs used during labour.

We had to wait until 2002 for a large-scale study to be published in the medical literature.(14) The researchers had at their disposal the recorded data from the Swedish nationwide Birth Register regarding all Swedish children born during a period of 20 years (from 1974 until1993). They also had at their disposal data regarding 408 children (321 boys and 87 girls) diagnosed as autistic after being discharged from a hospital from 1987 through 1994 (diagnosis according to strict criteria). For each case five matched controls were selected, resulting in a control sample of 2040 infants. The risk of autism was significantly associated with caesarean delivery, a 5-minute Apgar score below 7 (in other words: baby not in good shape at birth), maternal birth outside Europe and North America, bleeding in pregnancy, daily smoking in early pregnancy, being small for gestational age, and congenital malformations. Unfortunately the authors could not dissociate scheduled caesareans and caesareans during labour. Also, the variable ‘labour induction’ could not be taken into account, because it did not appear in the National Birth Register until 1991, as I learnt from personal correspondence with one of the authors."

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This is very interesting. I know a woman who's son was diagnosed at age 5 with autism. He thankfully lost his diagnosis at age 7, thanks to a drastic change in diet, and lifestyle. Her husband is a physician and they have a wellness practice that specializes in working with children with autism. Their theory is that certain individuals are born with systems that do not effectively clear toxins. So toxins build up in the brain, and lead to autism. It's much more complicated than that but that's the gist.

To me this fits in well with the findings in these studies. That is if you believe that things like pitocin and epidural anesthesia do cross to baby's system.
That is so wonderful that he lost his diagnosis! I love such hopeful stories! I agree that the world of autism is so much more complicated than just one thing or another. It's a plethora of things. I know one thing for sure....never has prenatal care and education on nutrition been more important than NOW with all the misguided labeling, toxic chemicals, overuse of pharmaceuticals, useless medical interventions during birth, etc...

Little do women know how proactive changes in their prenatal care and birth can alter the future for their child.

I would love to know about the wellness practice of your friends, as I often help families with autism and like to give them all the resources I can :)
We are in CA, here is their website. http://www.slettenwellness.com/
thanks for this, BTW :)
I try to keep up with the factors associated with developing autism since my middle children are identical twin boys who fall into the highest risk group. I can't even count the hours I've spent checking and rechecking the diagnostic criteria in order to reassure myself that their development is in the normal range. Autism is such a frightening spectre! I often wonder how many other families are paranoid that their children might develop symptoms which would land them on the ASD scale.

My husband works within the scientific community and has commented on epigenetic studies which suggest that cesarean section babies have different DNA methylation patterns which *might* put them in a higher risk group for developing diseases (including autism in some studies). There is so much work that needs to be done in order to create a checklist of ways to reduce the likelihood of autism in children, and IMO it makes a lot of sense to avoid disrupting pregnancy and all 3 stages of birth unless there are sound medical reasons to intervene.

http://www.medscape.com/viewarticle/705279

July 6, 2009 — Levels of global DNA methylation are higher in neonates born by cesarean delivery than in those delivered vaginally, according to a report in the July issue of Acta Paediatrica. The difference in methylation becomes nonsignificant within 3 to 5 days postnatal, but other studies — showing increased risk for allergies, asthma, type 1 diabetes mellitus, testicular cancer, and childhood leukemia in cesarean-delivered individuals later in life — suggest the possibility that the influence of these epigenetic changes may persist.

http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be...

Prior to the advent of medical delivery, and for all time in animals, it has been the natural way of things for a baby to stay on the umbilical cord for a significant period of time after delivery. Depending on culture and situation, the delay in cord separation could be a few minutes or even a few hours. In some cultures the placenta is left on for days, which of course I find excessive and gross (5). But whatever the culture and time on cord, the absence of immediate cord clamping allows fetal blood that was previously in the placenta to transfuse back into the baby. Studies have demonstrated that a delay of as little as thirty seconds between delivery and cord clamping can result in 20-40 ml*kg-1 of blood entering the fetus from the placenta (6).
Ugh! The medscape link isn't working properly. Here is the title of the article and the author:

Higher DNA Methylation in Cesarean-Delivered Newborns May Be Linked to Later Disease Development

Jacquelyn K. Beals, PhD

Text:

July 6, 2009 — Levels of global DNA methylation are higher in neonates born by cesarean delivery than in those delivered vaginally, according to a report in the July issue of Acta Paediatrica. The difference in methylation becomes nonsignificant within 3 to 5 days postnatal, but other studies — showing increased risk for allergies, asthma, type 1 diabetes mellitus, testicular cancer, and childhood leukemia in cesarean-delivered individuals later in life — suggest the possibility that the influence of these epigenetic changes may persist.

"We really don't know the cause of the difference in DNA methylation between infants born by [cesarean delivery] and those born normally, vaginally," said senior author Mikael Norman, MD, PhD, professor of pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institute and University Hospital, Stockholm, Sweden, in a telephone interview with Medscape Obstetrics & Gynecology. "That's one of the things that we're discussing in our paper."

The study involved 37 healthy infants (20 boys) of normal weight born after 40 ± 2.6 weeks' gestation. The births of 21 infants were by spontaneous vaginal delivery, whereas 16 were born by elective cesarean delivery before initiation of labor. Umbilical cord blood was obtained immediately after delivery, with follow-up blood samples from a peripheral vein obtained 3 to 5 days postnatal. DNA was extracted from white blood cells and analyzed to determine the extent of DNA methylation.

"Levels [of DNA methylation] in babies born by [vaginal delivery] seem to be stable [from] immediately postnatal to 3 to 5 days later. We do not know about the levels in utero, but we guess that global DNA methylation is higher — maybe at the same level...we found in babies delivered by elective [cesarean delivery]," noted first author Titus Schlinzig, MD, from the Neonatal Unit, Karolinska University Hospital, Stockholm, in an email to Medscape Obstetrics & Gynecology.

The study found that, immediately after birth, global DNA methylation was significantly higher (P < .001) in white blood cells of infants born by elective cesarean delivery. By 3 to 5 days postnatal, the difference in DNA methylation between vaginally and cesarean-delivered infants was no longer significant (P = .10).

Within the cesarean-delivered group, DNA methylation underwent a significant decrease between birth and 3 to 5 days postnatal (P = .01); no change was observed during this interval in vaginally delivered infants (P = .55). Among risk factors considered for potential correlation with neonatal DNA-methylation were maternal folate and C-reactive protein levels, duration of delivery, and infant folate and C-reactive protein levels; however, no significant correlations were found.

The diseases for which cesarean delivery increases the risk are immunological disorders. Although white blood cell functioning reportedly changes as a result of cesarean delivery, the present study acknowledges that "the underlying mechanisms for these associations are unclear." As Dr. Schlinzig observed, "Our data cannot explain the increased risk for asthma, allergy, leukemia...in later life, but it could be [a common] mechanism, and further studies are needed. The hygiene hypothesis could be another explanation," he added.

The hygiene hypothesis proposes that changes in the microbes that colonize the gut of newborns may affect the immune system and increase the risk for allergic diseases after cesarean delivery. "Of course the colonization of the gut and colonization of all mucous membranes and skin with bacteria certainly would activate the immune system," Dr. Norman agreed. "Colonization could also be a trigger of differences in DNA methylation. That could be, perhaps, another step in understanding why children and young adults have more allergy and asthma."

But the way in which DNA methylation affects the immune system is not clear. "We would like to reproduce our findings, but also see if there is an association between DNA methylation at birth and stress hormones like catecholamines," said Dr. Norman.

Moshe Szyf, PhD, professor in the Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada, regards this article as the first to demonstrate the effect of seemingly harmless interventions on our genome. "The DNA seems to record the changes to environments in early life. It will be interesting to see what fraction of these changes remain as a memory in our DNA for our life course," he said via email to Medscape Obstetrics & Gynecology.

Dr. Szyf also discussed variations in DNA methylation in a commentary published in the same issue of Acta Paediatrica, asking how the early global changes could affect health in later life. "Perhaps the answer to this question is to be found in the difference between global and site-specific methylation," he suggested.

Dr. Norman shares this view: "[W]e have looked at global DNA methylation in white blood cells, and of course we are very interested in more specific gene regions, or even genes. So that would be another way to go forward — to look in more detail at which genes are differently methylated in these 2 groups of infants."

Dr. Norman, Dr. Schlinzig, and Dr. Szyf have disclosed no relevant financial relationships.

Acta Paediatr. 2009;98:1082–1084; 1096–1099.
"But whatever the culture and time on cord, the absence of immediate cord clamping allows fetal blood that was previously in the placenta to transfuse back into the baby. Studies have demonstrated that a delay of as little as thirty seconds between delivery and cord clamping can result in 20-40 ml*kg-1 of blood entering the fetus from the placenta (6)."

Most midwives I know of, wait until the cord stops pulsating so that infusion of blood has a chance to run its course (critically important and very neccessary). I did not experience this with my hospital birth but did both times at home. I was very disturbed when I was told the story of a CPM then doula who watched the hospital staff clamp and cut the cord before the baby was fully out of mama, due to a very loose cord wrap. That baby was without oxygen for a a few minutes....scary!

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