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Does 'Vaginal Seeding' Work? Doctors Say There's Not Enough Evidence

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People will do just about anything for their kids. And for some parents of babies born by Caesarean section, that includes swabbing a baby with bacteria from their mother’s vagina. It’s a new idea, but it’s catching on—despite the fact that there’s no evidence that it helps, as several doctors note in the British Medical Journal (BMJ). 

The practice is called “vaginal seeding,” and aims to bolster a newborn’s health with the helpful starter bacteria he or she might have missed by skipping the birth canal. Microbiome is the collective term for the ecosystems of bacteria, fungi, and viruses living on and in your body. As you’ve probably heard by now, not all microbes are bad. In fact, you need a certain diversity and balance of microbes to keep your body functioning. You pick up these microbes everywhere you go, from the doorknob of a hotel room to kissing a friend on the cheek. Most people get their first microbial download as they enter the world. But C-section babies don’t. 

The concept seems sound enough. But, as the authors of the BMJ editorial explain, there’s simply no evidence that vaginal seeding is actually effective or safe.

"Demand for this process has increased among women attending hospitals in the UK—but this has outstripped professional awareness and guidance,” co-author Aubrey Cunnington said in a press statement. “At the moment we're a long way from having the evidence base to recommend this practice. There is simply no evidence to suggest it has benefits—and it may carry potential risks." 

Swabbing a baby transfers all kinds of microbes, both harmful and helpful. And since there’s no catalog of which bacteria are being shared, there’s no way of knowing which pathogens might be causing a baby’s sickness down the line. 

"In some countries, including the UK, we don't test pregnant women for the bacteria group B streptococcus,” Cunnington continued. “This is carried by around one in four pregnant women, and although it poses no risk to the mother, it can cause fatal infections in babies. There are also other conditions that cause no symptoms in the mother, such as chlamydia, gonorrhea, and herpes simplex virus that could be transferred on the swab. One colleague had to intervene when a mother with genital herpes, who had undergone a Caesarean section, was about to undertake this process. Swabbing would have potentially transferred the herpes virus to the baby." 

Hospital staff will also not expect a C-section baby to be vulnerable to the kinds of infections as a baby born of vaginal delivery. “It's important [that] parents tell staff they have performed the procedure, so the healthcare team are aware the baby is at risk of the same infections as a baby born by vaginal delivery," Cunnington added.

The bottom line is that parents and physicians should wait for more data before whipping out the swabs. In the meantime, Cunnington says, they can focus on evidence-based methods of boosting a baby’s microbiome: "Encouraging breast feeding and avoiding unnecessary antibiotics may be more important to a baby's gut bacteria than worrying about transferring vaginal fluid on a swab."

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How Your Sleeping Position Can Help (or Harm) Your Health
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Getting a good night's sleep is key to your health, but what's the best position for maximizing those benefits? According to SciShow, the answer depends on who you are and what your body is presently doing. Do you have acid reflux? You might want to avoid sleeping on your right side, since studies have shown that can aggravate heartburn (though scientists still aren't quite sure why). Are you pregnant? Aim for the left side, since it helps blood and nutrients flow to the placenta, among other benefits. Do you snore? Maybe avoid sleeping on your back, and roll over on your side instead. The video below goes over the whole menu of possible sleeping positions, and explains which ones will help you get the most out of your 40 winks.

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Harris and Ewing, Library of Congress
14 Facts About Margaret Sanger
Harris and Ewing, Library of Congress
Harris and Ewing, Library of Congress

Born in 1879, activist Margaret Sanger sparked both revolution and controversy when she began pushing for legalized access to birth control and founded the Planned Parenthood Federation of America. Sanger remains a controversial figure even today, more than 50 years after her death.

1. SHE BLAMED HER FATHER FOR HER MOTHER'S DEATH.

Sanger was born Margaret Louise Higgins, the sixth of 11 children. Her mother, Anne Purcell Higgins, also had seven miscarriages, for a grand total of 18 pregnancies within 22 years. She suffered from poor health for much of that time, and when Anne died of tuberculosis at age 50, Margaret was just 19 years old. According to TIME Magazine, Margaret confronted her father at her mother's coffin and said, "You caused this. Mother is dead from having too many children."

2. SHE WANTED TO BE A DOCTOR.

Margaret Sanger sitting at a table.
Harris and Ewing, Library of Congress

Sadly, medical school was too expensive, so instead she entered a probationary nursing program in 1900. In early 1902, she met architect William Sanger. The two got married later that year and moved to Hastings-on-Hudson, New York, a suburb about 20 miles away from New York City. They had three children.

3. HER HOUSE CAUGHT FIRE, LEADING HER TO MOVE TO THE CITY.

After the Sangers' house in Hastings-on-Hudson caught fire, Sanger stopped enjoying life in the suburbs. By 1911 the couple had decided to start a new life in Greenwich Village, where Sanger joined the Women's Committee of the New York Socialist Party. There, she met fellow radicals and reformers—like novelist Upton Sinclair, anarchist Emma Goldman, art patron Mabel Dodge Luhan, and intellectual Max Eastman—who supported her ambitions to help working women.

In New York City, Sanger decided to jump back into her career by working as a visiting nurse in the Lower East Side tenements. She often treated women who attempted to give themselves abortions because they didn't have the money to care for another child. Dismayed by the poor health and poverty she saw among immigrants there, she developed opinions that would later lead to her advocacy for birth control.

4. SHE BELIEVED BIRTH CONTROL WAS A FREE SPEECH ISSUE.

Soon after arriving in Greenwich Village, Sanger began writing sex education columns for the New York Call, a socialist newspaper. Her frank discussion of women's sexuality and reproduction offended some readers. In 1913, politician and post office official Anthony Comstock censored her column because he considered her usage of words like syphilis and gonorrhea too vulgar.

A year after her column in the New York Call was banned, Sanger launched The Woman Rebel, an eight-page monthly newsletter advocating contraceptive use. Operating under the slogan "No gods, no masters," Sanger used the newsletter to openly defy Comstock's eponymous 1873 laws. (The Comstock laws made it illegal to use the United States Postal Service to send anything containing information about contraceptives or anything else deemed obscene.) She was indicted in August 1914, but she fled to Europe to avoid arrest. She would eventually return to the United States to face trial, but in February 1916 the prosecution dropped the charges.

5. SHE WAS AGAINST ABORTION.

Despite her advocacy for family limitation, Sanger disliked the idea of abortion. She believed proper education and legalized contraceptives would reduce the need for the procedure. In her 1938 autobiography, Sanger described her experience treating Sadie Sachs, one of the women in the East Side tenements. In 1912, Sachs's husband called for Sanger's help after he found Sachs unconscious from a self-induced abortion. After three weeks of treatment from both Sanger and a local doctor, the only advice the doctor could offer Sachs was to avoid "any more such capers" and have her husband sleep on the roof.

Three months later, Sachs became comatose from another self-induced abortion, and Sachs's husband again reached out to Sanger for help. The woman died within 10 minutes of Sanger's arrival. Frustrated by the lack of resources and information available to lower-class women, Sanger resolved to make changes. From that time forward, she wrote, she wanted to "do something to change the destiny of mothers whose miseries were as vast as the skies."

6. SHE POPULARIZED THE TERM BIRTH CONTROL.

Sanger is often credited for coining the term, but that honor actually goes to Robert Parker, a friend of hers who helped create The Woman Rebel. In her 1979 biography on Sanger, author Madeline Gray described Parker as a polio victim who studied yoga with the hopes of gaining more control over his partly paralyzed hand. Gray wrote:

"It occurred to him that control might apply to birth as well. 'Birth control,' he mused. 'Birth control … I think I like it.' They all liked it. As they put on their hats and left, they agreed that birth control was the best name for the movement."

Otto Bobsien, another of Sanger's colleagues, was the first to use the term to proclaim the start of the Birth Control League of America, a new organization he later said "never had more than a nominal existence." In 1915, when Sanger was away in Europe, Bobsien joined the National Birth Control League and offered the fledgling organization use of the movement's new name. When Sanger returned from Europe later that year, she helped popularize the term, considering it more straightforward than phrases like "family limitation."

7. SHE OPENED THE FIRST BIRTH CONTROL CLINIC IN THE U.S.

Historical image of Margaret Sanger standing on a street in New York City
Sanger outside of her trial on January 30, 1917.
Bain News Service, Library of Congress

In October 1916, Margaret Sanger opened a birth control clinic in Brooklyn with the help of her sister, Ethel Byrne, and interpreter Fania Mindell. It was the first of its kind in the U.S., and she modeled it after a Dutch clinic she had visited while evading American police. In the Netherlands, Sanger had learned about pessaries and diaphragms and became convinced they were more effective than the suppositories and douches she promoted in the United States. Sanger brought that new knowledge to her Brooklyn clinic, which served more than 100 women on its first day. For a cover charge of 10 cents, Sanger gave every woman a pamphlet of her New York Call column on "What Every Girl Should Know," a lecture on the female reproductive system, and instructions on several types of contraceptive use. The clinic closed just nine days later when Sanger was once again arrested for violating the Comstock laws. Sanger immediately attempted to reopen the clinic after being released on bail, but, as she wrote, she was promptly re-arrested and charged as a public nuisance.

8. SHE ONCE TOLD A JUDGE SHE COULDN'T RESPECT EXISTING LAWS.

Sanger and Byrne's court trials began in January 1917. Sanger's sister was tried first and sentenced to 30 days in a workhouse, but she immediately went on a hunger strike; Byrne fasted for a week before being force-fed by prison staff. When Sanger went to trial on January 29, she was supported in court by several Greenwich Village socialites and about 50 of the women she'd treated in the Brooklyn clinic. Presiding Justice John J. Freschi offered her a lenient sentence if she promised to obey the law, but Sanger responded by saying, "I cannot respect the law as it exists today." Sanger was found guilty and Freschi also sentenced her to 30 days in a prison workhouse.

In 1918, Sanger appealed the court decision and won a victory for the birth control movement. Although the court upheld Sanger's conviction and she still had to serve her 30 day sentence, Judge Frederick E. Crane of the New York Court of Appeals also ruled that doctors could prescribe contraceptives and disseminate information about birth control under certain conditions. Sanger ran with the new loophole in 1923, when she established a new clinic staffed largely by female doctors. The new clinic operated alongside the American Birth Control League. Almost two decades later, in 1939, the league and the clinic merged, forming the Birth Control Federation of America, and in 1942 this new organization officially became known as the Planned Parenthood Federation of America.

9. THE ROCKEFELLERS ANONYMOUSLY SUPPORTED HER CAUSE.

In the mid-1920s, John D. Rockefeller Jr. anonymously donated $10,000 to the American Birth Control League to fund research into contraceptives. Rockefeller's son, John D. Rockefeller III, continued his father's early support of Sanger's work, albeit more publicly. The Rockefeller Brothers Fund donated money to Planned Parenthood until 1981, when it decided to start funding agricultural research—which was decidedly less controversial—instead.

10. LIKE MANY WELL-KNOWN INTELLECTUALS OF HER DAY, SANGER SUPPORTED EUGENICS.

Many historians believe Sanger's support of eugenics was part strategic and part ideological. Sir Francis Galton, a cousin of Charles Darwin's, initiated the Western eugenics movement by suggesting that traits like "talent and character" could be passed down to children through intentional breeding. Several British and American academics latched onto the idea, including figures like Theodore Roosevelt, John D. Rockefeller Jr., and Alexander Graham Bell. Sanger's support for sterilizing the diseased and "feebleminded" legitimized the birth control movement by aligning her ideas with those of contemporary intellectuals.

Sanger's belief in eugenics was a little different from other intellectuals', though. Eugenicists, she said, believed a woman's first duty should be to the state, and that all "fit" women should bear children. Sanger, on the other hand, thought a woman's first duty should be to herself. She contended the primary reason for birth control was to prevent pregnancies among women who couldn't support a child financially. Sanger believed her ideal of economic eugenics was morally superior to the views posed by traditional eugenicists.

The modern-day Planned Parenthood doesn’t hide Sanger's controversial support of the eugenics movement, but it doesn't endorse it, either. In a document published in 2016 [PDF], the organization said, "We believe that [those ideas] are wrong. Furthermore, we hope that this acknowledgement fosters an open conversation on racism and ableism—both inside and out of our organization."

11. HER BOOKS WERE AMONG THE FIRST BURNED BY NAZIS.

In May 1933, Nazis sanctioned the burning of more than 25,000 books deemed "un-German." Sanger had published at least nine books by that point, and they were all among that number, as were titles by Jack London, Ernest Hemingway, Sigmund Freud, Albert Einstein, and dozens of others. Sanger's books, which advocated for women's choice in everything from childbirth to politics, directly contradicted everything the Third Reich believed. Adolf Hitler supported traditional gender roles and wanted to maintain high birth rates, ideas Sanger decried in her books.

12. HER NIECE WAS PART OF THE INSPIRATION FOR WONDER WOMAN.

A panel of a Wonder Woman comic from 1978.
Tom Simpson, Flickr // CC BY-NC-ND 2.0

Olive Byrne, Sanger's niece, was involved in a polyamorous relationship with Wonder Woman creator William Moulton Marston and his wife, Elizabeth Holloway Marston. Marston credited both Olive and Elizabeth as his muses, according to historian Jill Lepore. In her 2014 book The Secret History of Wonder Woman, Lepore wrote that Marston based part of Wonder Woman's costume on the silver bracelets Olive often wore. Lepore also suggested Sanger herself may have been an influence on the popular comic book character. Feminist movements in the early 1900s often symbolized female oppression with chains, and Sanger was quick to adopt such symbolism with books like Motherhood in Bondage. Wonder Woman's use of chains and ropes as weapons echoed Sanger's vision for female liberation.

13. SHE WAS NOMINATED FOR THE NOBEL PEACE PRIZE 31 TIMES.

Margaret Sanger received 31 nominations for the Nobel Peace Prize between 1953 and 1963. In 1960 alone, she received 20 nominations from 16 university professors and four members of India's parliament (Sanger took several trips to India, where she worked with people like Gandhi to discuss birth control).

14. SHE LIVED JUST LONG ENOUGH TO SEE HER LIFE'S WORK COME TO FRUITION.

Planned Parenthood's publicity director looks over a poster in 1967.
H. William Tetlow, Fox Photos/Getty Images

Two important legal milestones happened after Sanger founded the American Birth Control League in 1921. In December 1936, the 2nd U.S. Circuit Court of Appeals effectively overturned all federal restrictions on birth control, making it legal for doctors throughout the United States to provide access to contraception. On the state level, contraception was legal in some form or another everywhere except Connecticut, Mississippi, and Massachusetts. In 1965, Griswold v. Connecticut overturned the state laws preventing married women from accessing birth control. Griswold v. Connecticut later served as precedent for cases like Eisenstadt v. Baird (1972), which gave unmarried couples unrestricted access to contraception; Roe v. Wade (1973), which legalized abortion; and Carey v. Population Services International (1977), which made it legal for doctors and pharmacists to distribute contraceptives to minors.

Sanger died on September 6, 1966, about a year after the Supreme Court decided on Griswold v. Connecticut. The next day, Alaska Senator Ernest Gruening spoke about Sanger in Congress. In an address to the president, Gruening said Sanger was "a great woman, a courageous and indomitable person who lived to see one of the most remarkable revolutions of modern times—a revolution which her torch kindled."

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