ISSN 0256-5004 (Print)

AIMS Journal Vol 26 No 4

Microbirth was released globally on 20 September 2014

An audience largely made up of birth workers and mothers – some with child in tow – gathered in Bristol for the screening of One World Birth’s new feature-length documentary. This event was one of hundreds held worldwide to mark its global release and one of 17 held by AIMS volunteers across the UK.

Most of us already agreed with British film-maker couple Toni Harman and Alex Wakeford’s credo Save Birth, Change the World. We were about to be shown new evidence to support the potency and truth of the statement.

After their film Freedom for Birth – which highlighted human rights abuse in childbirth – their new production Microbirth investigates the microscopic unfoldings around the time of birth and explores their role in shaping the short-and long-term health of the newborn, as well as their implication for the health of generations to follow.

Normal, undisturbed birth is likened to a ‘programming event’ during which a complex interplay of bacterial, hormonal and genetic processes are triggered to give the child the best start in life. The film focuses primarily on the transmission of bacteria from mother to child through vaginal birth, immediate skin-to-skin contact and prolonged breastfeeding. It explains how the seeding of this colony of bacteria, known as the microbiome, helps prime and educate the baby’s immature immune system and metabolism. It also describes how caesarean sections and other interventions in childbirth are proven to interfere with this seeding and the increasing evidence that links an incorrectly seeded microbiome to the development of one or more noncommunicable diseases later in life. These diseases include asthma, obesity, cardio-vascular disease, coeliac disease, some cancers and mental health disorders and currently account for 60% of global deaths.

Could safeguarding normal birth be the simple solution to a problem projected to bankrupt the world’s healthcare systems by the year 2030?

I am excited by the film’s invitation to reconsider our relationship with bacteria. In light of the research on the human microbiome, we now know that our bodies consist of ten times more microbial cells than human cells; a symbiotic cohabitation that has evolved over millennia and ensures our species’ survival. This natural defence system against pathogens should be cherished as our ‘maternal inheritance’ and our birth choices and indiscriminate use of antibiotics and all things anti-bacterial examined with scrutiny.

Microbirth assembles an impressive panel of experts to discuss some emerging, cutting-edge research. It recently received some recognition from the scientific community by taking home the top prize at the Life Sciences Film Festival in Prague. However, the film somewhat loses focus in trying to take on too much science; the subject of epigenetics and oxytocin in childbirth are touched upon but would both deserve an hour-long exploration in their own right.

The film’s overall tone was perceived as alarmist by a few audience members but I find it serves well to underline the urgency of the situation. With an estimated one third of our microbial diversity already lost, there is no sugar-coating the fact that we run the risk of breeding a weakening society.

Ecologists will remind us that diversity is key in maintaining a healthy ecosystem and parallels with the current environmental situation are inescapable, as is the fact that we might pay a high price for not heeding these early warnings.

Guilt surrounding their own birth experiences prevented some viewers from seeing the bigger picture that the film strived to portray. If mothers were the target audience, the issue of perceived judgement could have been dealt with more sensitively in order for the film to have a maximum impact with a lay audience, particularly as caesarean deliveries worldwide still far exceed the WHO’s recommended 10-15% of births.

One of the guest speakers at the event urged mothers to adopt a global rather than personal perspective on this matter. Indeed the film appears to target a wider audience: those currently absent from the debate who might not otherwise be sensitive to the subject of birth. By emphasising the socio-economic ramifications of the issue, it hopes to show policy-makers just how crucial birth is in shaping society and highlights the work that remains to be done on structures surrounding bir th as well as the need for funding the appropriate research.

This is an ambitious and thought-provoking film that has the capacity to start an important conversation. I would recommend it to anyone interested in birth and indeed thefuture of humanity. Yet the scale and complexity of the problem addressed detract from the potential simplicity of its solution. Should we really be looking at technology, research or yet another intervention to save us? Or should we follow the lead of our guest speaker, Amanda Rayment, and ask ourselves: what would happen if we left birth alone?

Muriel Chvatal

See www.microbirth.com

Wonderful AIMS supporters raised the funds needed for us to buy 10 licences for Microbirth, and another two licences were very generously donated by the filmmakers.
Due to additional requests to screen the film on behalf of AIMS, we bought another licence, and other generous supporters used their own for us. We have reached about 1,000 people with our screenings, including pregnant women, birth supporters and lay birth workers, midwives, obstetricians, paediatricians, biologists and more!
We raised over £2,000 for AIMS, raised awareness of the work of AIMS and most importantly helped to share the really fascinating topic of how birth may affect us with really influential people.

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