NHS Borders clinical guidelines
- If a mother enquires about artificial vaginal seeding give patient information leaflet that has been uploaded onto Badgernet and explain that NHS Borders staff are unable to perform the procedure but will support mother’s decision to do so.
- Advise mother that she will need to have either sterile gauze swabs or muslin to use for procedure and a sterile container or unused sealed zip lock freezer bag to take into the hospital with them.
- If a mother states that artificial vaginal seeding is on her birthing plan on admission to the ward, Midwifery staff should be made aware.
- Staff should inform mum of expected time of delivery to enable mother to insert swab or muslin into the vaginal passage for one hour prior to caesarean section. Gauze swab/ muslin should be folded into a fan/ concertina for maximum surface area for vaginal flora. Staff can supply sterile water to enable more comfortable insertion of swab/ muslin.
- Staff to ensure vaginal swab/ muslin has been removed prior to being taken to theatre for Caesarean Section and has been placed in sealed container by mother or birthing partner.
- Staff can supply hospital patient lab for container.
- Birthing partner to bring vaginal swab/ muslin to theatre in sealed container.
- Once baby has been born and does not require immediate care either mother or birthing partner can wipe gauze swab/ muslin over baby’s hands face and mouth to allow for seeding process to begin prior to first feed.
- Parents are responsible for disposal of used vaginal swab/ muslin. If in hospital this should be is a yellow bin bag
Artificial Vaginal Seeding for Elective Section
Warning
Objectives
In recent years, there has been increasing interest into the role of a newborn baby’s ecosystem of good gut bacteria which is known as the Microbiome. Research has shown that the bacteria the newborn’s microbiome is exposed to during and following delivery will have a significant impact in their developing immune system which will support them for the rest of their lives.
As there is limited evidence around the safety and benefits of vaginal seeding, NHS Borders Maternity Staff cannot facilitate this process. However, if a mother would like to try artificial vaginal seeding, midwifery staff should be able to help a mother prepare for the process.
Scope
Babies born by caesarean section will have different bacteria in their gut than babies born vaginally as their microbiome is not exposed to their mother’s vaginal bacteria but will be colonised by the mother’s skin bacteria. There have been some studies that would suggest babies born via caesarean section could be slightly more likely to develop allergies, asthma and obesity. This research has indicated the benefits of a newborn being colonised by their mother’s vaginal bacteria at birth through vaginal seeding. However more research is required as there is not enough solid evidence for NHS Borders to promote this procedure, but staff will support parents who wish to undertake vaginal seeding themselves.
Audience
Community Midwifery staff
Hospital Midwifery staff in both Labour and Post Natal Wards
Obstetric Staff
Due to the limited evidence available on vaginal seeding, we do not promote this procedure to our women and families. However, patient centred care is a pivotal element of our service at NHS Borders, and we will support our women to be able to make informed choices about their care.
- Pre-term delivery
- If there has been spontaneous rupture of membranes prior to your caesarean section
- If a mother is unwell or have any signs of infection such as increased heart rate or high temperature
- If a mother is a known carrier Group B Strep, Hepatitis B or C, or genital herpes