Tag Archives: Birth

Credit: Ami et al.

3D scans reveal how an infant’s head changes shape during birth

Credit: Ami et al.

Credit: Ami et al.

Doctors have been aware for a long time that infants’ heads change shape during birth. However, the details of fetal head molding remained unclear — until now. Using magnetic resonance imaging (MRI), scientists have captured 3D images of babies’ skulls as they move through the birth canal just moments before delivery.

Olivier Ami of Auvergne University in Clermont Ferrand, France, and colleagues performed MRI scans on the skulls and brains of seven infants before and during the second stage of labor — this is when the baby leaves the uterus and enters the birth canal.

The scans show that the infant skull and brain have a remarkable ability to mold as they experience intense pressure through the birth canal.

After birth, five of the newborns’ skull and brain shapes returned to their pre-birth state, but the changes persisted in two of the infants. Two of the three infants with the greatest degree of fetal head molding had to be delivered by an emergency C-section; the third was delivered vaginally with no out of the ordinary effort.

The unprecedented 3D images show that infants experience more skull stress during birth than doctors believed. This may explain why some newborns who are delivered vaginally may experience retinal bleeding and other temporary damage to the head.

“During vaginal delivery, the fetal brain shape undergoes deformation to varying degrees depending on the degree of overlap of the skull bones. Fetal skull molding is no more visible in most newborns after birth. Some skulls accept the deformation (compliance) and allow an easy delivery, while others do not deform easily (non-compliance),” Ami said in a statement.

The findings were reported in the journal PLoS ONE

Pictured: one of Mary's offspring in the aquarium at School of Life Sciences, University of Nottingham. Credit: Laura Dean.

A ‘virgin’ fish named Mary got pregnant without having sex

Pictured: one of Mary's offspring in the aquarium at School of Life Sciences, University of Nottingham. Credit: Laura Dean.

Pictured: one of Mary’s offspring in the aquarium at School of Life Sciences, University of Nottingham. Credit: Laura Dean.

Stickleback fish (Gasterosteus aculeatus) make babies without having sex. Like most other fish, the female lays unfertilized eggs which the males later fertilize with sperm in the nest. But somehow, one such female got pregnant and produced offspring through an emergency C-section. The female, aptly named Mary, shows that evolution is fluid and that nature doesn’t always play by the rules.

“We were astounded at what we found when we examined Mary in our lab in the Outer Hebrides. She looked like an ordinary egg-bound fish so we couldn’t believe it when we found she had almost completely developed embryos inside her ovaries. This is pretty much unheard of in an egg laying species. The embryos were perfectly healthy, not deformed in any way, and most have gone on to live a normal adult lifespan,” Dr. Laura Dean, a researcher at the University of Nottingham and lead author of the new study, said.

This isn’t the first time that scientists have come across developing embryos inside unfertilized egg-laying fish. Previously, only two such cases were known to science and both also involved stickleback fish. This most recent case is even more striking because this time, the embryos survived and many of the pups grew into adults that are still alive today.

Researchers found Mary while surveying egg-bound sticklebacks in Scotland — and she wasn’t in great shape. She was swollen with her young and very close to dying. Researchers euthanized Mary with drugs and then opened her up to extract the eggs. A total of 56 eggs hatched and survived to adulthood inside a laboratory aquarium. Twenty of these individuals are still alive today, three years later, the authors wrote in the journal Scientific Reports

VIDEO: Embryos moving showing beating hearts just before hatching. Credit: University of Nottingham.

Stickleback males don’t just contribute sperm. They have an active parenting role, helping eggs develop by fanning them with their fins for two weeks until they hatch. But it seems like the environment inside Mary was good enough to ensure healthy embryo development.

“Although this almost accidental find revealed a vanishingly rare phenomenon, it might help us to understand a really important change that has happened throughout the tree of life,” Andrew MacColl, an evolutionary biologist at the University of Nottingham in England, said in a statement. “Most animals lay eggs, but some (including almost all mammals, but few fish) retain their eggs inside and give birth to live young. Although this appears to be a difficult thing to achieve in evolution, this one little fish seems to have got there almost by itself.”

As to how Mary got pregnant in the first place, that’s a mystery that might never be solved. Researchers thought that perhaps Mary had cloned herself or that maybe she was a hermaphrodite with both male and female sex organs. However, the authors ruled these two possibilities out since genetic testing showed that the offspring had versions of genes that could only have come from a father.

What probably happened is that Mary strayed by a nest where a male had just recently ejected sperm to fertilize normal eggs. Some of that sperm must have traveled up Mary’s egg tube, fertilizing some of the un-laid eggs inside her.

Researchers are now planning to go the site where they found Mary, hoping the catch similar specimens. Some fish, such as guppies pupfish, are livebearers and this ability may have evolved independently. In this regard, Mary may offer researchers with a glimpse of how such an evolutionary leap might occur.

The UK royal “luxury” birth cost less than the average US birth

As a new royal baby was born to Kate Middleton and Prince William, the UK was abuzz, with word spreading of a lavish, luxurious birth. But the price for the birth and the mother’s recovery, which was $8,900, is significantly lower than what the average US woman pays under normal conditions.

The US is the most expensive place in the world for giving birth, with the average price being $10,800 in 2015. This doesn’t include pre and post-birth care, which raise the price to roughly $30,000.

Kate Middleton. Image via Wikipedia.

The UK takes its royalty very seriously — and the birth of a new royal baby is no small matter. So it’s only natural that the media was abuzz with the event, presenting even the tiniest details about Kate and William’s preparations. Among these details, it was revealed that the baby was delivered in a private room in St. Mary’s Hospital’s Lindo Wing. Perks include an “en suite” bathroom, a refrigerator, and a menu of “nutritious” meals — which, call me crazy, sounds decent rather than luxurious for a woman going through the struggles of childbirth. Still, the $8,900 price tag is nothing to scoff at and seems very luxurious — until you look at figures for the USA.

According to figures compiled by The Economist and circulated by Statista, this deluxe package for 24 hours, including the non-Caesarian delivery, still costs less than an average birth in the United States, which amounts to $10,800 (2015 figures). The Guardian reports that, including all expenses, US hospitals charged $32,093 for an uncomplicated vaginal birth and newborn care, and $51,125 for a standard cesarean section.

Of course, you can make a very valid case that the UK royal house is making too many expenses, that they’re ultimately funded through public money, and that they’re often quite lavishly wasteful. But really, a more important takeaway is that, even in these extremely troubling times, the British healthcare system (be it public or private) somehow manages to be more price-efficient than the US healthcare system. Even though American insurers often negotiate lower prices, the associated costs are still much higher. This is a recurring problem for the US, which spends more on healthcare than any other country, but in many aspects falls way behind other developed nations.

It’s not like the British system is a landmark either — other developed countries also have much lower birth-associated prices. For instance, in Spain, it costs about $1,950 to deliver a child. In Australia, the price is around $5,000, and in even Switzerland, a notoriously expensive country, it’s under $8,000.

To top it all off, if Kate and William had regular jobs, they would be entitled to 37 weeks of paid parental leave and up to 50 weeks unpaid leave. American workers have no national paid family leave policy and no national mechanism to help parents stay afloat financially after bringing a child to the world.

Increased demand for ‘vaginal seeding’, despite lack of evidence

Doctors are seeing a massive rise in the demands for the so-called vaginal seeding procedure, despite no evidence that this actually helps.

Also called ‘microbirthing’, the process involves taking a swab from the mother’s vagina and rubbing it over the baby’s mouth, eyes, face and skin shortly after a C-section birth. The idea is that exposing the baby to vaginal bacteria would enrich his own gut bacteria, protecting him from developing allergies and obesity in the future.

A newborn infant, seconds after delivery. Amniotic fluid glistens on the child’s skin. Photo by Ernest F.

Initially regarded as nothing more than a quirk, this practice has grown greatly in the past few years, despite professional advice. Dr Aubrey Cunnington from the Department of Medicine at Imperial College London says that there is no evidence to support this theory.

“Demand for this process has increased among women attending hospitals in the UK – but this has outstripped professional awareness and guidance. 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.”

Furthermore, Cunnington argues that this could even transfer harmful bacteria to the baby via the swab. Of course, in the case of a natural birth the baby would have been exposed to the bacteria anyway, but in the case of a C-section, doctors may not know that vaginal seeding took place. Parents should always let their doctors knew they took the procedure.

“Its important 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,” he says.

Just to clear this out, it may be the case that the practice is actually helpful. Differences in microbiome have proven to be surprisingly important, but we just don’t know if this helps the babies.

“There is now quite a lot of evidence that differences in the microbiome are associated with risk of developing conditions such as allergies and obesity. However people have made a leap of logic that gut bacteria must be the link between caesarean section and risk of these diseases. But we just don’t know this for sure – or whether we can even influence this by transferring bacteria on a swab from mum to baby,” says Dr Cunnington.

Also, it’s not a case of “let’s do it, it can’t hurt” – so there’s no reason to try it just because it might help.

“In some countries, including the UK, we don’t test pregnant women for the bacteria group B streptococcus. 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, gonorrhoea 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.”

Furthermore, she continues, there are much better ways to ensure the baby’s healthy 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.”

Pregnancy related deaths down by half in the last 25 years

Between reports of melting icecaps, starving polar bears and reports of food shortages, it’s easy to become pessimistic about life. But it’s not all bad, as a recently released report by the UN, published in The Lancet, shows how pregnancy-related deaths have fallen almost by half in the past 25 years.

Maternal mortality rates are down by half since 1990.
Image via flikr

Around 303,000 women died of complications during pregnancy or up to six weeks after giving birth in 2015 – down from 532,000 in 1990. While only nine countries hit the target set by the UN, WHO (World Health Organization) officials consider the results indicative of “huge progress” overall, with 39 countries dramatically lowering the number of pregnancy-related deaths.

“This report will show that by the end of 2015 maternal mortality will have dropped by 44% from its levels from 1990,” said Dr Lale Say, coordinator for reproductive health and research at the WHO.

But she warned that the progress was “uneven” – with 99% of deaths happening in developing countries.

“Many countries with high maternal death rates will make little progress, or will fall behind, over the next 15 years if we don’t improve the current number of available midwives and other health workers with midwifery skills,” said Dr Babatunde Osotimehin, executive director of the UN Population Fund.

Eastern Asia saw the greatest improvement, with maternal mortality falling from approximately 95 to 27 per 100,000 live births. The UN now aims to reduce the global ratio to less than 70 per 100,000 by 2030.