Labor Lube and your Microbiome
Labor Lube - Your Vaginal Health and Your Baby's Health
What is Labor/Birthing Lube?
You’re probably wondering what the heck ‘labor lube’ or ‘birthing lube’ is - let’s start with understanding that it has nothing to do with getting your groove on during labor.
Would you squeeze a bottle of baby shampoo into your vagina at any point in your life? So why would you do it in labor?
In this article we’re going to take a look at products likely to be used in your vagina during labor and what that means for your health - and your baby’s
The human body has millions of helpful, healthy bacteria. You have 10 times more microbial cells than human cells and 100 times more microbial genes than human genes. If we could weigh that extra bacteria we’re carrying around it would be about 5lbs! So if you’re worried about weight gain in pregnancy keep in mind that you’re probably carrying around an extra few lbs of bacterial hitchhikers that help keep us well.
The next time you look in a mirror, think about this: In many ways you're more microbe than human. There are 10 times more cells from microorganisms like bac...
So let’s talk about the microbiome downstairs, in your vagina and on the vulva. There are two main reasons you have this helpful bacteria in your vagina.
To protect you against infection.
To pass on important microbes to your baby during birth that will contribute to their long term health.
However it’s estimated that about 50% of women experience messed up microbes during their reproductive lives - and lubricant is one of the leading causes. If you’re having frequent vaginal exams with hospital lubricants in labor it’s likely that your baby isn’t getting the all the microbes he is supposed to get at birth. New research also suggests that an altered vaginal microbiome may be associated with more preterm births.
What can the Birthing Lubricants do to your microbes and how will it affect you and your baby?
Birthing Lubricant causes cell damage and changes the microbes your baby is supposed to come into contact with for his long term health. Recent evidence suggests that babies who aren’t exposed to these microbes as they are born by cesarean are missing out on key bacteria that train your baby’s immune system. These babies are more likely to experience health problems such as allergies, asthma, gastrointestinal problems and obesity. Normally baby gets some of them in utero, then in the vagina on the way out, skin to skin with mom and finally through your breastmilk. Yet there has been minimal research into the effect of lubricant (natural or otherwise) that is routinely used during labor in hospitals around the world.
To Lube or Not to Lube
We all have specific strains of bacteria in our vagina. Lactobacillus is one of the most important families of bacteria. A healthy woman will have around 100 different kinds of microbes present in the vagina. These microbes benefit us throughout our reproductive life and your baby is supposed to be exposed to these bacteria to start ‘training’ their immune system baby right from birth. Their nose and mouth are supposed to come into contact with this bacteria. Lubricant commonly used during labor destroys this bacteria.
What’s in Labor Lube?
Avoid any lube containing Chlorhexidine - it’s a preservative used in hospital lube and has been shown to destroy Lactobacillus microbes - it’s found in Surgilube and KY Jelly.
The pH of a lubricant to be used vaginally should be pH 3.8- 4.5. Lubricants with pH above 4.5 increases infection risks. Lubricant with a higher osmolality than normal vaginal secretions (osmolity is the ability to draw moisture out of tissues and cells). Parabens (often listed as methylparaben and/or propylparaben are preservatives that can damage the endocrine (hormone) system and also irritate the cells of the vagina. A water based lubricant is recommended over oils and one recent paper suggests using saline water for vaginal exams only.
Do I Need Lubricant in Labor?
As you’ve probably experienced. Most women have no shortage of cervical discharge in pregnancy. in labor there is a LOT of perfect lubricant your provider can use if you are having examinations so your careprovider can do a vaginal exam without lube. Of course you may have decided to limit vaginal examinations or do your own - with good reason.
Mineral Oil or Johnson's Baby Shampoo as a Birthing Lube?
The other circumstance to consider is the common (and very strange) use of Johnson’s Baby Shampoo or mineral oil applied to your vulva and around baby’s head so your careprovider can stretch your tissues thinking it’ll get your baby born more quickly.
One Step or Two Step Birth?
In most US hospitals your baby will be born using the ‘one step’ delivery technique - meaning your baby’s head is pulled on before your baby’s shoulders have rotated (this can cause more perineal injury). This is important information to discuss with your provider.
I contacted Johnson & Johnson about the ‘off label’ use of their baby shampoo and they replied “We would like to clarify that we do not recommend our product to be used in such usage if it was not created for the said purpose”.
I don’t think I need to spend to much time on the potential damage these routine care options could have on your vaginal health and baby’s access to specific bacteria found around the rectum (some scientists believe that there’s a reason why the rectum and vagina are so close together and why most babies are born literally looking at your butt before they restitute (turn). Your rectum has it’s own family of healthy ‘butt bugs’ - specifically Lactobacillicus johnsonii which is associated with healthy immunity. (How weird is it that this bacteria name is very similar to the baby shampoo…)
Natural Alternatives for Labor Lube - Coconut Oil / Olive Oil
There is limited research on natural alternatives. Coconut oil is known to have antimicrobial properties and feels great but there’s limited research on this at the moment. Some microbiome experts suggest organic extra virgin olive oil instead - but whatever you use don’t use the coconut oil/olive oil you’ve had sitting in your kitchen for the last 6 months as oils can go off. But it’s worth considering putting it in your birth bag and using it instead of the hospital based lubricant. Consider what you’re using for your pre-labor perineal massage too or if you’re using Evening Primrose Oil to try and ripen your cervix.
So - just when you thought you’d crossed all of your Ts and dotted the I’s for your birth preferences I go and throw another spanner in the works. But I think it’s an important one that most likely even your own careprovider might not be clued in on this important aspect of labor and birth.
You don’t need to use baby shampoo in your vagina EVER - not for labor, not for a ‘feminine wash’ - in a word - never.
Is this news to you? Is this something you’ve thought about or plan to talk to your midwife/OB about?
Tracy
Note:
I did come across this new product that claims to not disrupt the vaginal microbiome. https://www.fairhavenhealth.com/babyit-perineal-massage-postpartum-tear-gel (I’m not affiliated with this company but it seems to check all the boxes).
Blog inspired by https://www.mybirthrva.com/mybirthblog/please-stop-putting-baby-shampoo-in-our-vaginas (this approach is focused on preventing tearing).
Resources
McElroy, K. G., & Regan, M. (2016). Vaginal Microbiota and Lubricant Use During Labor: Implications for Nursing Research, Practice, and Policy. SAGE Open Nursing. https://doi.org/10.1177/2377960816662286
Slightly OT but this next study compared infection rates after gynae surgery between iodine and baby shampoo in the vagina and the study itself calls baby shampoo a ‘detergent’.
https://pubmed.ncbi.nlm.nih.gov/17980335/
