All language subtitles for Microbirth.2014.1080p.WEBRip.x264.AAC-[YTS.MX]

(dramatic violins)

Downloaded from
YTS.MX

Official YIFY movies site:
YTS.MX

(dramatic music)

- [Voiceover] Of the millions
of species that belong

to planet Earth, what
is it that sets us apart

from all the others?

Is it our inquiring minds?

Our ability to explore.

To discover.

And to reason.

Ever since the dawn of civilization.

We have pursued the
answer to one question.

Who are we?

We have looked to the stars.

We have searched our souls.

But the answers seldom satisfy for long.

Why are we so different?

We connect, communicate, invent,

and create.

We are able to cure,

to treat, to extend life,

even to create life.

We have built cities that touch the sky.

We have flown amongst the clouds.

- [Voiceover] That's
one small step for man.

- [Voiceover] And traveled far beyond.

- [Voiceover] One giant leap for mankind.

- We challenge ourselves.

And while we are not perfect--

- [Voiceover] We shall
fight on the beaches,

we shall fight on the landing grounds,

we shall never surrender.

- [Voiceover] I have a dream.

- [Voiceover] We endeavor
to better ourselves--

- [Voiceover] That all
men our created equal.

- [Voiceover] And now,
we have surely arrived

at the golden age of technology,

but our journey still continues.

- [Voiceover] Hello from the
children of planet Earth.

(men speaking foreign language)

Who are we?

We are amazing.

We are human beings,

and we have risen above
all others to become

the dominant species on planet Earth.

Never before have we
appeared to be stronger,

more powerful, and more in control.

Why is it then, that
at this moment in time,

our species has never been sicker?

- We think we're at the
pinnacle of our existence.

Look at the technology that
human kind has available now.

And yet the reality is,
we've never been sicker.

And it's going to get worse.

- We have been facing a
rising epidemic of plagues.

From asthma to obesity,
to allergic diseases.

This has been going on
continuously over the last decades.

And there's no real sign
that it's letting up.

- When you have asthma or
inflammation within the lung,

you see cells that are not
normally suppose to be there

invading that space,

so you cannot exchange
the air quite as well.

And this an example of that invasion.

And this is inflammation
within the lung sacks.

- [Voiceover] The World Health
Organization has declared

non-communicable diseases have
reached epidemic proportions.

Diseases such as asthma,
diabetes, coeliac disease,

obesity, cardiovascular
diseases, some cancers,

and mental disorders.

This diseases currently
account for over 60%

of all deaths globally,
and they are on the rise.

The World Health Organization
estimates total deaths

from non-communicable
diseases will increase by

a further 17% within the next decade.

The World Economic Forum
and the Harvard School

of Public Health have predicted
that the cost of treating

these diseases has the
potential to bankrupt

global healthcare
systems by the year 2030.

- So, the model that
was compiled together by

the World Economic Forum
and the Harvard School

of Public Health
estimated that the cost of

non-communicable diseases
between 2010 and 2030

would reach a staggering $47 trillion.

That is a huge sum.

To put this into context,
the combined economic output

of most countries in the
world in a given year

is less than $1 trillion.

And they're estimating
a cost of $47 trillion.

It is a staggering sum indeed.

- By the year 2030, almost
half of the net worth

of the world is going to go
toward treating these diseases.

That's not sustainable.

We're bankrupting ourselves.

And the problem is that we're
creating an invalid society.

We have people that are too sick to work.

We don't have enough
caretakers for those people.

We're not going to have
medical services to provide

for that number of people.

We simply can't afford it.

We're hitting the wall right now.

- We're increasingly
seeing a world out there

with what is really a
public health time bomb

waiting to go off.

And the research that
we're doing suggests that

it's only going to get worse,

generation on generation.

So, tomorrow's generation
really is on the edge

of the precipice.

- Unless we face it, there's
no indication that it's

gonna get any better.

And I'm afraid that it will get worse.

And that means shorter lives.

And lives with more misery.

And more susceptibility
to the big pandemics.

So, there's a lot of risk out there.

But we have the tools.

And if we had the way, we could fix it.

- [Voiceover] Four lifestyle
risk factors have been

identified by the World
Health Organization as driving

this epidemic:

smoking,

misuse of alcohol,

poor diet,

and lack of exercise.

But what if this isn't
the complete picture?

What if there is an
important piece of the jigsaw

that up until now, has been missed?

Scientists have recently
embarked on a new journey

of discovery.

A journey that takes us through
the lens of a microscope

to discover who we really are.

And how a species could
get so sick so fast.

Let's rewind to the
origins of life on Earth.

To 3.4 billion years ago.

All life on planet Earth
evolved from bacteria.

Over billions and millions of years,

bacteria spread far and
wide across the planet.

In the deepest oceans, in
the heart of mountains,

in the atmosphere.

- Life appeared on Earth
about 3.4 billion years ago.

And they were first.

This is a microbial planet.

Mostly bacteria.

And any other forms of
life that came after

had to deal with bacteria.

Some bacteria involved into
and with other life forms

to become more complex organisms

and complex ecosystems.

For life at its healthiest,
exists as an ecosystem.

A diversity of species that coexist.

That live in harmony.

That live in balance.

But when the harmony is disturbed

and the balance is upset,

or when that diversity
of species is reduced,

the ecosystem may become
vulnerable to disease,

and could even die.

- If you removed half
of the types of trees

in a very diverse forest,
it doesn't stay the same

for the rest of the trees that are there.

There's extra space.

The dynamics of the interactions
are completely changed.

Of the insects, the
animals, may be changed

because of habitat, and the entire forest

takes on a totally different flavor.

And in some cases, a very
unpredictable flavor.

This can happen in a local ecosystem.

It can happen at a planetary level,

but it can also happen at the micro level.

It can even happen within us.

Because we are a walking ecosystem.

The human body is host
to trillions of microbes.

They outnumber our human
cells by an astonishing ratio

of 10:1.

- So, it's estimated that
we have about 10 trillion

human cells in our body,

and the current estimate
is that we have about

a 100 trillion microbes
living in our body.

And that's how it is everyday of our life.

- We're 90% microbial
and only 10% mammalian.

The microbial part is
said to be our microbiome.

- So, the microbiome are all the organisms

that live in the human body.

Bacteria, fungi, viruses, protozoa.

They're the organisms
that live in and on us

that make us home.

- We estimate that they're
approximately a thousand

species in the intestine.

Approximately 700 in the mouth.

Approximately 300 to 400 in the vagina.

Approximately 700 in the skin.

- You know, I used to be aware that I had

organisms on my skin and in my gut

and inside me,

but to now think about this me,

which is more microbe than human cells,

I don't know as if it connects
me to universe a bit more.

- [Voiceover] This
relationship between bacteria

and our human cells is
one based on cooperation

and collaboration.

For thousands of years, this
relationship has evolved.

We provide a home, a
habitat for the bacteria.

In return, the bacteria in us and on us

help provide security.

Their important in helping
us function as humans

should not be underestimated.

Bacteria help regulate our metabolism,

and they play an essential
role in setting up

our immune system.

- We have grown up with our microbes

over many, many generations.

And in fact, we form what's called

a symbiotic super organism.

Because we do things for each other.

And those things are very
important for the health

of the total organism.

- [Voiceover] Oue own
ecosystem has thrived,

a diversity of species and balance.

But in the last century or so,

this ecosystem has become under threat.

- Just like a forest, you
can't start cutting out

major sectors, major tree
species, reduce the diversity,

and expect things to stay the same and

that forest to stay healthy.

It doesn't and we don't when
we've lost the diversity

in our microbes.

- [Voiceover] The way we live our lives

has changed dramatically.

And scientists are now
hypothesizing that this is having

an effect on our ecosystem.

The balance has become disturbed.

The scales are starting to tip.

The ecosystem has become sick.

- Let's say you have 10 diseases that

are rising at the same time.

Each one might have a separate cause.

Or perhaps there's one
thing that's fueling

them all, that's causing
all of them to rise.

And I think that one thing is a change

in our microbiome,

and what I've called missing microbes,

or the disappearing microbiota hypothesis.

That our ancient
microbiome which protected

us against many diseases is degrading.

And with that degradation,
these diseases are being fueled.

- When we compare our microbiomes

with those from peoples
living isolated in jungles

of South America for example,

with no record of exposure
to antibiotics before,

we estimate we have lost
about a third of the diversity

of our microbes.

- It's pretty clear that
our diversity is going down.

And that to an ecologist is dangerous.

Because the diversity protects us.

We have evidence that the
organisms are disappearing.

So, the question is why?

And I would say part of it is modern life.

Nothing prepared our microbiome

for clean water, and smaller families,

and Caesarean sections,

and anti-bacterial substances everywhere,

and of course 70 years of antibiotics.

- [Voiceover] In 1928,
Sir Alexander Fleming

made a world changing discovery.

Penicillin.

- Initially, a very small amount

of penicillin could be made.

In the case of penicillin,
it's caused by a fungus,

or a mold.

And in the early 1940s,

while World War II was going on,

scientists were looking for
a good source of penicillin,

a mold that really produced a lot.

And that mold where
most of the penicillin,

even til today comes from,

came from one moldy
cantaloupe in Illinois.

And that was the great
strain that produced

huge amounts and we could harness that

to good for us.

- [Voiceover] That moldy
melon, and the arrival

of mass produced
antibiotics changed the face

of modern medicine.

- For those of us who've
lived in recent decades,

historically, we've lived in
a quite a privileged period

of human history, because we've had these

powerful medicines to fight these bacteria

that cause disease.

- Antibiotics underpin most medicine.

It's hard to do surgery
without antibiotics.

It's hard to do transplantation,
or chemotherapy.

We need antibiotics to help
protect us against bacteria.

And in consequence,
antibiotics are being used

more and more and more.

And certainly, here in the United States,

they're very much overused.

- [Voiceover] Widespread
use of broad spectrum

antibiotics kill off good
bacteria as well as disease

causing pathogens.

Combined this with the use
of antibacterial products

that claim to kill 99.9% of all bacteria.

And it seems that over the past 70 years,

we have been waging war on our microbes.

This may be taking its toll
on our microbial populations.

But where does our microbiome come from?

When are the seeds of our
bacterial ecosystem sewn?

The critical time for
seeding our microbiome

happens during childbirth.

Preparations for founding
the baby's bacterial

ecosystem actually start inside
the mother during pregnancy.

Scientists believe the baby grows up

in a near sterile environment in the womb.

Emerging research suggests
that a small number

of bacterial communities may
be present in the placenta.

And other recent research
suggests that small colonies

of bacteria might also
be present in the womb.

But the main seeding
event occurs at birth.

In the weeks and days
leading up to the birth,

key bacterial species gather
in the mother's breasts

and her vagina, then
during labor and birth.

A special cocktail of
bacteria is transferred from

the mother to the baby in the birth canal.

(woman laughing)
(water splashing)

- And as the baby starts going out through

the birth canal, the baby is acquiring the

mother's bacteria from the vagina,

the baby is covered with the bacteria.

The baby is coated, is
swallowing the bacteria.

And that's the baby's first introduction

to the world of bacteria.

The world that we all live on.

That's the founding
microbiome for that baby.

- [Voiceover] Rodney Dietert,

Professor of Immunotoxicology
from Cornell University

believes that this microscopic
process that happens

during childbirth is
critical for future health.

His hypothesis is called
the completed self.

- The completed self is the
idea that we are intended

to be majority microbial from
the very beginning of life.

At birth, we are supposed
to be 90% microbial.

And that's the way it should be.

That's the way it is when we're healthy.

When the baby comes down the birth canal

during vaginal delivery, that
is the major seeding event

and we know that the gut
microbes in particular

are absolutely crucial in what happens

with immune system, and in
the capacity to break down

different nutrients and different
environmental chemicals.

That's where the action happens.

So, that is probably the
single most important event

that's going to chart
the course for whether

that baby becomes complete,

and whether that baby experiences a life

filled with health or
one filled with disease.

- [Voiceover] The next stage
for the microscopic transfer

of microbes happens during
skin to skin with the mother.

Immediate skin to skin contact
allows for the transfer

of skin bacteria from mother to baby.

And is important for other hormonal

and biological processes.

- When that baby comes
out, the natural habitat

for that baby is the mother's body.

And that baby should go directly

skin to skin with the mother.

When that happens, oxytocin's released

and the cortisol starts to dampen down

that was released during labor.

The baby starts to smell and search for

the mother's breasts.

The skin is to skin is
so amazing, that the mom

will warm up if the baby's cold.

That being on the mom's skin will regulate

the baby's blood sugar.

It regulates the baby's breathing.

It reduces crying.

It reduces stress.

It basically brings
that baby into the world

in the gentlest way possible.

And helps it to adapt to
being outside in the world.

- And it's an absolutely a critical time.

You know, the oxytocin levels are high.

It's the moment when the
mother and the father

will see the eyes of the
baby, and often this kind

of position, the baby
recognizes the human face.

They will never have that moment again.

It's the first stage of falling in love.

And it actually sets a
template for future life.

- [Voiceover] For the
baby to have immediate

skin to skin with the
mother, is the perfect

situation to establish breast feeding,

the next critical step in
terms of the physiological

process of birth.

- When that baby then breastfeeds,

there's a whole other
connection and cascade

of hormones that occurs.

The mother's releasing prolactin.

She's releasing oxytocin.

She's calming down.

She's relaxing.

She's falling in love with her baby.

Her baby's feeling the same for her.

- [Voiceover] Breast milk
is a very complex substance,

exquisitely designed to
provide everything needed

by the baby.

But importantly, breast milk also provides

everything needed by the baby's microbes

that have just been
seeded in the baby's gut.

- In breast milk, you have several things

that the baby needs.

First of all, the mother
provides certain immune

hormone-like substances
that are really important.

Some of those are anti-inflammatory.

And that's going to be
part of the challenge.

The baby needs those.

She provides antibodies as well.

And in addition, she
provides some microbes

from her own breast tissue,

but she also provides sugars,

oligosaccharides they're called.

- [Voiceover] For many
years, scientists were

really puzzled by one
of the main components

of breast milk.

The sugars, the oligosaccharides
were indigestible

by the baby.

So, why were they there?

- It's very, very complex.

But it especially contains
indigestible carbohydrates,

indigestible substrates that the baby will

not be able to digest,

but the good bacteria will.

- [Voiceover] It's only
recently that scientists

have discovered that the sugars were there

to feed the newly seeded
bacteria in the baby's gut.

To feed, to nurture, and to
help them grow in number.

- Breast milk is the best
source for the baby's microbes.

And breast feeding beyond six months

were possible, even up to two years.

A lengthy duration of breast feeding

is really important because breast milk

contains the sugars that
help the baby's microbes

to mature themselves.

They're exquisitely
designed for those microbes,

and they're the best nutrient source.

And so that becomes extremely important.

To nurture a well seeded
microbiome that's in the baby.

- [Voiceover] What happens
if you interrupt this

complex process of feeding
the newly seeded microbiome?

- If we break the natural
rule of breastfeeding,

naturally, we may also
be helping to compromise

the education of the
immune system of the baby.

- [Voiceover] When a baby
is born, it's immune system

is completely naive.

It doesn't what is safe,
and what is dangerous.

So, the baby's developing
immune system has to learn

which bacteria are the good
ones that should be tolerated,

and which bacteria are harmful
that should be attacked.

- It is a fascinating story already,

from what we're learning
about the interaction between

the gut microbod in the
infant as it develops.

And also the development of
the infant immune system.

They're connected.

And so, as the gut microbod is developing

over the first year of life,
so is that immune system.

And the way it is
developing, it's learning

what is friend and what is foe.

You know, what is
beneficial good bacteria,

and what is harmful.

- So, what we have here is
an image of one of the types

of immune cells in our
body called macrophage.

We study the mechanisms of exactly how

other cells in the body are told,

"Hey, we have an infection,
come help us out."

- [Voiceover] The first bacteria to arrive

in the baby's gut kick
starts this process.

They prime the baby's immune system.

Scientists believe that the immune system

has one chance to do this.

One chance for optimal future health.

- This is extremely important,

and if you upset this
process, which is so crucial

in the early life, then we
may have consequences later.

- We need our microbes in place,

at birth or shortly thereafter.

And the reason is, that that's
when the immune training

needs to happen.

You may have an opportunity
to correct the balance

in the microbes by taking
probiotics later in life,

and that's great in a way,

but it doesn't answer the
problem with the immune system.

There's one chance.

There's a narrow window.

If we miss the window, at
that point, then the immune

system never matures correctly.

And that could lead to haphazard responses

and production to disease later in life.

- [Voiceover] If this complex
seeding and feeding process

is interfered with, this
could effect the development

of a child's bacterial ecosystem.

This could effect metabolic processes

and the immune system.

As a result, this could make our children

more susceptible to disease.

Scientists are hypothesizing
this is what could be

happening born by Caesarean section.

Caesarean rates have sky rocketed

in the past few decades.

In the U.K., a quarter of
all babies are now born

by Caesarean section.

In the U.S., it is around a third.

In China, it is about half.

And in some private hospitals in Brazil,

the Caesarean rate is over 90%.

- The rate of Caesarean
section is going up

around the world.

Now, in many instances,
that is a jolly good thing

because Caesarean section
can be life saving.

And there are parts of
the world where women

need Caesarean sections
for their own health,

for the health of their
babies, and they don't

have rapid access to them.

So, we've got a paradoxical situation,

where in some parts of the world,

women who need Caesarean
sections can't get them.

And in other parts of the world,

women who don't need Caesarean sections

are having their deliveries in that way.

- My personal view of why
the Caesarean section rate

has been rising steadily
ever since high qualified,

is that we keep making Caesareans safer.

And because they're safer,
that means the threshold

of risk in labor in which we
would resort to a Caesarean

gets lower and lower, and lower.

And it's not just the
professionals who perceive this.

The women themselves perceive Caesareans

as being relatively safe,
which of course they are.

And hence, they're more likely to request

Caesarean section at a lower
level of risk than they would

have done in 20 or 30 years ago.

- [Voiceover] Caesarean sections
are sometimes essential,

and can be life-saving.

But there are some known
short-term health risks

for the baby associated
with being born in this way.

- Babies born by elective
Caesarean section

who haven't been exposed to
the normal process of labor,

do have more in the way of
short-term health problems.

Perhaps the one that's most well known is

respiratory problems, and
they can be quite unwell

with these respiratory problems,

they can need intensive care.

Obviously the majority
just have mild degrees

of respiratory problems.

These babies also find
it much more difficult

to establish feeding.

They're much more likely to
have low blood sugar levels.

They tend to be sleepier,
a bit more drowsy.

The short-term problems
are well-recognized.

But where our research
is asking new questions

is are there long-term
implications from having been

born by Caesarean section as well?

- Until recently, the main
emphasis with the Caesarean

has been to avoid the
damage of difficult labor

to the mother, and to the baby,

cause the baby can get
short of oxygen during

a difficult labor.

And it's been assumed that if you deliver

the baby in good condition by Caesarean,

that therefore the baby
will do perfectly well

in the long term.

Unfortunately, it turns out
that there is some aspects

of normal natural birth through the vagina

which are missing when you
do a Caesarean section,

and it's turning out that
that may lead to some problems

for the baby in the long term.

- [Voiceover] If a baby
does not pass through the

birth canal, that baby will
bypass the mother's bacteria,

encountering instead, bacteria potentially

from other sources.

Scientists are hypothesizing
this could come with its

own set of problems.

- So, there's several issues
with Caesarean delivery.

First of all, it bypasses the
process where the baby's gut

would be seeded by the
microbes from the mother's gut

and established at birth,
through vaginal delivery.

In addition, the mother
is likely to have been

administered drugs, or
antibiotics that will effect

both her microbes, and
the baby's microbes.

And finally, with Caesarean
section occurring in hospitals,

the baby is going to get
gut microbes from somewhere.

And unfortunately, they may be of the kind

that exist in hospitals, and
are not necessarily healthy

for the baby, such as
Clostridium for example.

- And we think, and this
is still a hypothesis,

that that's part of the
problem, that this generation

of kids have.

There immune system has been primed

by the wrong set of bacteria.

The seeding of the baby's
micobiome could be critical

not just for the gut and the
developing immune system,

but the latest research is
also linking the seeding

of the baby's microbiome
with the development

of other tissues, including the brain.

- The baby's microbes that
are seeded by the mother

into the gut are important,

not just for the gut, but
for most of our tissues.

And one example is, the brain.

Because we now know that
depending upon the seeding,

that occurs, and the diversity
of the microbes in the gut,

that affects the brain
and the nervous tissue.

So, that a number of
neural behavioral disorders

had been linked with the microbes being

not diverse enough.

That the seeding is inadequate.

And as a result, the
byproducts that are produced

from normal nutrients by
that baby affect the brain

in ways that produce
behavioral alterations

that can be a problem.

- The fact that we can get
these long term problems for the

baby doesn't mean that we
should stop doing Caesareans.

They're clearly going to
go on being necessary.

So, the challenge for us
is to find ways of dealing

with this particular problem.

Just like we've improved
the surgical technique.

We've improved the anesthesia.

We now need to improve
how we deal with the baby.

So, that it overcomes
this particular problem.

- If a mother must have a
C-section, then there are things

that she can still do.

That can be really helpful for the baby.

So, it's very important to have
immediate skin-skin contact

when that's possible.

Breast feeding of a significant duration,

six months or more, is really important.

Again, to nurture the
microbes in the baby's gut.

In addition, there is an
idea of using vaginal swabs,

and how that may be important
in attempting to seed

what the baby would have
gotten had the baby had

vaginal delivery.

- [Voiceover] Dr. Maria
Gloria Dominguez Bello

is leading a pioneering study
across multiple countries,

where babies born by Caesarean
section are inoculated

with bacteria from their
mother's birth canal.

- So, what we do is we take a gauze,

eight centimeters by eight centimeters,

we wet it with a sterile saline solution,

we fold it, and we make
like a tampon with a slot of

surface exposed, we fold it as a fan,

and we incubate it in mom's vagina

during the last hour before the procedure,

before the C-section.

And the surgeon takes
the gauze out just before

the procedure which
lasts, it's really fast.

It lasts between 15 and 20 minutes.

So, the gauze is put
into a sterile container

while the surgeon does the procedure,

and when the baby's born,
the first thing the baby

will see immediately is that gauze.

We pass it through the mouth first,

then the face, and then
the rest of the body.

So, we are currently doing the study.

It's a big study.

The full results will not be ready

before two or three years.

But we have decided to
take the first babies

and publish a month of their progression,

of their bacterial communities.

And what we can tell so far,
is that the baby's inoculated,

although they were born by
C-section, they look more

similar to vaginal delivered
babies than to C-section

delivered babies.

- Swabbing newborn babies could
help introduce the mother's

bacteria to babies born by Casesarian,

but there doesn't appear
to be a substitute

for the complex interplay
of hormones and stresses of

natural child birth that could be

critical for future health.

- The single most important
thing we can do for a

healthy baby across a
life course, is to ensure

that microbial seeding
occurs completely at birth

through vaginal delivery when possible,

the skin-skin contacts
occurs, and that the microbes

are supported through breast feeding of

significant duration.

This should be on every birth plan.

Every health professional,
every medical professional

attending to the pregnant
woman, to the birth process,

through infancy should
be aware of these things,

should be aware of the
importance of the microbiome

and supporting a healthy microbiome

because that's what's going
to influence the health

across a lifespan versus
one filled with disease

for that child.

- [Voiceover] Science has shown
that bacterial populations

in the gut are passed on
from generation to generation

during vaginal birth.

So, a grandmother has
similar bacterial species

in her gut as her daughter,
and even her granddaughter,

if they all have vaginal births.

And so bacterial transfer
can be viewed as a kind of

maternal heritage that is
passed on from generation

to generation, from grandmother
to mother to daughter.

But what happens if one
generation gives birth by

Caesarean section?

This could be breaking the
chain of maternal heritage.

Could we be producing a
generation of children

who are missing vital bacteria?

And could that be passed down and down

for all future generations?

What is not known is what the
consequences of this might be

for humanity.

There's other transgenerational processes

possibly happening during
childbirth that could also

have ramifications for our species.

This is the emerging field
of epigenetics in childbirth.

Epigenetics very, very
simply are heritable changes

in gene expression that
are independent of the

underlying DNA.

So, while your DNA is
what you inherit from your

mom and your dad, there
are parts of your gene

that switch on and switch off.

So, epigenetics is above the gene.

And epigenetics is simply
saying that there are

changes made that silence
parts of your genes

that can then be passed on
into the next generation.

- And what we know happens
at birth is that there

is a whole series of genes
that you need to be switched on

in order to survive post birth.

And there are genes that
you've had switched on

before birth that you need
actually need to switch off.

You no longer them throughout life.

And birth appears to be the point that you

switch genes on or switch them off.

- A very, very long period
of evolution has brought us

to the point that we are today.

It's highly plausible that
normal labor, normal delivery

is in someway a programming event.

And by that, I mean that it
turns on genes that affect

certain health trajectories.

- Anything from things occurring
in the actual environment

of the mother giving birth to
interventions that can occur

during the birth process
like giving antibiotics,

inducing labor, providing
the mother with pitocin,

C-section delivery,

forceps delivery, and
things of that nature.

All of these interventions
we believe may have an

implication or may cause
changes in the epigenome

that can have later
impacts on health outcomes.

- [Voiceover] The actual
process of labor as well

as vaginal birth could be
critical for long term health.

It could be that the
stress of labor is actually

good for the baby.

It could help prime the
immune system epigenetically

via a complex process
involving hormones and also

have a long term effect on metabolism.

- [Voiceover] What evidence do you have?

- So, at the moment we
don't have a lot of evidence

that there are epigenetic
changes during pregnancy

and birth.

We got good epidemiological
evidence showing that there

are links between ways
babies are born and disorders

later in life.

But there are a couple of
studies that have come out

showing that there are
mutilations or changes seen

genetically with Caesarean section.

There are also studies
showing that antibiotic use,

even antibiotic use
during labor has been able

to show some evidence of mutilation.

So, we've got some evidence.

But because we've skipped this whole area,

nobody's been looking,
and so we're now saying

turn the microscope on birth,
it's a really important

part of a human being's
life, and therefore probably

has much greater impact
genetically than we ever thought.

- [Voiceover] Also have been
few large scale university

research studies about
the long term effects of

Caesarean sections, the same can be said

about another commonly used intervention.

The use of synthetic oxytocin
to induce or speed up labor.

- I have spent the last
33 years trying to answer

the question you have asked me:

what are the long term
consequences of pitocin

or syntocinon?

And I would say we still don't know.

The only way we could find out
would be to do an experiment.

And I don't think anyone really

wants to be in that experiment.

But because the procedures that are used

to facilitate birth, the
use of pitocin, syntocinon,

oxytocin, all the same thing,

has increased so much,
we're now at the point,

where there's almost nobody left to study

that hasn't been exposed to
it in some way or another.

- Animal studies are
indicating that exposure to

synthetic oxytocin
around the time of birth

can have detrimental outcomes.

But we can't study the same
kind of mechanisms in humans.

So, while we have our
correlational studies,

but we certainly need large
population based studies

where we can look at associations between

birth exposures and long term outcomes.

- [Voiceover] With the
potential transgenerational

effects of epigenetics,
long term effects that can

be seen for up to and
even beyond 100 years

in the future, we could be altering

genetic components of future generations

right now without even realizing.

- We're interfering and
altering so many biological

processes during labor and child birth.

We don't have a clue as
to what kind of long term

heritable, intergenerational
changes can take place.

It's irresponsible to be
biological manipulating

this emerging system in the baby.

This sensitive transitional
system in the mother,

and not know the consequences.

- You know, people who work
in epigenetics will tell you

you are what your grandmother ate.

This can go on to several generations.

So, we need to start the research now,

so that we haven't waited
several generations

before we've got really
good answers to things

that we can correct today.

- [Voiceover] Whatever the actual cause,

whether it is epigenetics,
or alterations to the baby's

microbiome, a mixture
of the two, or possibly

another reason altogether, it
appears something is happening

with Caesarean section
that is being linked to

increased risk of disease later in life.

- Epidemiologically the data
is quite strong, it's linked

to Caesarean section long term outcomes.

Large population studies
have shown that asthma

has increased, about a 20%
increase risk of asthma.

If you're born by Caesarean
section childhood,

compared to if you're
born by vaginal delivery,

about a 20% increase in the
risk of Type 1 diabetes.

Smaller increases in
gastrointestinal problems,

so gout, related
conditions, Crohn's disease,

coeliac disease.

All of those conditions cause
a link to the immune system,

which is a common theme with them.

Obesity, we see a similar
kind of increase in the risk

of obesity.

- [Voiceover] Scientists
at Imperial College, London

have recently conducted
a study into the link

between Casesarean section
and increased risk of

obesity later in life.

- We've just completed and
published a very large systematic

review and meta analysis.

In other words, we put
together all of the published

world literature which
examined the relationship

between obesity and overweight,
and mode of delivery.

- So we took a data from
over a 100,000 people,

from adults born from around the world,

born by the Caesarean
section or vaginal delivery.

And we showed that if you
were born by Caesarean

section, on average you
had half a unit BMI greater

than if you were born by vaginal delivery.

Half a unit increase BMI in an
individual means very little.

I could gain that and lost that in a week,

and wouldn't notice any
difference in health impact.

But across the population,
half a unit BMI increase

is a massive public health risk.

You see a very large increase in strokes,

in cardiovascular disease,
early mortality, etcetera,

all through half a unit BMI increase.

- [Voiceover] As scientists
are very keen to point out,

an association is not
the same thing as cause.

- We don't know whether
or not being born by

Caesarean section causes
certain health problems,

causes you to be overweight or obese.

We know there's an association,
and I have to emphasize

a phrase in science that is
really, really important,

which is that association that
does not mean as causation.

So, for example, you might
find that the increased

risk in being overweight
or obese, if you're born

by Caesarean section is
actually because your mom

was overweight, and the risk
isn't anything to do with

how you were born, but
it's to do with the genes

that you inherited, or it
might be due to the environment

in which you were brought up.

So, you can see that we
have to be really careful

about whether or not
actual mode of delivery

causes these problems.

But it's clearly a very,
very important problem.

Because if it is causal,
if Caesarean section

does cause health problems,
rather than just being

associated with them, then we potentially

have a very big problem on our hands.

- Over the last 20 to 30
years, we've seen dramatic

increases in childhood asthma,
Type 1 diabetes, celiac,

childhood obesity.

And we've also had increases
in Caesarean delivery.

Does Caesarean cause these conditions?

No.

What Caesarean is to not
allow the baby to be seeded

with the microbes.

The immune system doesn't mature and the

metabolism changes.

It's the immune dysfunction
and the changes in metabolism

that we now know contribute

to those diseases and conditions.

- [Voiceover] The story
of later life disease

associated with Caesarean
section doesn't stop there.

- With Caesarean delivery,
the problem is those children

are an elevated risk of
asthma, Type 1 diabetes,

celiac disease, and obesity.

But that's just the tip of the iceberg.

One of the things that happens
with Caesarean delivery,

increasing the risk of
these childhood diseases

such as asthma, coeliac
disease, and Type 1 diabetes

is that the other diseases
where there's elevated risk

may occur later in life.

That the children are essentially
programmed as a result

of these early environmental
conditions for the appearance

of subsequent chronic diseases.

We know that non-communicable
diseases are interlinked.

That if you have one, particularly
as a child, your chances

of having another and
maybe a third later in life

are very much increased.

So, for example, a child
diagnosed with asthma,

it's not just asthma that
we need to worry about,

because that child has a
greater risk of being obese,

of having behavioral
issues, and eventually

developing lung cancer
than children who don't

have asthma.

The same thing happens for
children with Type 1 diabetes

and very specific
non-communicable diseases.

In that case, many of them
are autoimmune diseases.

The same thing for children
with coeliac disease,

which is increasing at prevalence.

So, that it's not just the
first disease that's encountered

in childhood because of
low microbial diversity,

but it's the progression
of potentially multiple

chronic diseases or
non-communicable diseases,

each one requiring a
heavy medical intervention

and drug therapies.

- [Voiceover] This emerging
science all seems to be

pointing in one clear direction.

That there is a link
between Caesarean section

and increased risk of
our children developing

not just one, but multiple
non-communicable diseases.

If we continue on the same
path, it is conceivable

that our actions could actually
be accelerating us towards

the disaster scenario predicted by the

World Economic Forum and
Harvard School of Public Health,

the bankruptcy of our
global healthcare systems.

- You could also actually
begin to think about

non-communicable diseases
as a deeper threat

to national security.

If we don't find ways for
managing these diseases better,

if we can't come up with
cheap, or cost effective ways

to address them, we're going to be landed

with quite a big socioeconomic problem

that could be destabilizing
in the worst case scenario.

And so I think that's
why also we need to raise

more awareness around
non-communicable diseases

and get more coordinated action on this.

- [Voiceover] Non-communicable
disease is now

being recognized by world
leaders as a serious global

health threat.

Action plans are being devised.

But what appears to be completely
missing from their agenda

is the link between how we
give birth and increased

risk of our children developing multiple

immune-related diseases later in life.

- Well, one thing is for sure.

Is that if you take information
to very, very busy world

leaders that is not the
subject that is actually being

debated, you stand very little
or no chance of being heard.

So, it's crucial to take
a subject that they're

all working on first,
and then say in order

for you to achieve the goals that we have

all agreed to, you need to know this.

- [Voiceover] Are we too late?

- I don't think we're too late.

But we're definitely not too early either.

This is a really big challenge.

It's something we have
to confront urgently.

We have to change our thinking.

We're gonna have to get our
brightest minds on this.

We're gonna have to get
coordinated at action

both within countries but
also between countries.

And I think this is what
we're all going to have to

pitch in together for
the benefit of humanity.

Looking into the future, if
antibiotics are no longer

effective because of
antibiotic resistance, and if

we are unwittingly producing a generation

of children with
compromised immune systems,

we could be sending our children out into

a world of disease with
their shields down.

You can imagine the
situation that if we continue

reducing our bacterial
diversity, our children

could become more susceptible
to infectious disease,

including pandemics.

- Well, the worst case scenario
is in fact really terrible.

And that is that we know
that the good microbes

of our body help protect us
against the bad microbes.

And so the risk, is that of
our microbes get too depleted,

then we will become quite
susceptible to an invader,

a pathogen that arises
somewhere, and that could

spread through our communities
all over the world,

and cause a terrible plague or a pandemic.

Pandemics have occurred in the past,

and we're vulnerable to pandemics.

There are many more of us.

We live closer together.

Because of jet planes and
other forms of travel,

we're no more than two
days away from any village

in the world.

So, we have a very large
interconnected community.

And that makes us more
susceptible to pathogens.

And now, if our coastal
defenses are weakening,

if we don't have the diversity,
then we're more susceptible.

That's a scenario that I've
called antibiotic winter,

which is very bleak, because
it could really cause

untold numbers of death.

Now, if this happened
tomorrow, it's too late.

There's not that much
we could do about it.

But if it were going to
happen 50 years from now,

then we could find ways
to protect against it

and to restore our diversity.

And that's what we have to do.

- [Voiceover] Could we
now be doing to ourselves

what we have already
started doing to the planet?

Human kind's impact on
our inner ecosystem seems

to be mirroring the
influence we are exerting

on our global macro ecosystem.

We're disturbing the balance.

- Our westernized lifestyle
and our technology,

which has given us so many good things,

have also collateral damage.

And we have to understand
what is the impact

and try to correct before it's too late.

Both at the level of the
planet, of our environment,

of our macro ecoystems,
and of our own microbial

ecoystems that live with us.

- [Voiceover] Over a
quarter of a century ago,

scientists warned mankind
was causing damage

to our own planet.

The scientists faced fear resistance.

And the repercussions of
inaction perhaps are now

being witnessed.

The same warnings are now
being echoed with respect

to our own species.

Let's not make the same mistake again.

We can't afford to wait
decades before action is taken.

Before wide scale
studies are commissioned.

Before the global community wakes up

to what we may be doing to ourselves.

And it all starts with birth.

- [Voiceover] What's
the worst case scenario

if we don't change?

- Well, the worse case
scenario if we don't change

is that the humanity is
heading for a huge health

crisis which will impact
on us economically.

It will impact on our quality
of life, but also most

significantly it's gonna
impact on the next generation.

And it takes several
generations to sometimes

sort out the problems
we've created previously.

So, we absolutely have to act now.

If we're wrong, and if it
was all smoke and mirrors,

then we've done no harm.

However, if we ignore it, we've
potentially done huge harm.

So, that's why we
actually have to act now.

- I think we're in the midst
of the largest experiment

in human history.

And we're not running the
controlled studies that

we need to know what the consequences are.

I think that's unethical.

I don't think it's acceptable.

I'm not saying we shouldn't
use the procedures

and the medical advances that we have.

I'm saying we owe it to the
children that we're producing,

to know everything we can
about what the consequences

for that child of those procedures are.

(dramatic piano music)

- I think it's extremely
urgent because the sooner

we can identify, and if
there are truly risks

for negative health
outcomes down the line,

we can make a significant impact on health

for all mankind.

For the first time ever, the
obesity epidemic has reached

such proportions, that
we're likely to see children

who have a shorter
lifespan than their parents

or their grandparents.

If how we're born affects our
chances of long term health,

can we do anything to
reduce this obesity epidemic

even by a very small degree,
we need to do something

about this now.

We need to seize this
opportunity to actually turn

the course of human health.

The jigsaw is sort of
being built isn't it?

This feels like another really
important bit of the jigsaw.

It's pointing in a clear direction,

which is child birth is
important for the future health

of our children, and we
need to get it right.

- We have to alert the
public about what's going on,

so that they understand
what the stakes are.

And where this is coming from.

And we need to do more science to pinpoint

the problems and also
develop the solutions.

If we're right, and I think
we've only just begun to scratch

the surface on how right we may be,

then we have got potentially
a huge issue coming up

to face us.

And a bit like climate
change, even though we don't

have all of the answers as
to what's going on, why,

and how severe that issue might be,

we're putting resources,
we're putting politics,

we're putting policies behind it,

and we're changing things
because it would be

so dreadful if we allowed this to escape

and become a bigger problem than it may.

- Scene, take one.

- It's a global problem.

It's not an American problem,
it's not a European problem,

it's not a Japanese problem,
it's not a Chinese problem.

It's a humanity problem.

It is (laughing).

- If we don't take the
bigger perspective and fund

research that asks the smart questions,

the big questions, the
developmental questions,

intergenerational questions,
epigenetic questions,

how do we know that we're
not altering the course

of humanity?

(dramatic orchestral music)