Incorporating bacteria into childbirth education

germs1How can knitted bacteria help spread important information about birth and the microbiome?

Our understanding of how the microbiome is affected by how we are born, fed and cared for is growing rapidly. The past few years have seen more bacteria-related research, thinking and discussion than ever. And there is a noteable swing away from the one-sided view that germs are ‘bad’ things to be avoided and washed away with antibacterial soap. We’ve moving towards a more nuanced understanding of the complexities of our human microbiome. That is, the mass of bacteria which are the key to our survival.

This page offers an overview of resources for those who share information relating to birth. I have gathered together a few of the resources on my site and elsewhere. And this page also tells the story of how I began to knit bacteria and sell them in an Etsy shop. (Yes, you can now buy your own!)

If you’re the owner of a knitted bacteria, it also offers a few tips about how you might like to use this in your work!


Bacteria-related resources

So first, I haven’t written an overview of research relating to the microbiome. That’s because Jessie Johnson-Cash and Rachel Reed already wrote a wonderful blog post on this elsewhere. It contains everything that I would have said and more. If you haven’t see it, it’s a great read: The Human Microbiome: considerations for pregnancy, birth and early mothering

I have, however, written a two-part article in which I gave more of a potted overview for midwives. Here it is:

Rethinking Bugs (part 1)

Rethinking bugs (part 2)


Another useful resource is a more recent Science and Sensibility blog post by Anne Estes, which has some really useful illustrations by Cara Gibson: The Healthy Birth: Dyad or Triad? Exploring Birth and the Microbiome


Here are a few other blog posts which may be of interest to those discussing the implications of different decisions with parents-to-be.

Maternal antibiotics (e.g. for GBS) and imbalance in baby’s gut bacteria

Mode of birth and feeding matter for bugs!

Microbiome seeding and woman-centred care

Group B Strep resources


Knitting bugs!

4464549449_f18a3a0fc6Then, a few years ago, I illustrated one of the above blog posts with this rather colourful picture, which is actually a molecular model of bacterial cytoplasm. A certain couple of midwives who are interested in the microbiome asked if I had knitted that. And no, my attention span is too short to knit anything that big! But it did start me thinking.


germs4I realised that it might be quite useful to have a friendly bacteria in my bag as a conversation starter. Something to use as a way of engaging people in discussion about these recent advances in our knowledge. A conversation starter, if you like. So I took myself into the garden with a cup of tea that afternoon and knitted the first of an entire friendly family of bifidobacterium infantis. The friendly kind of bacteria that babies need.

And now, we sell them in our Etsy shop, in case you’d like one of your own!


How to use bacteria in childbirth education

Bearing in mind that childbirth education isn’t just about classes, here are some ways that you could incorporate your bacteria into birth education.

  • Add it to your ‘goody bag’ of things for parents to pull out and discuss when you have a few spare minutes in sessions.
  • Get out your own bacteria and use it to begin a conversation.
  • Use the bacteria to illustrate and discuss how type of birth, feeding and what happens in the first hour or so after birth can impact baby’s health.
  • Lead into a discussion of what the ‘next best’ options are if plans change.
  • Use your bacteria to illustrate what happens when women or babies have antibiotics.
  • Move into a conversation about why it’s important to weigh up the risks and benefits of individual interventions rather than automatically accepting the population-level recommendation.
  • You can also use your bacteria to illustrate conversations about hygiene, washing, passing the new baby around and where the baby will spend its first few days. It’s actually amazing how many conversations it will start!
  • And if you’re teaching health professionals, or want a deeper discussion, you can use the bacteria to illustrate the importance of the microbiome during birth.
  • Finally, for academic settings, there’s a section in my Group B Strep Explained book about our attitudes to bacteria. That includes a conversation about how we have tended to ‘personify’ bacteria in discussion and debate. The fact that my friendly bacteria have ‘faces’ make them a great audio-visual aid in that conversation!


  • If you have any other ideas, please feel free to share them in the comments!


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And if you’re a midwife or other birth worker who enjoys unpacking research, seeing what’s behind the headlines and sharing wisdom with like-minded others, come and join Sara and colleagues from all over the world in one of our online courses!
photo credit: A molecular model of the bacterial cytoplasm by Adrian Elcock via photopin (license)

4 comments for “Incorporating bacteria into childbirth education

  1. Jessie Johnson-Cash
    December 10, 2015 at 7:02 am

    They are beautiful and I think they are a wonderful tool to add to your bag of tricks.
    Following on from this, Rachel and I have recently authored an article for AIMS, written for women with information about supporting a healthy microbiome for their babies.

  2. Jessie Johnson-Cash
    December 10, 2015 at 9:17 am

    Excuse my shameless self promotion. Excited about my first published writing 🙂

    • December 10, 2015 at 11:37 am

      Haha, no worries! Congratulations 😀

  3. December 10, 2015 at 11:11 am

    I’m captivated by recent/ongoing developments in the microbiome field. I discuss with all clients the value of embedding seeding into birth preferences in the ‘what if’s’, and pinning a sterile gauze swab in mat notes, purely to serve as a visual reminder to care team of intentions.

    We talk about the importance of not only vaginal microbes, but through S2S & b/f also, and to encourage only necessary contact with baby in the early days, so that familiar germs are the feature.

    Such a simple procedure, with nothing to lose. If Mother/Father carry our swabbing, all the better.

    I raise awareness of this topic with my positive birth group, sharing relevant articles, encouraging discussion. It’s not seized upon as readily as most other birthy issues, and I get that #happytobeagermnerd

    Having said that it’s in people’s thoughts, and within our group women are considering it as part of discussions with their care team 🙂 Featured in Milli’s recent article, as a client carried out swabbing during her unplanned c/s – big news here in Wales!

    Lisa (Doula)

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