Acknowledgements I would like to express my sincere gratitude to all the people involve in the development of this project. My family and friends for emotional and technical support. Kieren Jones and Agi Haines for mentoring through the process of MYKROH. My designer friends that help me polish my vision and concept. The experts that enriched my knowledge with wisdom; and the universe for its unique timing and great light that helped me create this project with love, motivation and passion.
1. Foreword 2. Background descriptions, methods 3. The human microbiome - Bacteria and birth - Seeding and feeding event 4. The maternal microbiome 5. MYKROH- HOlobiont birht - Project summary - The place - The artifacts - The transfer - The people 6. CONCLUSIONS 7. BIBLIOGRAPHY
The safety and scientific validity of MYKROH study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the NHS or the WHO Know the risks and potential benefits of this design proposal and talk to your health care provider before participating. Read our disclaimer for details.
Fig 1.
Experts: Jen Edmonds - Mother- Vaginal Seeding Expert Doctor Paul Cardenas - Microbiologist Francois Joseph Lapointe - Microbiologist , artist Professor Mel Greaves - Institute of Cancer Research Suzaane Anker - Bioartist Sponsor: Diana Munoz Information: Research papers Mothers NCT groups Midwives Interviews
Fig 2.
1. Foreword: Neonates delivered by schedule caesarean section will go through a bacteria therapy immediately after they are born. They will be swaddled with a top worn by the mother containing skin bacteria and wear a face mask created by the mother’s vaginal fluids and collagen. This is to encourage Lactobacilli bacteria to be transferred to the child to enhance the human microbiome, which is so important in future health. This is achieved through the use of personal designed artifacts, accepted in the medical environment. MYKROH explores the relationship between bacteria and future health, and how we can improve our health benefits through a cocktail of bacteria transferred at birth through a set of designed artifacts and why is it important.
2. Background description Us, humans are 1:1 ratio with bacteria.. The human body is host to an essential ecosystem specially designed to nurture bacteria that form a symbiosis with the body to keep it healthy. This is called our human microbiome, the group of bacteria that is in charge of regulating our pH levels, fighting against pathogens, aiding metabolism and keeping our organs healthy from viruses or infections. This important group of living organisms is set up at birth. Some even claim that bacteria are colonizing the embryo in utero. Unfortunately, we have become obsessed with the idea of cleanliness and we are reducing the biodiversity of these organisms that help us go through life. This project takes place in this century addressing the medical practice of cesarean sections. As medical technology advances caesarean section delivery has become a more common surgical procedure, usually directed to increase the chances of a healthy delivery and to protect both the mother and baby. It is intended to bring up healthy babies reducing the chances to mortality or other complications at birth, for both the babies and the mother. More caesarean section births are happening around the world: “doctors use of caesarean section to deliver babies has nearly doubled in 15 years to reach ‘alarming’ proportions in some countries, a study says. Rates surged from about 16 million births (12%) in 2000 to an estimated 29.7 million (21%) in 2015” (https://www.bbc.co.uk/news/world-45834011)
The increase in the use of this procedure is matched by a notable increase in NCD diseases (non communicable disease) especially in humans born in this way. With the strong associations between metabolic disorders, weak immune systems, and babies delivered by caesarean section we can hypothesise that these disorders are, in part caused by the failure the important microbial community to reach the child from the mother.
Fig 3.
Fig 4.
At birth two main events that happen: first, new life is created; and second, at a microscopic level a new ecosystem of bacteria is planted inside the baby’s body. These two events are key to the development of future health. Overshadowing one event over another might bring consequences in our immune system. When mother’s choose to have a caesarean section birth this important bacterial community is lost and never transfered to the baby. Since the baby will not enter the world through the birth canal, the payload of vaginal bacteria that the mother has ready will be missed and it will never get to the baby’s gut. “While restoring labor is not possible, restoring the microbes that colonize infants during birth through exposure to vaginal flora, is feasible, and has been shown in a small pilot study, to normalize the microbiota of the intestine, skin and mouth during the first month of life” (https://clinicaltrials.gov/ct2/show/NCT03298334). Although this is just a clinical trial. The literature so far is still divided about the real and long-term benefits of vaginal seeding. Vaginal seeding practice is about introducing a sterile gauze inside the birth canal prior birth and after colonizing vaginal bacteria the gauze will be use to swab the baby. This is in a way traumatic for the baby and in danger of being contaminated by other pathogens. With my project MYKROH I explore how to allow this transfer of bacteria in a less intrusive manner and to effectively shape the baby’s immune system for future health. Analyzing and identifying specific factors lost from a canal birth at a microscopic level, it will try to bring to design a system that will collect vaginal through a pump and skin bacteria from a swaddle these artifacts will allow the mother’s microbiome to be colonize by her bacteria and transfer to the baby. .
Methods: Designing medical personal artifacts that will encourage the growth of the proper bacteria and deliver them safely to the baby. In this way increasing the biodiversity in the gut flora and reducing the possibilities of NCDs in the future. This artifact will play a major role when having a caesarean procedure. The language chose for the aesthetic of the artifacts will follow a medicalized from in order to place the design inside an operating theater. This is because it needs to be accepted in the medical community and also have soft elements of design in order to be attracted to the patient (the mother) for its use.
STUDY
DESIGN:
Study type: Interventional pre-birth and after birth Masking: Participant, care provider and researcher Primary purpose: Transfer the human microbiome in a safe and less intrusive manner. Looking into the direct link between mother vaginal and skin microbiota and newborn. Study start programme : 1st of November 2018 End of study start program: 18 July 2019
THE HUMAN MICROBIOME: The decrease in the biodiversity of the tiny organisms around us is bringing about alarming situations in human health. This is in large part due to our obsession of cleanliness and over-medicalized society. We assume that the word bacteria means disease. However, we need to understand that not all bacteria are germs. There are 20 research papers a day coming out about the importance of bacteria within our human microbiome and the way our immune system is developed. “They make vitamins in our gut, coat our skin to protect us from harmful microbes, and help us digest food” (http://www.bbc.com/future/story/20151118-can-you-be-too-clean, access May 16 2019) They are also responsible for avoiding NCDs. “The microbiome has been linked to immunity, autism, allergy, autoimmunity, mood, and the development of our central nervous system,” says Mary Ruebush, microbiologist and instructor at Becker Professional Education School. This is why their biodiversity is essential to build a healthy microbiome at birth.
Fig 5.
Why is this important? There is an estimate of between 20,000 and 25,000 genes within the human body. Researchers within the human microbiome project “estimate that the human microbiome contributes some 8 million unique protein-coding genes or 360 times more bacterial genes than human genes. If that estimate is correct, there could be several hundred times more genetic material within our microbes than there is carried within our human genes�1 Human beings have a symbiotic relationship with the microbes that live on, and inside, our bodies. In other words, the relationship between human cells and microbes is a two-way street. Your human cells do things that benefit the bacteria inside your body, and conversely the bacteria do things that benefit the human cells, your health and your organs. The immense biodiversity of bacteria inside your body is responsible for setting the pH level inside our body and ruling the gut. It is so important because the gut will help you process food and send vitamins where your body needs it. This is why it is so important to help the right bacteria reach your gut at the right moment. The problem we are facing now is that nothing prepared our microbiome for clean water, smaller families, caesarean sections and antibacterial substances everywhere, and of course 70 years of antibiotics. This has greatly reduced our microbiome biodiversity and is actually making us sicker consider ing diseases related to the microbiome. Research has been done about NCDs that cannot be transmitted by anything, but are born inside of our body due to a lower count of bacteria. On the other hand research has also shown wrong bacteria getting inside our body first and making its way to develop leukemia. Our human microbiome takes 2-3 years to establish. Once it is strong and healthy approximately 6-10% of the composition of the gut does not change through life. The other 30-40% might change because of diet, stress, environments and other factors. This is why we need to pay attention and have a successful seeding event at birth.
THE INFANT MICROBIOME AND IMMUNE SYSTEM The infant microbiome is usually determined by the maternal community of bacteria that they get at birth and through close contact with the mother in the following growing years. Babies associate with another form of delivery rather than birth canal delivery and those fed on formula milk and therefore with reduced direct skin to skin contact have been associated with a weak immune system and metabolic problems. As our human microbiome interacts dynamically with the environment and its host there is no place for a community of microbes if they are washed away or missed during a determined moment in life. The important of these microbes reach as far as to be responsible for psychological triggers and actual regulators of health. Their significance means that they should be considered a new organ. Looking back at what we know about bacteria, it has become an ancient belief that bacteria is only composed by pathogens that are considered dangerous for human health. But there is still a lot of information missing and what we could do about it. If we try to restore it, it might bring internal and psychological changes to the newborn. It is why only by mimicking nature in a suitable way should we try to implement this procedure without the risk of future consequences. After birth it is not only vaginal bacteria that is responsible for our newborns’ healthy microbiome but so too is breast milk. Breast milk brings a lot to the new bacterial community; it is not only to provide food for our babies but brings a specific set of proteins and sugars that cannot be processed by the newborns but are intended to feed to the specific set of vaginal bacteria previously introduce through birth to the baby’s gut flora. The gut flora is the main organ of humans that hosts the microbial community that is in charge of setting the right pH and strengthening our immune system for fighting against pathogens and processing food. Therefore, it is not that formula milk will not feed your baby with the proper nutrients but that it is not engineered to feed the existing bacterial community already living in the gut flora.
Fig 6.
BACTERIA AT BIRTH. During the third trimester of your pregnancy your body begins to prepare for the birth of your new baby. Breast milk gets stronger, full of food and special bacteria and sugars that can’t be processed by your baby, but are intended to feed its gut bacteria. Breast milk is as important as the vaginal fluids to your baby’s microbiome. The feeding process is a key part in the complete cycle of transferring the human microbiome. Your vaginal microbiome gets colonized by main Lactobacilli and its normal biodiversity lowers. This is done to prepare the “vertical microbial transmission to the newborn during vaginal delivery,” to quote Dr. Maria Gloria Dominguez-Bello’s 2015 paper.
This is because Lactobacilli are the main bacteria your baby will need to arrive to the gut and set the entire pH level of its body for future food and bacteria specimen. Not only is determined to set the acidic levels, but it also contains their own antibiotic that will stop other harmful bacteria as pathogens get inside the body. The group of lactic acid bacteria that gets to colonize your vagina will provide energy to your baby’s body. The change involves a colonization of L.vaginalis , L.crispatus, L jensenii, and L, gasseri. These species increase so much that they crowd out other bacterial species, limiting bacterial diversity overall. Vaginal bacterial transfer will be known as seeding since the organisms need to seed inside the body to start creating their own ecosystem and the symbiotic relationship with us. Seeding
and
feeding
event
The microbial changes create a special cocktail of exactly the right mix of microbes in the mother to transfer to the newborn through seeding and feeding process. Since the baby is developed in a semi sterile environment (the womb) it does not have any direct contact with bacteria so, which bacteria gets in first is of extreme importance. In the third trimester, the balance of the mother’s vaginal microbiome shifts. There is a higher portion of certain types of bacteria that are intended specifically for the baby. During the vaginal birth, the water breaks and the amniotic sacs burst exposing the baby to the specially designed vaginal microbiome. The vaginal microbes sometimes, the baby is also exposed to gut bacteria (fecal microbiome released during expulsion efforts) coat the baby’s skin and enter through the eyes, ears, nose, genitals and mouth; immediately the baby swallows some of the microbes in order to guide them to the gut. This is called the colonization party and is where the main seeding event happens. After this process is complete the baby reaches to get food from the breast milk in order to reinforce the previous vaginal bacteria ingested. This process is called feeding. During this process the baby gets oligosaccharide coming from milk, these are specially designed to feed the bacteria from the vaginal community.
Fig 7.
Although it’s still very early to determine if the baby’s immune system is affected by third party practices “the best available evidence suggests that these practices that compromise the microbial colonization of the newborn gut should be used prudently and followed by measures to restore the natural composition of the microbiome.” (Noel T. Mueller,1,2 Elizabeth Bakacs,3 Joan Combellick,4 Zoya Grigoryan,3 and Maria G. Dominguez-Bello3)
LOVER BIODIVERSITY
ANTI INFLAMMATORY BACTERIA
FIMICUTEs
PROTEOBACTERIA
BACTEROIDETES
Fig 8.
THE MATERNAL DURING
MICROBIOME PREGNANCY
Pregnancy affects all our metabolic and internal processes. Organs enlarge, psychological changes are altered by hormones and physical changes will adapt the body in order to prepare the newborn to grow healthy and comfortable preparing he/she for birth. As explained above the body begins to cooperate with the microbial community in order to prepare a healthy human being. Studies state that there it is not only the vaginal microbiota that changes to prepare for the new life, but also fecal bacterial biodiversity decreases and specific composition of anti-inflammatory bacteria found in fecal matter increase. The decrease of vaginal bacteria biodiversity is because through the course of the pregnancy it will help painting a low pH level inside the birth canal. As a result, it limits and prevents bacteria from amending to the baby in the womb, where they can infect the amniotic fluid or the placenta and harm the baby itself. The female body is wise and wired as a machine that works alongside nature to bring up a healthy human being. “Gestational changes in the vaginal and fecal microbiota are likely to be part of an adaptive response to protect and promote the health of the fetus and provide the newborn with a specific microbial inoculum at birth, before exposure to other environmental microbes.� ( (Noel T. Mueller,1,2 Elizabeth Bakacs,3 Joan Combellick,4 Zoya Grigoryan,3 and Maria G. Dominguez-Bello3)
Mimmicking nature to go back to our roots
Fig 9.
There has always been an interaction between nature and humans. We take advantage of its beneficial systems and we cooperate with it to create a successful healthy life. But somehow we have forgotten where we came from and turned to technology to entrust our daily life activities. Over the past decade technology has taken over all of our actions and is now taking part in the main natural act that we have, birth. Birth has been unassisted and “natural” in every species of animal and human beings. It is important to re-tell the importance of birth looking into a different perspective. That is, that we need to successfully have a holobiont birth in order to give importance to microscopic events occurring at birth that are necessary for life. Holobionts are “ an eco evolutionary and functional implications of host–microbiota interactions in all ecosystems” A relationship between host -- organism. “Usually, human birth narratives focus on the origins of a new individual, focusing on the heroic travails of the mother or the amazing journey of the fetus. I wish to discuss birth as the origin of a new community1. For not only is the eukaryotic body being reproduced, but so also are the bodies of its symbiotic microbes and so is the set of relationships between these organic components”. Thanks to consumerism and technology, we have become a “sterile society” looking to get rid of everything that is important in our lives, bacteria. Therefore, we have lost contact with nature. We have turned our backs to micro-organisms that allow us to stretch, enrich and define our human capabilities. The oil and energy that lives inside our body helping us digest, synthesize, detox and mandate as long as we are alive; allowing a natural synergy between body and bacteria. This project mimics nature by bringing missing lost microbes inside our baby’s body that are born through a caesarean section procedure in an over-medicalized world. In other words, re-creating a holobiont birth in an overmedicalized world. It consists in a group of artifacts that are used in the form of a ritual, to give our newborns what they are lacking having been born by caesarean section. How can I give the baby vaginal and skin bacteria directly from the mother in order to strengthen his/her gut? In this project the main value of it is to open the possibilities of these positive fluids inside our baby’s body. More important than the shape of each artifact is the system around it that happens in the operation theatre. A chain of events that are followed after birth that are part of a medicalized ritual that happens after the baby is born.
A HOLOB I O N T B I R T H
Fig 10.
After our baby is born from cesarean procedure the baby is taking into a separate table in order to be cleaned and extract the excess of amniotic liquid ingested and finally cutting the umbilical cord before cleaning him/ her and giving it to the mother. This procedure avoids any immediate contact with the mother’s vaginal and and sometimes skin microbiome missing an important step for developing future health. Instead it exposes the baby to air and foreign bacteria first before having any contact with the mother’s microbiome. Therefore, by designing artifacts that help to get this important microbial community inside the baby I will be adding another step of actions that will be a part of this medicalized ritual in order to mimic what a “natural birth” brings. Before going through the aesthetics of the project and the design solution selected for this issue there should be multiple considerations to be taken before performing a bacteria colonization therapy that MYKROH encourage through their artifacts.
CRITERIA FOR MYKROH • Scheduled for caesarean delivery at 37-40 weeks • Pregnant with single newborn, in good general health • Negative maternal testing for infections transmitted through vaginal and/or other body fluids performed as standard of care tests in early pregnancy ( This is done routinely inside the UK) • Negative testing for GBS at 35-37 weeks gestation • Vaginal pH < 4.5 indicative of Lactobacillus-dominated vaginal microbiota • No maternal or fetal complications that may inhibit the ability to perform microbiome restoration per protocol -Infant condition after delivery requires no more than standard neonatal resuscitation* or is otherwise medically unable to receive the full VMT procedure It is of extreme importance that the testing is undergone prior birth, in order to avoid Strep B or hepatitis or any kind of threatening bacteria approaching the newborn. Because of the danger that pathogens contaminate the vaginal microbiome specimen the material choice for each artifact must be considered in the development of the design solution of MYKROH.
THE PLACE
Mykroh takes place inside the operating theatre: a semi sterile environment where we can reduce and control the biodiversity of bacteria that enter the room. The project is designed to be part of the chain of actions that happen after birth, similar to cutting the umbilical cord. Vaginal seeding and skin bacteria transfer in my opinion should be considered a priority to deliver the baby with all the micro-organisms that he/she needs.
Fig 11.
THE ARTIFACTS One of the artifacts designed addresses the vaginal bacteria and how to collect vaginal fluids to apply it to the baby. After consulting with gynecologist, microbiologist and feminine product designers my artifact consists of a vaginal pump attached to a subtle pump that will collect the vaginal microbiome of the mother and transfer it to the baby through a face mask. The vaginal fluids are pumped directly to a face mask that is implemented in the design preventing any aerobic bacteria to enter the mask and reducing the contamination of other pathogens. The container of the mask will not alter or damage the vaginal microbiome collected.
VISUALS OF THE EVOLUTION OF THE PUM WHITE COLOR PRINT.
This project also tries to restore the human microbiome by bringing the baby into close contact with the skin bacteria of the mother. By designing a swaddle top that is going to be worn by the mother prior to birth. This top is designed to capture skin sweat bacteria of the mother through an absorbent designed solution.
MP ( TWO PAGES ACETATE PRINT AND
THE V-PUMP The process for prototyping was developed in consultation with mothers-to-be and existing mothers, and also through rigorous talks with a gynecologist. The shape of the final pump has evolved from something that resembles a sex toy to a more medical appliance that will bring comfort for a personal use.
Fig 12.
Fig 13.
EVOLUTION OF THE PUMP
Fig 14.
Anatomical measures were taken into consideration such as the size of a birth canal in its day to day state, and prior to birth. Materials chosen to develop the project also have a major part at MYKROH since they are going to be interacting with the inside of the body and in a medical environment. BPA medial grade silicon is used for the vaginal pump in order to not distress the microbial community or altering it. It is designed to sit comfortably inside the vagina while collecting and colonizing the required bacteria directly into a face mask.
THE MASK Consists of a blend of collagen, hydrogel, distilled water and vaginal microbiome in order to sit comfortably on top of the new born face for 5 minutes in order to allow a successful transfer through eyes, nose, mouth and ears. This will help the baby skin and openings absorb the bacterial community that has been embedded in the mask.
Fig 15.
Fig 16.
Fig 17.
Fig 18.
The Swaddle-top The top addresses the skin microbiome and it is designed to capture the bacteria in order to let it transfer later into the babyâ&#x20AC;&#x2122;s new and porous skin. It is designed to be worn by the pregnant mother without washing it and stored in a closed plastic container provided by MYKROH. This is to prevent threatening pathogens getting near the top. Thanks to the transformable pattern that the top has it will be the newbornâ&#x20AC;&#x2122;s first swaddle, allowing time for the skin microbiome absorption and transmissions re-enforcing the baby with bacterial community missed out on.
Fig 19.
SWADDLE PATTERN Fig 20
THE MEDICAL
TRANSFER: RITUAL
After successfully extracting the vaginal fluids, and storing them in its sterile container that is keeping the face mask rich with vaginal bacterial community, it is ready to be transferred to the newborn to restore the missing microbes. When the facemask is rich with bacteria ready to be transferred to our new born it should be gentled put on top of the babyâ&#x20AC;&#x2122;s face to rest while the invisible process of bacterial transfer is happening. This takes places exactly when the baby is being cleaned up to be given to the mother. The mask will be applied, and the newborn will be given to the mother with the clear vaginal bacteria mask. The mask should be resting on the babyâ&#x20AC;&#x2122;s face for 3-5 minutes to allow a successful transfer from mouth, eyes, nose and ears. Simultaneously after the baby is clean up and getting ready to be given it to the mother it will be swaddled with the top that the mother has been wearing prior to birth to re-enforce the skin bacterial transfer. This is then followed up with a skin to skin direct contact with the mother. After following these actions, and introducing them in the chain of events of a medicalized ritual, the transfer of the human microbiome is ready to be done
Fig Fig 21 21
Fig 22
Fig 23
THE PEOPLE As mentioned above, interviews with new mothers, pregnant women, microbiologist, biologist and bio artists shaped MYKROH and their elements. The decision of making a vaginal pump and an enclosed system that will act to take care of transferring the human microbiome was made as a result of long conversations with them. Time and space for MYKROH was also defined by conversation with experts. Vaginal seeding needs to be taken care in a medical room and with extreme care to be successful. So I needed an element that will be accepted in the medical world but also be adopted by new mothers. The mask was the best medium to represent how bacteria migrate on top of a material and rest in an encapsulated sterile bag in order to allow a safe transfer. The baby needs to have direct contact with the bacteria in a way that the skin and the orifices absorb the organisms in a proper matter. So talking to mothers and doctors helped me to design a gel mask that will collect the fluids and then proceed with a transfer. The skin bacteria collection was also a concern during C-sections, sometimes the mother is too tired or the ability to create a direct skin to skin contact was impossible. This is why the swaddle top was designed in order to collect skin bacteria previously to the mother and be ready to swaddle the baby when its born.
â&#x20AC;&#x153;My birth was an emergeny c-section. My baby was healthy only with an eczema problem in the skin. I think if I had knew there was a system to revocer lost microbes that are important at birth I could have probably chosen to do it. If its gentle on the babys face rather than any intervention is better.â&#x20AC;? PRISCILLA SEMINARIO
“I had an emergency c-section and if I would have known about the opportunity of bathig my baby with the rich bacteria I would have done it. I guess if doctors talk more and recommend it more to patients I will feel more comfortable in doing it. The shape of the pump doesnt really matter but maybe is better to design it pre-birth because after birth your vagina takes a long time to heal. “ SUSANNE STANGL
“We wanted to give our baby the best choice possible of getting all the bacteria that she needed to establish a healthy immune system. The doctors in thailand were completly against it, but we signed a consent form that it was under our own risk. Now my baby is healthy and growing. The seeding is absolutely safe if its from your own bacteria and prior testing is done like every little thing that you have to test when you are pregnant. The experience was nice i didnt even feel the gauze so the adaptor shape doesnt really matter I guess it will be easy something like the moon cup, for me it was more rough the way my baby was swabbed. if it could be something that sits comfortably on top of their face would be ideal” JENNIFER EDMONDS
Fig 24
“The mask gives an additional layer to the design. If the mask is pre-made and the bacteria is added to the mask seems to me that is the closest thing you could do to create a successful vaginal seeding. Because you have to encapsulate and protect the vaginal fluids from environmental and medical bacteria. “ “We can speculate in a future were seeding will become part of a ritual in every mothers journal. For me it becomes interesting when science and art collide. A space to communicate through objects , performance and art knowledge” François-Joseph Lapointe biologist/bioartist
Fig 25
â&#x20AC;&#x153; You can create scenarios that coonect with your concept speculating alternative realities as a result of your reearch and analysisâ&#x20AC;? Anne Vandraager
Microbiologist - researching about the human microbiome. Paul shared his knowledge and research about the vaginal microbiota and how the diversity shift towards the last trimester preparing to recieve the baby and bathe it with the bacterias it needs. Also explained different methods of encapsulation, how keep bacterias alive, how to process a proper transfer in a speculated scenario
Fig 26
Fig 27
C O N C L U S I O N : With this project Iâ&#x20AC;&#x2122;m trying to return something that has been lost with the increase of the medical procedure of caesarean section. In this way it will bring the same biological benefits of a canal birth. Getting the human microbiome intact and creating a direct link between the motherâ&#x20AC;&#x2122;s microbiota and the babyâ&#x20AC;&#x2122;s new ecosystem of bacteria. I would like to open a conversation of the importance of bacteria in the early stages of life, and our symbiosis with them for the rest of our life. How can we work with technology to re-create a holobiont birth in an over-medicalized society that has made us believe that a clean sterile environment lends itself to a healthy and safe life. But is not this way we get it. If we eliminate bacteria out of our lives we will be entering crisis of natural development and how is supposed to be. With the set of artifacts designed to be part of the caesarean procedure we will not only be restoring the human microbiome at birth but designing a holobiont birth specifically addressing the microscopic event that happens at birth through technology.
BIBLIOGRAPHY Books : 1. Symbiosis as a Source of Evolutionary Innovation: Speciation and Morphogenesis , Lynn Margulis, René Fester, University of Massachusetts Amherst Massachusetts Lynn Margulis, MIT Press, 1991 2. Your baby’s microbiome: The critical Role of Vaginal Birth and Breastfeeding for Lifelong Health, Toni Harman Alex Wakeford, Chelsea Green Publishing , White River Junction , Vermont February,2017 3. Dirt is good : The advantage of Germs for your Child’s Developing Immune System; Jack Gilbert , Rob Knight, St Matin’s Press , New York, June 2017 Articles: 1. Scott F. Gilbert,A holobiont birth narrative: the epigenetic transmission of the human microbiome 1,2,* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137224/ , Access November 20th 2018 2. . Maria G. Dominguez-Bello,1,2,* Kassandra M. De Jesus-Laboy,2 Nan Shen,8 Laura M. Cox,1Amnon Amir,3,7 Antonio Gonzalez,3,7 Nicholas A. Bokulich,1 Se Jin Song,3,4 Marina Hoashi,5Juana Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5062956/I, Access December 3rd 2018 3. Peter J. Turnbaugh,1 Ruth E. Ley,1 Micah Hamady,2 Claire Fraser-Liggett,3 Rob Knight,4 and Jeffrey I. Gordon1 The human microbiome project: exploring the microbial part of ourselves in a changing world, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709439/ , Access January 6th 2019 4. Tina Donvito , What Is Vaginal Seeding, and Should You Do It? The birthing trend for babies born by C-section has some experts concerned about health risks , nhttps://www.parents.com/pregnancy/giving-birth/cesarean/what-is-vaginal-seedingand-should-you-do-it/ , Access January 6th 2019 5. Aubrey Cunnington, Clinical Senior Lecturer, Imperial College London , What Is Vaginal Seeding? https://www.iflscience.com/health-and-medicine/what-vaginal-seeding/, Access January 6th 2019 6. M. Fettweis,a,b Myrna G. Serrano,a,b Philippe H. Girerd,c Kimberly K. Jefferson,a and Gregory A , A New Era of the Vaginal Microbiome: Advances using Next-Generation SequencingJennifer. Buckhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3517151/ , Acesss January 6th 2019 7. Olivia Willis, Why your vaginal microbiome (like your gut) is important , https://www.abc.net.au/news/health/2017-11-22/vaginal-microbiome-why-it-is-important-for-womens-health/9176782 , Access January 7th 2019 8. James Gallagher , Does Vaginal seeding boost health, https://www.bbc. co.uk/news/health-43785523, Access January 7th 2019 9. Huang B. et al. 2014. The changing landscape of the vaginal microbiome. Clin Lab Med. 34(4):747–61. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254509/ , Access January 9th 2019 Podcasts: Website Access http://www.microbiomeinstitute.org/podcast/v Episode 9: The skin microbiome and AOBiome with Dr. Larry Weiss Episode 8: The vaginal microbiome with Dr. Jacques Ravel Episode 4: What’s hot in the microbiome field with Kristina Campbell Episode 2: All things microbiome with Dr. Jonathan Eisen
Films: 1.
Microbirth , ALTO FILMS , One World Birth, Tony Harman, Alex Wakeford
Images: Fig.1 : Gut bacteria plays different roles in males and females, Available at, HTTPS:// AJP.COM.AU/NEWS/GUT-BACTERIA-PLAY-DIFFERENT-ROLES-IN-MALES-AND-FEMALES/ , Access date : May 14 2019 Fig 2. Boost C-section babies by giving them vaginal bacteria, Available at: https://www.newscientist.com/article/2075768-boost-c-section-babies-by-giving-them-vaginal-bacteria/ , Acces date: May 14 2019 Fig 3. The Global Epidemic of Unnecessary Cesarean Sections (Part 2) Available at: https://www.mhtf.org/2017/01/25/the-global-epidemic-of-unnecessary-cesarean-sections-part-2/ , Acces date : May 14 2019 Fig 4. The Global Epidemic of Unnecessary Cesarean Sections (Part 2) Available at: https://www.mhtf.org/2017/01/25/the-global-epidemic-of-unnecessary-cesarean-sections-part-2/ , Acces date : May 14 2019 Fig 5. Technical graphics, Diana Munoz Fig 6. Graphics , Vaginal microbiome changes, Diana Munoz Fig 7. Microbiome biodiversity, Maria Gloria Dominguez bello Fig 8. Maria Paula Perez Reyes, Melissa Nevarez Photographer. Maternal microbiome graphics , Diana Munoz Fig 9. Mykroh Artifacts, Diana Munoz Fig 10. Mykroh Artifacts , Diana Munoz Fig 11. Operatin theathre Available at: https://www.ew.nl/app/uploads/OK-ziekenhuis.jpg , Access May 20th 2019. Fig 12. Mykroh Artifacts, Diana Munoz Fig 13. Mykroh Artifacts, Diana Munoz, Technical drawings pump, Diana Munoz Fig 14. Mykroh Artifacts, Diana Munoz Fig 15. Mykroh Artifacts, Diana Munoz Fig 16. Mykroh Artifacts, Diana Munoz Fig 17. Mykroh Artifacts,Florencia Schneider Fig 18. Mykroh Artifacts,Florencia Schneider Fig 19. Mykroh Artifacts,Florencia Schneider Fig 20. Mykroh technical drawings swaddle pattern , Diana Munoz Fig.21 MYKROH , Tom Mannion Fig.22 MYKROH , Tom Mannion Fig.23 MYKROH , Tom Mannion Fig 24.Priscila seminario, Susaane estangl , Jennifer Edmond. Interviews Fig 25. Fig26. Franรงois-Joseph Lapointe , Paul Cardenas , Paulina Exocbar , Anne Vangdrager. Fig.27 MYKROH , Tom Mannion
MYKROH Diana Munoz 2019 Central Saint Martins