Lotus Birth: What you should know

By Anchen Verster – Registered nurse and midwife, SA certified perinatal educator (SACPE)

Your baby will be born with his cord attached at the umbilicus and the other end still attached to the placenta which in turn is attached to the inside of your uterine wall. Usually as soon as he is born the cord will be cut. After this the placenta will detach from the wall and be birthed with contractions. Before it exits your body the cord usually will have been clamped and cut. Lotus birth (umbilical cord non-severance) is the practice of allowing the placenta to remain “attached” to the baby via the cord until the cord spontaneously dries and separates the two. This may take 4 days or it may take 14 days (or longer).

In the meantime the placenta is wrapped and placed in a bowl or rubbed with oils and salts. It is said to extend the birth time, provide extra blood oxygen and nutrients to the baby and discourage interference and unnecessary holding by non-family members.  Caregivers wait for the cord to stop pulsating, wash and pat it dry and then allow it to lie in a sieve for 24 hours to drain any excess fluid. After this it is covered in sea salt and wrapped in a cloth where it rests in a bowl near the baby until the cord dries and separates the baby and placenta.

This process is said to maintain the natural progression of birth to severance from the mother (placenta) at the time nature intends. It is said to promote the Spiritual connection between mother and baby. Proponents also say it keeps the postnatal period calmer and limits intrusion… because you can’t go to the mall with your baby’s placenta. Granny Suzie may also want to save her cuddle of your newborn for when she doesn’t have to grasp a placental bowl too. Some see it as a way of keeping the overwhelming visitors at bay.

The practice is said to have its origins in the US and in Australia. Its name is borrowed from the Lotus flower that is highly esteemed in the Buddhist and Hindu faith and bears symbolism to purity, ‘its beauty coming out of a long stem’. Lotus birth is rare in South Africa. Although some families choose Lotus birth for various reasons there are some factors worth considering.

Unfortunately, we do not have large studies or reviews on Lotus birth so the information comes from individual case studies. It is also not a practice that you can easily design a trial for because you cannot randomize moms and babies to this practice if there are potential harms – that would be unethical. So, the research we can do is looking at the outcome of Lotus births by comparison to non-Lotus births.

Here are a few factors to consider before considering a Lotus Birth:

  • The placental tissue is no longer living after the birth and so will begin to decompose. This process usually will begin to smell which is why salts and essential oils are used. Mother smelling baby and baby smelling mother is documented as an important part of the bonding process and the “getting comfortable with each other”. This stimulates the mother’s hormone release and it helps the baby with knowing and feeling safe with the mother and finding the breast. The smell of the decomposing placenta or the smell of the essential oils are likely to interfere with this process.
  • One of the top 3 reasons for neonatal death world-wide is infection or sepsis. Allowing an infant to remain attached to the placenta may increase this risk because the tissue begins to decompose and may aid in the transfer of bacteria from placenta to baby particularly during handling.
  • There have been cases of idiopathic hepatitis attributed to Lotus Birth. This is inflammation of the liver where there is no other known physiological cause.
  • The practice is said to increase iron levels (haemoglobin) in the newborn and said to lower the risk of anaemia. According to current research this can be achieved by practicing delayed cord clamping (30-90 seconds from birth) or only clamping once the cord stops pulsating. No more blood should pass to the baby beyond this stage in which case you can still achieve those benefits without leaving the placenta attached for days.
  • The cord has no nerve supply from the mother or the baby so neither mom or baby experience any sensation during severance. The natural progression after birth is not for the baby to be attached to the placenta but for the baby to be re-attached to the mother at the breast. So, begins the next step of their relationship as nature has ended the first connection by birthing. Remove a baby from suckling at the breast and he or she will quickly let you know that that is where nature intended him to be and where he wants to be; separate him from the placenta at the cord and he won’t respond at all.
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