Lotus birth

thumb|Intact umbilicus one hour postpartum, an extended-delayed cord severance

'''Lotus birth''' (or '''umbilical cord nonseverance – UCNS''') is the practice of leaving the umbilical cord uncut after childbirth so that the baby is left attached to the placenta until the cord naturally separates at the umbilicus.<ref>{{Cite book|title=Evidence-based care for normal labour and birth : a guide for midwives|author=Walsh, Denis|date=2007-01-01|publisher=Routledge|isbn=978-0415418904|oclc=156908214}}</ref> This usually occurs within 3–10 days after birth.<ref name="HUFFmaster" /> The practice is performed mainly for spiritual purposes, including for the perceived spiritual connection between the placenta and the newborn.<ref name="BURNS">{{cite journal|last1=Burns|first1=Emily|date=Winter 2014|title=More Than Clinical Waste? Placenta Rituals Among Australian Home-Birthing Women|journal=The Journal of Perinatal Education|volume=23|issue=1|pages=41–49|doi=10.1891/1058-1243.23.1.41|pmid=24453467|pmc=3894590}}</ref>

As of December 2008, no evidence exists to support any medical benefits for the baby.<ref name=RCOG /> The Royal College of Obstetricians and Gynaecologists has warned about the risks of infection as the decomposing placenta tissue becomes a nest for infectious bacteria such as Staphylococcus.<ref name=RCOG>{{Cite news|date=2008-12-01|url=https://www.rcog.org.uk/en/news/rcog-statement-on-umbilical-non-severance-or-lotus-birth|title=RCOG statement on umbilical non-severance or "lotus birth"|website=Royal College of Obstetricians and Gynaecologists|language=en-US|archive-url=https://web.archive.org/web/20170322221453/https://www.rcog.org.uk/en/news/rcog-statement-on-umbilical-non-severance-or-lotus-birth|archive-date=2017-03-22|access-date=2020-02-06}}</ref> In one such case a 20-hour old baby whose parents chose UCNS was brought to the hospital in an agonal state, was diagnosed with sepsis and required an antibiotic treatment for 6 weeks.<ref>{{Cite journal|title=Umbilical Cord Nonseverance and Adverse Neonatal Outcomes |journal=Clinical Pediatrics|volume=58|issue=2|pages=238–240|language=en|doi=10.1177/0009922818805243|pmid=30280596|year = 2019|last1 = Ittleman|first1 = Benjamin R.|last2=German|first2=Kendell R.|last3=Scott|first3=Emily|last4=Walker|first4=Valencia|last5=Flaherman|first5=Valerie J.|last6=Szabo|first6=Joanne|last7=Beavers|first7=Jessica B.|s2cid=52912265}}</ref><ref>{{Cite web|url=http://www.skepticalob.com/2018/12/lotus-birth-leaves-a-newborn-critically-ill-with-a-heart-infection.html|title=Lotus birth leaves a newborn critically ill with a heart infection|last=MD|first=Amy Tuteur|date=2018-12-19|website=The Skeptical OB|access-date=2018-12-20}}</ref>

==History==

Although recently arisen as an alternative birth phenomenon in the West, super-delayed (1+ hours post-birth) umbilical severance is common in home births.

Early American pioneers, in written diaries and letters, reported practicing nonseverance of the umbilicus as a preventative measure, as they believed it protected the infant from an open wound infection.<ref>Leavitt, Judith Walzer. Brought to Bed: Childbearing in America, 1750 to 1950. New York: Oxford University Press, 1986 pp.21-37</ref>

===Modern practice=== [[File:Yogini Parvati.jpg|Jeannine Parvati Baker, yoga master|thumb]] In the 1980s, yoga master and midwife Jeannine Parvati Baker was the main advocate for the practice in the United States.<ref name=HUFFmaster>{{cite news|last1=Bindley|first1=Katherine|title=Lotus Birth: Does Not Cutting The Umbilical Cord Benefit Baby?|url=http://www.huffingtonpost.com/2013/04/12/lotus-birth-not-cutting-umbilical-cord_n_3072021.html|accessdate=22 March 2017|work=Huffington Post|date=12 April 2013}}</ref> The practice spread to Australia by a midwife, Shivam Rachana, founder of the International College of Spiritual Midwifery and author of the book ''Lotus Birth''.<ref name="SUNtele">{{cite news|last1=Hansen|first1=Jane|title=Risky new trend of lotus birth|work=The Sunday Telegraph|date=23 June 2013|ref=Pg 31}}</ref> In the full lotus birth clinical protocol, the umbilical cord, which is attached to the baby's navel and placenta, is not clamped or cut. The baby is immediately placed on the mother's belly/chest (depending on the length of the cord) or kept in close proximity to the mother in cases when medically necessary procedures such as resuscitation may be needed. In Lotus birth, the placenta is delivered vaginally, often with the maternal informed choice for passive management of third stage of labor, allowing for natural detachment of the placenta within appropriate time allowed for it, with no hormonal injections (such as oxytocin) or via cesarean section.<ref>[http://transform.childbirthconnection.org/resources/datacenter/factsandfigures/ stats]</ref>

Following birth, the placenta is simply put in a bowl or quickly wrapped in absorbent toweling and placed near the mother-baby. Caregivers step back to allow for undisturbed maternal-child bonding to occur as the primary event for an hour or more. It is only after this initial intense bonding period that the placenta is managed by rinsing, drying, applying preservatives, and positioning it in a way that allows for plentiful air circulation and proximity to the baby. The placenta, once ejected from the womb, has no circulation and quickly dies;<ref name=RCOG/> and within 3–10 days postpartum the umbilical cord dries and detaches from the baby's belly.<ref name=HUFFmaster/> The practice requires the mother and baby to be home bound as they wait for the placenta and umbilical cord to dry, decompose, and separate from the baby.<ref name="Woo Watch">{{Cite web|url=https://skepticalinquirer.org/exclusive/lotus_birth/|title=Lotus Birth|last1=Senapathy|first1=Kavin|date=2018-04-13|work=Skeptical Inquirer|url-status=dead|archive-url=https://web.archive.org/web/20190505221825/https://skepticalinquirer.org/exclusive/lotus_birth/|archive-date=2019-05-05}}</ref>

In 2015, the American Heart Association and the American Academy of Pediatrics updated neonatal resuscitation guidelines to recommend delaying umbilical cord clamping for 30 to 60 seconds in both term and preterm infants who do not require immediate intervention. For term newborns, delayed clamping has been associated with higher hemoglobin levels at birth and improved iron stores during early infancy, which may support development. In preterm infants, it may contribute to improved circulatory transition and increased red blood cell volume. However, a modest increase in the incidence of neonatal jaundice requiring phototherapy has been reported in term infants, and appropriate monitoring and management are therefore advised. However, these recommendations apply to short delays in cord clamping and do not extend to prolonged practices lasting several days.<ref>{{Cite journal |last=Monroe |first=Kimberly K. |last2=Rubin |first2=Alexandra |last3=Mychaliska |first3=Kerry P. |last4=Skoczylas |first4=Maria |last5=Burrows |first5=Heather L. |date= |year=2019 |title=Lotus Birth: A Case Series Report on Umbilical Nonseverance |url=https://journals.sagepub.com/doi/10.1177/0009922818806843 |journal=Clinical Pediatrics |language=en |volume=58 |issue=1 |pages=88–94 |doi=10.1177/0009922818806843 |issn=0009-9228}}</ref>

=== Risks === thumb|Location of fetus and placenta in the uterus Lotus births are an extremely rare practice in hospitals.<ref name="BURNS"/> The Royal College of Obstetricians and Gynaecologists (RCOG) has stated, "If left for a period of time after the birth, there is a risk of infection in the placenta which can consequently spread to the baby. The placenta is particularly prone to infection as it contains blood. At the post-delivery stage, it has no circulation and is essentially dead tissue," and the RCOG strongly recommends that any baby that undergoes lotus birthing be monitored closely for infection.<ref name=RCOG/> Other risks include jaundice caused by abnormally high bilirubin and polycythemia, which is an abnormally high percentage of red blood cells in circulation.<ref>{{Cite web|url=https://www.aol.com/article/lifestyle/2018/04/05/lotus-births-are-trendingand-theyre-probably-a-terrible-idea/23403770/|title=Lotus births are trending….and they're probably a terrible idea|accessdate=23 April 2018|work=Pure Wow}}</ref> Case descriptions about adverse medical conditions related to this praxis are emerging, indicating severity of potential complications.<ref>{{cite journal | last1 = Ittleman | first1 = Benjamin R. | display-authors = etal | year = 2019| title = Umbilical Cord Nonseverance and Adverse Neonatal Outcomes | url = https://journals.sagepub.com/doi/abs/10.1177/0009922818805243?journalCode=cpja | journal = Clinical Pediatrics | volume = 58| issue = 2| pages = 238–240| doi = 10.1177/0009922818805243 | pmid = 30280596 | s2cid = 52912265 | url-access = subscription }}</ref><ref>{{cite journal | last1 = Tricarico | first1 = Antonella | display-authors = etal | year = 2017 | title = Lotus birth associated with idiopathic neonatal hepatitis | url = https://www.pediatr-neonatol.com/article/S1875-9572(16)30075-4/fulltext | journal = Pediatrics & Neonatology | volume = 58 | issue = 3| pages = 281–282 | doi = 10.1016/j.pedneo.2015.11.010 | pmid = 27423760 | doi-access = free | hdl = 11380/1136826 | hdl-access = free }}</ref> The World Health Organization does not support Lotus Birth, instead recommending a delayed cord clamping.<ref>{{cite web |last1=Park |first1=Kidong |title=Dr |url=https://www.who.int/vietnam/news/commentaries/detail/mothers-dying-needlessly-due-to-lack-of-proper-health-support |website=www.who.int/ |publisher=The WHO}}</ref> {{clear}}

=== Deaths === In May 2020, the Coroners Court of Victoria concluded that a baby died 16 hours after birth from sepsis in the setting of a lotus birth, which took place in 2017 at the Royal Children's Hospital in Melbourne.<ref>{{cite web |last1=JAMIESON |first1=AUDREY |title=CORONER |url=https://www.coronerscourt.vic.gov.au/sites/default/files/2020-06/17.4078%20Baby%20S%20%28Final%20Redacted%29.pdf |website=Coroners Court Victoria |publisher=Coroners Court Victoria}}</ref> The investigation identified that the most significant and severe risk factors for sepsis were vaginal seeding and lotus birth.

==Spiritual== [[Image:Merlin Lotus Birth 2006.jpg|thumb|Postpartum water immersion shortly after home birth, with umbilical nonseverance]]

===Relation to nature===

In the animal world, the placenta is usually consumed by the mother. This is called placentophagy. Primates have been observed keeping the placenta attached to their newborns for a longer period. Primatologist Jane Goodall, who was the first person to conduct long-term studies of chimpanzees in the wild, reported that they did not chew or cut their offspring's cords, instead leaving the umbilicus intact, like many other primates.<ref>See ''In the Shadow of Man'' by Jane Goodall.</ref> Other researchers report that chimpanzees consume placentas after birth.<ref>{{cite journal| pmid=26769192 | doi=10.1007/s10329-016-0510-x | volume=57 | issue=2 | title=Placentophagy in wild chimpanzees (Pan troglodytes verus) at Bossou, Guinea | year=2016 | journal=Primates | pages=175–80 | last1 = Fujisawa | first1 = M | last2 = Hockings | first2 = KJ | last3 = Soumah | first3 = AG | last4 = Matsuzawa | first4 = T| s2cid=16636343 }}</ref> Though other mammals may sever their offspring's cords, they only do so after initial maternal sensory reception, unwinding of the cord, massage/cleaning (through touch), and initiation of nursing.<ref>Human Birth: An Evolutionary Perspective. Wenda Trevathan PhD, Univ of New Mexico Press, 2011. {{ISBN|1412815029}}</ref> This has been observed to last at least one hour, if left undisturbed.

===Energy=== Pseudo-scientific proponents of lotus births view the baby and the placenta as one on a cellular level, as they are from the same source, the egg and sperm conceptus. They also assert that the newborn and the placenta exist within the same quantum field, thus influencing various expressions of quantum mechanics that influence health.<ref>The New Physics of Healing lecture, Harvard Medical School, Deepak Chopra MD, Cambridge, MA {{ISBN|156455919X}} , Audio recording.</ref> They claim transfers of energy & cellular information continue to take place, moving gradually from the tissue of the placenta to the baby during the drying process. Scientists challenge this claim of a metaphysical dimension related to quantum mechanics.<ref name="Quantum Quackery">{{Cite web|url=https://www.csicop.org/si/show/quantum_quackery|last=Stenger|first=Victor|title=Quantum Quackery|accessdate=23 April 2018|work=Skeptical Inquirer|date=January 1997}}</ref>

==References== {{reflist|30em}}

==Further reading== *Buckley MD., Sarah. ''Gentle Birth, Gentle Mothering'', Australia, 2006 *Davies RN, Leap RN, McDonald. ''Examination of the Newborn & Neonatal Health: A Multidimensional Approach'', Elsevier Health Sciences, 2008. {{ISBN|0-443-10339-9}} *Lim CPM, Robin. ''After the Baby's Birth: A Complete Guide for Postpartum Women'', Ten Speed Press, U.S. 2001 *Parvati Baker, Jeannine. ''Prenatal Yoga & Natural Childbirth'', North Atlantic Books, U.S., 2001 *Rachana, Shivam. Lotus Birth: Leaving the umbilical cord intact, Good Creation Publications, Australia, 2011 *Trevathan, Wenda. Human Birth: An Evolutionary Perspective, Univ. of New Mexico Press, 2011 *World Health Organization (WHO). ''Care in normal birth: A practical guide, report of a technical working group'', Geneva, Switzerland, 1997

Category:Childbirth