I was surprised to find that we haven’t covered Lotus birth on SBM, at least not that I could find. We do cover a lot of nonsense here, some of it very dangerous and with very little if any potential benefit. That’s a pile onto which I would throw the practice of Lotus birth, known as umbilical cord nonseverance in medical parlance.

What and why is Lotus birth?

Lotus birth occurs when, despite a complete lack of plausible benefit and the warnings of pediatric and obstetrical experts, the decision to leave the placenta attached to a newborn infant by an intact umbilical cord is made. This decision is made because of the influence of medical misinformation and the desire for a special birth experience. Information available online often plays up the benefits while downplaying the risks.

Genevieve “Mama Natural” Howland describes the relationship between a fetus and their umbilical cord in almost magical terms, even referring to it as a “teddy bear” to be nuzzled up to. She claims to be providing objective information so that curious mother’s can make an informed choice, yet refers to Lotus birth as a “quiet and respectful transfer of attachment, without the trauma of being cut from the mother.”

There are no nerve endings in the cord. Cutting it is painless and absolutely not traumatic. It is magical thinking that leads to such a false statement.

Howland’s article further confuses her readers by claiming that Lotus birth has been practiced for hundreds of years:

And records of not cutting the umbilical cord appear on the American continent as early as the pioneer days. In Western nations, lotus birth seems to be a new birth trend steeped in early tradition.

The link she provides, however, is about delaying the clamping of the umbilical cord but not Lotus birth, which involves allowing the cord to naturally separate. This can take anywhere from a few days to a couple of weeks. During this time, the placenta, now lacking a blood supply to deliver oxygen and remove metabolic waste, begins to rot. In reality, Lotus birth is a lot like placentophagy in that it has only entered the scene in the past few decades. It is essentially just New Age nonsense.

According to Howland, there is a sacred relationship between baby, cord, and placenta. But, she adds, there may be other benefits such as the transfer of extra blood to the baby. This is potentially true, although the placenta would need be carefully positioned so as to not allow gravity to drain blood from the baby. In conventional obstetrical care, as long as the baby does not require urgent resuscitation, we typically delay the clamping of the cord for a minute or two for just this purpose. The benefit in most babies is a reduction in the risk of iron deficiency, which can result in poor brain development.

The remainder of the proposed benefits mentioned by Howland are nonsense, particularly that it is better for maternal healing or the baby’s emotional well-being. Especially ridiculous are claims that it reduces risk of infection in the baby. You’ll soon see why that is wrong and quite dangerous.

Why is Lotus birth dangerous?

As I mentioned above, Lotus birth involves leaving a baby attached to the placenta via a tube containing blood vessels that allow blood to travel back and forth. This connection also allows the passage of pathogenic bacteria as said placenta begins to rot. It really is just that simple.

To illustrate the risk, a recent case series published in Clinical Pediatrics provided details on three Lotus births. In the second of three cases, the association of Lotus birth with severe jaundice was tenuous in my opinion. This is a common medical problem in newborns, particularly when breastfeeding is not going well. This case does illustrate how irrational medical decisions tend to cluster. In this case, the mother also refused the solidly evidence-based recommendation for intrapartum antibiotic prophylaxis in the setting of a positive screen for group B strep. But that’s a topic for another day.

The baby in the first case was born at home and underwater after limited prenatal care (more clustering), and brought in for medical attention because of labored breathing. The baby was found to be dangerously hypoglycemic and to have an abnormally elevated percentage of red blood cells, both of which can result in injury to the brain. The baby ultimately was found to have a bloodstream infection and bacterial grown on one of the heart valves, an extremely dangerous diagnosis, and required inpatient care for several weeks.

In the third case, a baby who was still attached to the placenta developed an infection of the umbilical stump and surrounding abdominal wall in the first two days of life. Known as omphalitis, this infection is dangerous because it can easily spread to the umbilical vessels and cause a systemic infection. Because of this, the mortality rate can be as high as 15%. Luckily the baby had a good outcome.

Conclusion: Cut the cord!

There is no reasonable expectation of benefit from delaying clamping and cutting of the umbilical cord after delivery for more than a couple of minutes. There is, however, plenty of plausible risk, particularly that of serious bacterial infection. Lotus birth is a dangerous practice and anyone promoting it is putting the lives of newborn babies at risk. Cut the cord.


Posted by Clay Jones

Clay Jones, M.D. is a pediatrician and a regular contributor to the Science-Based Medicine blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @SBMPediatrics and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey. The comments expressed by Dr. Jones are his own and do not represent the views or opinions of Newton-Wellesley Hospital or its administration.