Michelle Santhi – Midwife
Many healthcare practitioners and parents alike wonder what the effects of not cutting the baby’s umbilical cord would be. This is known as a lotus birth. One mostly asked question is, will the baby get an infection?
The answer to this can be varied among literature. The Royal College of Obstetricians and Gynaecologists state they believe that the biggest risk of a lotus birth (where the cord is not severed from the placenta) is infection. This opinion is solely based on he views of obstetricians and not from evidence based literature.
However my take on this would be that bacteria would still be able to get through the gaps of a clamp that’s placed on the umbilical cord. Bacteria can also enter the surrounding open wound where the umbilicus attaches [then detaches] and create a systemic infection from the umbilicus so I can’t see how not clamping would increase this risk.
By nature we are mammals and there are plenty of mammal animals among us who naturally leave the placenta attached (chimpanzees) or allow it to snap (horses) or bite through it…(cats). So what do humans do?
Well in the UK were leaning towards optimal cord clamping (because evidence says this is best for each individual baby’s health) however some mothers choose to lotus birth.
In other countries immediate cord clamping is still routinely used, as is cord burning once the cord turns white, cord severing, cord tying, and lotus birth too. It seems that umbilical infections in the cultures that practice cord cutting relate to the type of blade or instrument that was used to sever the cord and what bacteria is present on the blade or instrument.
So is there a risk of not cutting the cord?
In 2018 there was a case where the baby had an infection that traveled to his heart. This infection was called staphylococcus lugdunensis and it is a skin infection that colonised the baby’s skin and then migrated to the baby’s heart. American paediatricians and obstetricians refer to the cause as the placenta, but in reality this is a correlation not a causation.
Staphylococcus lugdunensis can be found in amniotic fluid “Case reports of early neonatal sepsis also suggest that the infection process is likely to be triggered in utero “ (Marchocki et al, 2013) so just like many other organisms present on human skin it is a risk for all humans who carry staphylococcus lugdunensis. It is likely the mother was a carrier and the baby was infected in utero (it’s also a less common cause of post-partum sepsis in mothers)
A very small case study was conducted again in 2018 on lotus births and infections which concluded no infections were present in any case they studied. You can read this study here… https://www.google.co.uk/amp/s/www.researchgate.net/publication/328391275_Lotus_Birth_A_Case_Series_Report_on_Umbilical_Nonseverance/amp
It is now known that the placenta is a sterile organ and thus only infectious bacteria that comes into contact with the placenta once the amniotic sac has broken could cause an infection.
The answer to this is for midwives and obstetricians to make sure women are screened for infections properly, the sepsis pathway is followed correctly, and women and babies are treated according to most current evidence in a timely manner.
Monroe, Kimberly & Rubin, Alexandra & Mychaliska, Kerry & Skoczylas, Maria & Burrows, Heather. (2018). Lotus Birth: A Case Series Report on Umbilical Nonseverance. Clinical Pediatrics. 58. 000992281880684. 10.1177/0009922818806843.