INTRODUCTION:

Bond between mother and child start from the womb and cord is a precious connection between them. Soon after birth separation of cord has become a special matter. Lotus births (or umbilical cord nonseverance - UCNS) and physiological (delayed) cord clamping have grown in popularity among expectant parents. In both procedures, the umbilical cord is not severed right away after birth. Lotus births take the practice of delayed cord clamping a step further by letting the placenta attached until it falls off naturally, as opposed to waiting a few minutes to cut the cord. The lotus birth approach was initially adopted for home births, but it is currently becoming more popular for cesarean deliveries as well. Although it is uncertain how common lotus birth is, some regions of the United States, Australia, Turkey, and Italy strongly support the practice.

Although the first lotus birth was documented in Australia in 2014, about 100 women annually ask to use this "integral birthing method" or "lotus birthing."¹

MEANING OF TERMS:

Lotus birth is a practice of leaving umbilical cord uncut after childbirth and baby is left attached to placenta until the cord naturally separates at the umbilicus which usually occur within 3-10 days.²

Fig: 1 Lotus birth baby

Whereas, physiological cord clamping occurs after the baby is delivered but before the placenta is delivered. When using delayed cord clamping, wait before cutting the umbilical cord. We clamp and cut the umbilical cord after waiting for 30 to 60 seconds, and occasionally for up to five minutes.³

Fig: 2 Different in immediately and delayed cord clamping

Steps for Giving Birth as Follows:

Lotus Birth:

1. The placenta and baby are held together immediately after birth, without the umbilical cord being clamped or severed.

2. Any blood clots are removed by gently rinsing the placenta with water.

3. The excess fluid is then drained for a few hours in a bowl or sieve after it has been patted dry.

4. Once the placenta has been drained, it is placed in a breathable container, such a basket or cloth bag, and preserved with absorbent materials like sea salt, dried herbs, and occasionally essential oils.

5. The baby is always maintained near the container, and the umbilical cord is watched for indications of spontaneous separation.

6. Parents are encouraged to use clean hands when handling the placenta and make sure.

7. The cord typically dries and falls off naturally within three to ten days, marking the completion of the lotus birth process^.4

Delay Cord Clamping Vaginal Delivey:

1. After the baby is delivered, place them on the mother's abdomen and start the ENC right away. Dry them completely and check their breathing.

2. Give the mother a uterotonic medication as soon as possible, or within a minute after delivery. The suggested uterotonic medication is 10 IU of oxytocin administered intravenously.

3. For all births, wait one to three minutes after the birth before clamping the umbilical cord.

4. Continue with Essential Newborn Care during the one to three minutes that pass before the cord is clamped. Make sure the baby is kept warm and dry by placing skin-to-skin contact on the mother's chest and that they are breathing or screaming normally. Cover the infant's head and entire body with a blanket or dry towel.

5. Clamp the cord if it stops pulsing or after three minutes. Note: A skilled birth attendant may perform controlled cord traction before clamping the cord if they are to do so.

6. Examine the uterine tone after the placenta is delivered to detect uterine atony early. If atony is evident, massage the uterus.

Delay Cord Clamping Caesarean Delivery:

1. Place the infant on the sterile operating field, away from the surgical site, and start the ENC right away. Dry the infant completely and check their respiration.

2. Give the mother a utero tonic medication as soon as possible, or within a minute after delivery.

3. For all births, delay cord clamping should be done 1 to 3 minutes after delivery.

4. As you wait one to three minutes to clamp the cord, make sure you can see the surgical field well (use retractors to remove any blood or fluid) and locate the corners and margins of the uterine incision. If bleeding, use clamps or ring forceps to grasp the edges of the uterine incision.

5. Keep the baby warm and dry and make sure they are crying or breathing normally while doing ENC for one to three minutes before clamping the cord.

6. To deliver the placenta, use controlled cord traction. ⁵

Purpose:

Lotus Birth:

Lotus delivery is the technique of leaving the placenta attached until it separates on its own, rather than cutting the umbilical cord after the infant is born. It is thought to be a tender custom that soothes the infant.

Delay Cord Clamping:

It gives a burst of blood that is rich in oxygen, nutrients and raises the volume of blood in circulation overall.

Benefit:

Lotus Birth:

· A healthier and more organic choice for the baby

· Baby's gentle, less invasive journey from the womb to the outside world

· Babies that are calm, serene, and trouble-free

· Increases blood flow and provides the placenta with nourishment.

· reduces the risk of belly button injuries

· Permits the full return of blood to the infant from the placenta and umbilical cord.

· Serves as a spiritual rite to honour the placenta and baby's combined life.

· Increases the amount of iron that the baby's blood contains, which is important for the development of a healthy brain.

· Boost the immunological system of the baby

· Prevent the new-born’s anaemia and jaundice.⁸

Delay Cord Clamping:

Term Infants:

· Higher haemoglobin levels in the early neonatal phase in term newborns

· Greater transfer of essential stem cells

· Higher ferritin levels between 2-4 months of age

· Lower rates of anaemia at 4 months of age

· Higher iron stores between 2 and 4 months of age.⁶

Preterm Babies:

· Better red blood cell volume establishment

· reduced requirement for blood transfusions

· reduced risk of necrotizing enter colitis and intraventricular haemorrhage

· enhanced transitional circulation ⁷

Risk:

Lotus Birth:

Blood will no longer flow through the placenta after it and the umbilical cord exit the womb. The material will be dead tissue. The placenta becomes vulnerable to infection as a result. In this case, the infant will also become infected. The placenta can be stored or kept safe in a variety of ways. Additionally, no medical guidance is available on how to do this. Others choose to leave the placenta outside, while others choose to store it in a bag. Some even adorn it with herbs and aromatic scents. There has been no scientific investigation into any of these techniques. Additionally, if the cord is unintentionally torn from the baby's body, they run the danger of suffering harm. Cord avulsion is the term for this. It's thought to be a soothing, gentle routine for the infant.⁹

Delay Cord Clamping:

Delayed umbilical cord clamping has little effect on maternal outcomes, including the likelihood of postpartum hemorrhage or the requirement for blood transfusions. Furthermore, compared to rapid umbilical cord clamping, delayed clamping had no effect on postpartum mother hemoglobin levels. In the event that the infant is not breathing or if another issue need immediate medical intervention¹⁰. Although the rate of phototherapy did not rise, term neonates were linked to considerably higher mean transcutaneous bilirubin levels, more serum blood samples, and more clinical diagnoses of jaundice¹¹. Red blood cell counts that are increased in a baby are known as polycythemia. An excessive thickening of the blood can result in issues with breathing, circulation, and bilirubin levels. There is a chance that the baby's blood count will rise too high due to delayed cord clamping, but phototherapy can help control that.

The Bottom Line:

Delayed cord clamping has more established advantages than lotus birth. Although a lotus birth is thought to lessen the trauma of childbirth for both the mother and the infant, it also allows the baby to break its attachment to the placenta on its own. However, each method has advantages and disadvantages. There are many ethical questions raised in practice of lotus birthing method. Ask a midwife or medical professional for their advice and expertise with lotus births before deciding to have one. If choose to have a lotus birth, seek out a practitioner who has knowledge of this delivery technique.

REFERENCE:

1. Dursun, Z. C. (2019, September 17). The second lotus birth in Turkey. Retrieved from http:// www.haber7.com/genel-saglik/haber/1202217 turkiyede-lotusyontemiyle-ikinci-dogum

2. Kaur Sandeep, text book of Midwifery / obstetrics and Gynecology nursing, CBS publisher, pageno:32

3. Delayed Cord Clamping: How Long, Benefits & Risks. December 2021

4. https://www.nicebabyname.com/blog/pregnancy/your-body/understanding-lotus-birth-an-in-depth-look-at-its-significance-and-process.

5. World Health Organization. Delayed clamping of the umbilical cord to reduce infant anaemia. World Health Organization.

6. Bhatt S, Alison BJ, Wallace EM, et al. Delaying cord clamping until ventilation onset improves cardiovascular function at birth in preterm lambs. J Physiol. 2013; 591(8): 2113-2126.

7. Rabe H, Gyte GML, Díaz‐Rossello JL, Duley L. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes. Cochrane Database of Systematic Reviews. 2019; 9. Art. No.: CD003248. pub4. Accessed 09 April 2025.

8. Sonar m. Lotus birth. Journal of Applied Science And Research. 2023; 11(1): 1-4.

9. Taylor Norris Italian Journal of Pediatrics: “Medico-legal considerations on “Lotus Birth” in the Italian legislative framework. February 11, 2024.

10. Maria A. Mascola, et.al Delayed umbilical cord clamping after birth. ACOG Committee Opinion No. 814. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2020; 136: e100–6

11. Sophia MD et.al Association of a Delayed Cord-Clamping Protocol With Hyperbilirubinemia in Term Neonates Obstetrics & Gynecology. 2019; 133(4): 754-761.

Received on 09.04.2025 Revised on 05.06.2025

Accepted on 14.07.2025 Published on 16.08.2025

Available online from August 25, 2025

Int. J. Nursing Education and Research. 2025;13(3):201-203.

DOI: 10.52711/2454-2660.2025.00041

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