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alternative medicine, complementary and alternative medicine, pregnancy, woo

A lotus birth is leaving a newborn attached to a decomposing placenta

Perhaps you have heard of the latest “natural” birthing trend called a “lotus birth”? This practice involves leaving the newborn attached to the placenta until the umbilical cord separates “naturally” or, to be blunt about it, rots off.

Let’s get two sets of basic facts established before we continue:

  1. The placenta receives its oxygenated blood from the maternal side. The uterus keeps the placenta alive. The umbilical vein in the umbilical cord carries oxygenated blood from the placenta to the fetus and the umbilical cord arteries return deoxygenated blood from the fetus to the placenta.
  2. When organs lose their blood supply they die and decomposition sets in within minutes. Dead flesh is a good place for bacteria to grow.

There have already been reports of tragic but predictable outcomes. Several colleagues have told me about serious infections in newborns and there has been a reported case of hepatitis. Someone told me their friend kept the placenta attached in its own diaper (as one does), but had to discard the placenta after a day or two because the cat fancied more than a nibble. Excellent, feline oral bacteria in a culture medium attached to a newborn baby. What could possibly go wrong?

How did this madness start?

I admit I became rather obsessed with the origin story of “lotus births.” The ancient Greeks had nothing to say on the subject of dry aging the placenta. It seems the afterbirth has always been an afterbirth. This does not surprise me as we humans figured out pretty quickly that it was better to bury or cremate our dead and not to shit where we eat. For thousands of years people have also known that raw meat was a source of illness.

The first mention of a “lotus birth” in the medical literature was in 2001 in a journal titled Midwifery Today International Midwife (Issue 58, Summer 2001), which is basically a collection of essays about particularly magical births and opinion pieces. The article which I could not locate through the journal’s website is available online here. I use the term article loosely because at times it reads like an incantation in a book of spells. The article includes this vignette:

My now grown daughter Dj is in a panic. “I’ve lost my purse! Mother help me. I’ll die without my purse!” Dj’s purse is oval shaped, weighing about 1 1/2 lbs., is brown-red in color and has a long strap. Misplacing it causes her to panic, her breathing becomes labored. She cries for mother. Moments after Dj cried, “I’ll die without my purse!” Our eyes met in a moment of “a-ha”. She laughed out loud and said, “This is all your fault mother, you never should have let my cord be cut.” We hugged and one of Dj’s brothers unearthed the essential purse, the surrogate placenta. 

Never has a paragraph rendered me so entirely and utterly speechless.

But wait, there’s more. The author writes about a five-day old placenta still attached to a newborn and swaddled in a diaper (apparently treated with herbs, I’m guessing for the odor but that is glossed over) that apparently “pulsed.” The father, a Ph.D., proclaimed, “ I am not fooled by the dry appearance of the cord, deep in the center there is life. Something essential is being provided to my baby by his placenta.”

The author herself ponders on the many babies that she has delivered who have cried out or flinched the very moment their cords were cut. I would like to pause and insert the biological fact that the umbilical cord has no nociceptors and as such is unable to transmit sensations of pain. In addition, no fetal stress response has been identified with puncturing the umbilical cord during in utero procedures. Apparently anatomy and physiology are trivial matters to be discarded when they don’t fit the narrative.

But chimpanzees do it!

The actual origin of the “lotus birth” seems to belong to someone named Claire Lotus Day who in 1974 heard that chimpanzees did not sever the umbilical cord after birth so yeah, humans should totally do it! That is the extent of it. Really.

Obviously it must have escaped Ms. Lotus Day’s attention that chimpanzees have many differences from humans, such as significant anatomical differences, they do fine with unassisted births (unlike humans), have a different diet, and of course they throw feces.

Sigh.

So here we are with grown adults thinking a dead placenta magically nourishes a newborn because a woman heard chimpanzees leave their cords alone. Then some midwives and an Australian doctor named Sarah Buckley decided to brand it as a modern ritual. And then a “journal” legitimized it. And legitimized it some more.

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And now you can buy hand crafted lotus birth placenta bags on Etsy. No really, you can. 

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The facts

The placenta is an organ and without blood flow organs die. A newborn does not supply blood to a placenta.

It is generally a good thing to delay cutting the cord by up to 60 seconds. This increases the hemoglobin and iron stores for term babies and has some significant benefits for preterm infants.

Once separated from the mother the placenta starts to decompose and becomes a breeding ground for bacteria. This is not a metaphor.

The umbilical cord is physiologically incapable of transmitting pain signals so no one is hurting anyone when the cord is cut, however, my brain is on fire knowing anyone in charge of delivering babies could believe cutting the umbilical cord causes pain or distress and that an editor printed it.

Real serious consequences for newborns have been described. Who knows if parents decide to do this in a hospital if the placenta could be a bacterial vector and contaminate other babies, siblings, or immunocompromised patients?

If you lose things it is not because you were detached from a dead piece of tissue it means your house is disorganized or you are stressed or you just forgot or instead of teaching you organizational skills your mother always blamed your silly old placenta. 

It amazes me that people will disbelieve the risk of leaving a dead placenta attached to their baby but would never drive their newborn without a car seat.

The placenta cannot nourish anything after it is separated from the uterine wall.

If a placenta has cultural significance for you then bury it with the appropriate ceremony.

A “lotus birth” is biologically unsound, untested, and real harm to babies has been described. It is the equivalent of diapering up a raw steak and attaching to your newborn for three to five days. It is not a magical, historical or cultural practice forcibly torn away from women by an uncaring patriarchy it was something a woman dreamed up after hearing about chimpanzees. To brand this as a modern ritual is nothing but predatory marketing. 

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Discussion

48 thoughts on “A lotus birth is leaving a newborn attached to a decomposing placenta

  1. Let’s not badmouth the cat in the story – it actually had more common sense, than the parents of the newborn. Cats always eat all of the placenta right after the kittens are born. So, basically, cat was the better mother 🙂

    Posted by neverwintersand | August 29, 2017, 10:39 pm
    • I agree, the cat was in the right, though a mother cat will sometimes eat stillborn or sickly kittens, I am not entirely sure that a mother frying up a stillborn or sickly baby would be considered socially acceptable.
      Placentas though would probably make good cat food. Maybe there is a business opportunity there for someone.

      Posted by peterjf2014 | August 30, 2017, 2:35 am
  2. As a former L&D RN and Chilbirth Educator, this concept strikes me as both mind blowingly stupid and nauseating. I would think that there would be a real risk to the newborn of developing infections, from mild to full-blown sepsis. I also used to work at a hospital that sold the placentas to a cosmetics company. They were all kept in a huge biohazard garbage can, and picked up twice a month. Even keeping the container in a cooler didn’t prevent the overwhelming odor. Lotus births are just a useless, disgusting, scary practice.

    Posted by Patricia Smith | August 29, 2017, 11:42 pm
  3. Not only is this stupid, it’s also really, really gross. Oh well, gene pool maybe cleaning itself, I guess…

    Posted by Michaela Istok | August 30, 2017, 2:27 am
  4. Here’s the cover of Issue 58, it does not look very scientific…. https://web.archive.org/web/20010619234752/http://www.midwiferytoday.com:80/magazine/ They only had a selection of their articles online, here’s one list from 2016 that included a publication from 2000, and there is no Lotus listed https://web.archive.org/web/20161128042142/https://www.midwiferytoday.com/articles/index.asp

    Posted by Debora Weber-Wulff | August 30, 2017, 2:33 am
  5. Once again, Dr. Gunter, I am SO GLAD that you blog!!!

    Posted by Laura G. | August 30, 2017, 4:09 am
  6. My first question is how are these women even getting to keep the placentas? Hospitals will not allow patients to retain these specimens (yes, specimens) because they are biohazards. Are these out of hospital births? Even better.

    This entire idea makes me cringe. Fresh placentas have an odor. I can’t imagine what they smell like after a few hours, much less a few days.

    Stupidity has no bounds apparently.

    Posted by mdfinfer | August 30, 2017, 4:39 am
  7. Dr. Gunter, I ran across your blog while Googling stories of how certain MD’s were discrediting GOOP. You are so informative, and a breath of fresh common sense and science in this world!

    Posted by Nichole Frische-Delaney | August 30, 2017, 4:56 am
  8. AFAIK / from my research- you can’t even call in primates for a backup on this one – I believe placentophagy is derigeur amoungst our cousins (though primate parturitions are rarely observed, those that are feature fairly rapid chewing down!

    I am not sure where the idea that chimpanzees somehow leave the afterbirth attached!

    Posted by Ben Maclean | August 30, 2017, 5:44 am
  9. So one day someone does this and the placenta takes on a horrid life of its own, sucks the life out of the baby and takes off, growing into a monstrous entity that looks human but… Y’know, that’d explain some people I’ve met, or heard of…

    Posted by Angiportus | August 30, 2017, 6:35 am
  10. In the 1980s I had to fight and then travel far to find a doctor who would agree to let me give birth in the position of my choice instead of on my back strapped down in stirrups, who would not insist I be separated from newborn for 24 hours after the birth, who supported my decision to nurse instead of using a bottle, and who would not do a routine episiotomy to ensure my husband would have a nice tight vagina for his pleasure and my uterus would not fall out when I turned forty. So there is valid criticism of the medicalization of birthing in hospitals. I have long been a strong advocate of midwifery because of my own nasty experiences with medicalized birthing. I therefore tend to bristle when doctors poke fun at midwives. However, this lotus born stuff is clearly just as unjustifiable and as potentially harmful as routine episiotomies for everyone. Poke away. They deserve it.

    Posted by tumbleweedstumbling | August 30, 2017, 6:39 am
    • Agreed

      Posted by 5flatKat | August 31, 2017, 12:28 pm
    • The experience you had was unfortunate, and used to be routine practice. That was a long time ago. Modern best practices include no episiotomy unless absolutely necessary, immediate placement of the baby on the mother’s abdomen for several hours of skin to skin bonding (or on the father), breastfeeding initiation during this time, and delayed bathing.
      Vital signs, vitamin K administration, and antibiotic eye ointment are all done at the bedside.
      Mother’s can choose whatever birthing position they want, and are encouraged to do so. Completion of the delivery in a water bath is not recommended. Times have changed.

      Posted by Yvonne Treece, MD, FACOG | April 17, 2018, 5:05 pm
      • I wish I could accept that but watching my grandchildren being born makes me think there is still a whole lot left to be done in demedicalizing birthing. Routine round the clock fetal monitoring that restricts a woman from moving around in labor, near routine “augmentation” and/or “induction” with pitocin in an IV, near universal epidural, any one of which comes with its own set of risks and potential complications. Okay maybe the routine episiotomy is gone and that’s a huge improvement but we are still a long way from birthing the way the mother wants unless she argues and demands. I had a nurse threaten to have security remove me just for asking if an induction was really necessary with one of my grandsons and that was just seven years ago. Don’t be too quick to pat yourself on the back.

        Posted by tumbleweedstumbling | April 24, 2018, 6:04 am
      • I never said birthing needed to be “demedicalized.” It needs to be comfortable for the mother and baby, and as safe as possible. If someone wants intermittent fetal monitoring, or a remote monitor so she can walk, that’s not discouraged. If a woman asks for an epidural, no one is going to try to discourage it. That is extremely low risk intervention.
        I don’t know what your religion is, but delivering babies like “Mother” would want is not a part of my philosophy. I seriously doubt you were threatened with security because you asked a question. I wonder what else you were complaining about. If a family member is constantly being negative and making my patient uncomfortable they will be leaving. Sounds like maybe you were making the birth of your grandchild unpleasant, and upsetting the mother (not the one in the sky, the one in labor). Maybe not everyone shares your philosophy, including your daughter/daughter in-law. We’ve all had to deal with the hypercritical family member who just will not stop trying to make the birth about her instead of the laboring woman. It makes everyone miserable. Perhaps some internal reflection about placing your values onto others, and having the grace to be supportive, even if you don’t agree with every choice a mom to be makes in labor.
        Having IV access isn’t that awful compared to trying to get IV access in the middle of an emergency. Quite frankly, patients are often leading the charge to be induced. I’ve turned down far more requests for induction than told patients they have to be induced. And if I recommend it, then yes, the induction is necessary.
        How unnecessarily rude to to comment I shouldn’t “pat myself on the back yet.” It DOES make me feel good when a labor and delivery go well, and the family has a good experience. Why can’t everyone in the room pat themselves on the back for a job well done? We all work hard.
        I can totally see why a family member with a crappy attitude got asked to leave. Small hint…we usually follow the guidance of the laboring mother when clearing the room. Security isn’t necessary most of the time. When it is, there’s usually a very disruptive person in the room that needs to go. Was that you?
        Maybe you should step back and let the mother of your grandchildren direct her own birth.

        Posted by Yvonne Treece, MD, FACOG | April 24, 2018, 9:44 am
      • My son, my DIL and I were in the intake area and the nurse came in and announced my daughter-in-law would be being induced because her waters had broken and it had been 12 hours. I said “Oh no! Can we talk to the doctor about this?” That was all I said. Nothing else, not one word beyond that, no foul language, no name calling, nothing, just that. The nurse replied, “This is not your decision. You have no say in it. If I hear one more peep out of you I will call security and have you escorted out of here.” Of course it is always easier to blame the patient and family rather than accept any responsibility for bad behaviour from your staff. It’s also very easy for a doctor to decide the family is the nutty one given they aren’t around for 98% of what is happening.

        Posted by tumbleweedstumbling | April 25, 2018, 12:19 pm
      • I also don’t know what kind of stereotype you are invoking by bringing up ‘my religion”. As a matter of fact I am a Conservative Jew, my daughter-in-law is a Philipino Catholic and my son is a non practising agnostic. They asked me to be with them in delivery room because she has no family here and she wanted support and we have a good relationship and I am PhD Clinical Human Geneticist and that wanted me around because I can understand medicalese and personally worked with many of the doctors. I also said “You shouldn’t be patting yourself on the back” speaking in the general context of the medical profession of which you are one and of which you were speaking as a representative. Given the context that should have been obvious. You chose to take it personally instead and then make all sorts of unwarranted assumptions about my religion, and my behaviour. I can only assume you are one of the many arrogant MDs who think they are next to God and who assumes you know the best of everything and everyone.

        Posted by tumbleweedstumbling | April 25, 2018, 12:40 pm
      • And you can lecture me on how low risk an induction is after you have proven you have published more peer reviewed articles on the topic of complications of pregnancy than I have.

        Posted by tumbleweedstumbling | April 25, 2018, 12:55 pm
      • TUMBLEWEEDSTUMBLING , you said and I quote” I said “Oh no! Can we talk to the doctor about this?” That was all I said. Nothing else, not one word beyond that, no foul language, no name calling, nothing, just that. The nurse replied, “This is not your decision. You have no say in it. If I hear one more peep out of you I will call security and have you escorted out of here.”

        Your daughter in law is in labor and you say ” can we talk about this” and then you wonder why the nurse came down on you? Can you not hear how self absorbed you sound? How you tried to make your daughter in laws labor all about you and your feelings? ANd while you say that is all you said, I get the strong feeling this wasn’t the only thing you were doing to aggravate your daughter in law and the staff. Oh and I have a PhD in cognitive psychology and an MD in Rheumatology after my name because it isn’t like people put up bullshit credentials on the internet to give their opinion more weight.

        Posted by korlafuth | June 9, 2018, 10:00 pm
  11. Obviously you’ve never heard of Placenta Helper!

    (An old SNL bit)

    Posted by The Professional Scold | August 30, 2017, 6:48 am
  12. I’m speechless.. wouldn’t surprise me if this showed up in Waldorf community 😳

    Sent from my iPhone

    >

    Posted by Ivana | August 30, 2017, 8:05 am
  13. Once again, a great article! Another new age myth debunked. Thank you.

    Posted by Christy | August 30, 2017, 9:21 am
  14. I never heard of this – but I’m with comment number 1 – the cat shows better sense than the mother. On the other hand, Darwinism, ya know.

    Posted by jennifermacaire | August 30, 2017, 10:13 am
  15. As a graduate student in Anthropology I was curious about the assertion that chimpanzees leave the placenta attached to their newborns. So like any good student, I did a little research. What I learned is that even in long term field studies (some as long as 35 years) observations of great ape births in the wild are exceedingly rare. In fact, as of 2016 only three chimpanzee births and one bonobo birth have ever been directly observed by researchers. In each of these cases the placenta was eaten by the mother within two hours of giving birth.

    Granted, I didn’t do an exhaustive literature review, but what I did read seems to suggest that placentophagia (eating the placenta) is common among populations of wild chimpanzees, mountain gorillas and in captive bonobos. With that said, in one 1967 case, where the birth itself, was not directly observed, Jane Goodall did report that the placenta was left attached to the umbilical cord for less than 36 hours, when it as discarded by the mother chimp. To be honest, this is the only case I could find of a wild chimpanzee leaving the placenta attached. I couldn’t find anything on captive chimpanzee behavior, apparently even in captivity the ladies like their privacy. So there you go, dumb human behavior based on faulty assumptions.

    Posted by LBrown | August 30, 2017, 2:01 pm
    • I looked as well and found very few witnessed births, but wondered if I had the right source as it’s not my area of expertise. So a lie built on a lie.

      Posted by Dr. Jen Gunter | August 30, 2017, 4:43 pm
      • Exactly, “a lie built on a lie,” that’s a great way to put it. Maybe these folks are privy to some research of which I am unaware, but chimpanzees also commit infanticide and I don’t see anyone advocating for that. It’s bad enough that these dippy new-agers appropriate and then misrepresent the practices and traditions of other cultures, but promoting something so clearly dangerous as this is downright irresponsible. Thanks for being an advocate for the truth!

        Posted by LBrown | August 31, 2017, 2:47 pm
  16. Congratulations on taking on this insanity

    Posted by Susan | August 30, 2017, 6:43 pm
  17. Cows tend to eat the placenta. Not that a cow eating a placenta is a good reason for a human to do so. Ick. Goop probably has a smoothie recipe for a placenta. What is wrong with these people?

    Posted by Carole Nowicke | August 30, 2017, 7:07 pm
  18. Oh dear, I remember reading about this when I was pregnant in 2005 and 2007. I’d hoped it had petered out by now.

    Posted by Rebecca | August 30, 2017, 9:34 pm
  19. While I personally think the lotus birth idea is kinda gross & silly, in Buddhist & Hindu cultures it does feature in the birth stories of Buddha & Vishnu so there IS historical precedence far beyond some wacko in the 70’s… I love this blog & Dr Gunter’s frankness but sometimes find it a tad on the judgy side towards anything slightly different from the standard North American science… As long as it’s reasonably safe (which lotus births aren’t) & has a moderate chance at efficacy (which is also all most big pharma drugs/standard treatments can offer) I think there’s nothing wrong with the somewhat woo-woo & feel a bit alienated by posts like this one… Hospital births for low risk mothers/babies are a huge gamble in themselves – hospitals are huge vectors for incidental disease – & almost everyone who goes into a hospital for a normal healthy birth ends up “requiring” some kind of intervention – that tells me something… like maybe a little bit of woowoo & taking personal responsibility for one’s own health instead of always depending on the “experts” might not be such a bad idea now & then…?

    Posted by 5flatKat | August 31, 2017, 12:26 pm
    • Not to be a jerk, but I think you’re confusing myth with history. For example, Athena springing fully formed from her father Zeus’ head does not provide historical precedent for skull births, if you see what I mean.

      Posted by equivalenceprinciple | September 1, 2017, 9:14 am
      • Agreed, & just to be clear – I am in no way advocating for that unhygienic practice… To be honest, I’m not a Buddhist or a Hindu so probably have no right to mention it but just thought I’d point out there is a historical reference within certain cultures.

        Posted by 5flatKat | September 1, 2017, 3:14 pm
    • Three hospital births, three healthy children, and zero subsequent intervention. And that was 30 years ago when we were still being ‘medicalized’. And if I hear the term Big Pharma one more time…..

      Posted by thisoldchick | September 1, 2017, 10:15 am
      • Wow really?! No episiotomy, no epidural, no forceps, no separation or infant circumcision?? That is a great accomplishment for hospital births – congratulations… You must have been thrilled… But maybe recognize that your story is the exception not the rule in that setting – at least on this continent. And please – if you’ve got a better term for the corporate bloodsuckers who prey on the sick & vulnerable, often charging profit margins way over 100% above what it cost them to develop & produce, let me know – – I don’t like the term either, sounds cliché & fringe, but I just don’t have a better short name for them yet… Ideas?

        Posted by 5flatKat | September 1, 2017, 3:08 pm
      • 5FLATKAT, please remember that the Obstetricians, Anesthesiologists, RNs and other medical staff who work very hard, delivering babies in the hospital, have one goal… to send home a healthy and happy Mom and baby. I know many feel there are too many opportunities for medical intervention, but those interventions absolutely save lives. As far as circumcisions go, the parents always have the choice to refuse that procedure, which I did, when my son was born 26 years ago. I think midwife deliveries at home, or in a birthing center are wonderful, but not every pregnancy is a safe candidate for a non-hospital birth.

        Posted by Patricia Smith | September 3, 2017, 1:57 am
      • I absolutely agree with you, I only mentioned that for low risk normal healthy pregnancies, an out of hospital setting could be less invasive … I come from a long line of health care professionals, always striving only for the best patient outcomes… It was not my intention to doctor-bash, I’m very grateful for the medical system where & when it’s needed, just think maybe it’s not needed as much as it’s used for low risk normal healthy births, & get a bit protective of midwives being derided as they champion women’s health… Coming back to the point – Dr Gunter’s blog is awesome, (just makes me feel like an outsider sometimes, even when I agree with her), but she’s an amazing person & I’m very glad the world has her; and placentas are raw meat & therefore unsafe to keep attached to babies… Seems like a no brainer imo

        Posted by 5flatKat | September 3, 2017, 4:09 am
    • The OB/Gyn community in hospitals does not just start throwing drugs and interventions at patients. We care about patients and their babies. It pleases us greatly when a woman comes in and has a normal, low intervention delivery. We work do far along with nurses, anesthesia, and yes, midwives and doulas to make a birth a wonderful experience. I’m saddened when people like you denigrate all our efforts, training, and care. Over the years I’ve laughed, cried (in joy and pain), and saved many lives.
      The hospital is a safer place to give birth than a home. The neonatal mortality rate shows a slight but significant increase in fetal and neonatal death for home births.

      Posted by Yvonne Treece, MD, FACOG | April 17, 2018, 5:15 pm
  20. Thank you for another awesome post. When my highly educated friends tell me about how they’re planning to do this type of crap for their births, I just sigh internally. Now I can casually send them a link to your blog and say, “Check out this cool post about vaginal discharge” and hope they explore further. It’s awesome that you’re putting this out there.

    Posted by E* | August 31, 2017, 3:52 pm
  21. So glad I found this site. A refreshing (and factual) antidote to Goopers et al. Keep ’em coming Dr. Gunter. And BTW, what is ‘functionalized’ medicine?

    Posted by thisoldchick | September 1, 2017, 10:17 am
  22. I’m so disgusted by this ridiculous, dangerous, and completely nonsensical concept. I’m neither a doctor nor a scientist, but empirical evidence is unequivocal on this. Ugh.

    Posted by The Shameful Narcissist | September 1, 2017, 1:57 pm
  23. so bizarre right? what patients decide and WHY is beyond me (like the fact that they’ve “heard that ‘they’ say that c-sections are bad’ and will fight against them, and YET at 3 am they seem to call their doc to verify that TYLENOLl is safe in pregnancy (even though, might i point out, that “they” say it IS safe???)….

    i’ve actually pointed to lotus births to my patients when they ask about placental encapsulation–citing the fact that “eating one’s placenta” is NOT something human’s have ever done–though “keeping our placentas attached” is something that PERCHANCE was done in cavemen times before we knew to cut the cord….

    NOW I SAY IT NOT to ENCOURAGE it–but merely to POINT OUT that at LEAST it MAY have some historical reference (and my patient population is often grossed out, by this rightly so!) but that EATING the placenta has NONE….

    Posted by sghofrany | September 3, 2017, 12:12 pm
  24. I am a practicing, board certified OB/Gyn in the US. I could not agree more that leaving the placenta attached presents a very real danger of bacterial infection. Many of the benefits described by Lotus Birth proponents can be achieved via methods other than leaving the rotting, bacteria-laden placenta attached.

    Many, many placentas and umbilical cords are already infected at the time of birth as evidenced by pathology reports showing objective signs of infection, and when cultured, dangerous bacteria are found. This is of particular concern if the patient is delivered in a non-medical settings where signs of infection in the mother or baby may not be properly monitored, prolonged ruptured membranes, and completing birth in a water tub. I have seen tragic neonatal deaths from infection. One of the saddest cases was a mother who sat in a tub at home with her water broken for 48 hours. She was eventually brought to the hospital and delivered by cesarean. She had severe chorioamnoinitis (infection of the uterus and placenta, and in this case, the baby). Mom almost died. The baby died despite aggressive treatment. Group B streptococcus (GBS) was the culprit. Her prenatal and initial birth care were given by a lay midwife. She never received any standard lab tests including GBS testing. The mother was crushed with guilt despite every staff effort to assure her she was not at fault. Her caregiver was.

    Benefits of Lotus Birth can be achieved with delayed cord clamping, placing the infant on the mother’s abdomen immediately (even during cesarean, and staff and family protecting bonding time. Delayed bathing is beneficial as well. Skin to skin contact with initiation of breastfeeding, with assistance as needed, is rapidly becoming the standard of care even in large hospitals such as mine. Advice for the mother to “rest” for 2-6 weeks is misguided and can lead to deep vein thrombosis. Moving around is essential.

    Once the cord has stopped pulsating, the placenta should be safely discarded or ceremoniously handled in a safe manner.

    Posted by Yvonne Treece, MD, FACOG | April 17, 2018, 4:52 pm
    • Yvonne Treece, MD, FACOG… Excellent comments. There have always been “natural birthing” proponents eager to denigrate hospital-based childbirth. As a RN and Childbirth Educator, I remember learning about Bradley’s method of preparation and childbirth, as well as others, and was insulted and horrified at the way they portrayed hospital births. My least favorite point from those proponents is that childbirth is natural and doesn’t require hospitals, doctors and medical care. Childbirth IS natural, as is death. Obviously, the point of medical care is to prevent death where possible, and to start baby’s life and continue Mom’s as healthy and happy as possible.

      So many preach about “low risk, normal, healthy pregnancy” not requiring medical care or a hospital. The problem with that scenario is that those low risk, healthy pregnancies can become complicated and life threatening in an instant. There is no way to accurately pick the “easy deliveries” before a mom has given birth.

      I love nurse midwives (CNM), and was lucky enough that my first position in L&D was in a hospital with both experienced MDs and midwives. It was a wonderful learning experience and incredibly fascinating. Unfortunately, for women who want to deliver at home, most CNM’s liability insurance and their own healthy fear of complications won’t allow them to perform home deliveries. This leaves those women with lay midwives performing their prenatal and childbirth care. I’m sure many lay midwives are attentive, experienced and as knowledgeable as they can be without having attended a formal nurse-midwife master’s program, their “education” still leaves frightening and possibly life-threatening gaps in their practice.

      Posted by Patricia Smith | April 18, 2018, 4:40 am
      • Thank you for your perspective as well. It’s amazing how quickly a low risk birth can become a major hemorrhage, shoulder dystocia, terminal bradycardia requiring immediate cesarean birth to prevent death or disability, amniotic fluid embolus, placental abruption, eclampsia…the list goes on. You know if you’ve spent any time on the labor ad delivery unit. I’ve seen and managed all of those. I’ve seen CNM’s recognize and initiate treatment while calling for help. I call for help. That’s protocol. We still struggle with unacceptably high maternal-fetal mortality and morbidity in the US, but we are grappling with the problems and trying to fix them.
        No one person can manage many of these emergencies no matter how skilled. It takes a skilled, well trained team to avert disaster, and still disasters can happen despite our frequent simulation training involving the entire team, and debriefings with each other and patients.
        With regard to midwives….I’ve learned so much, and incorporated it into my practice. As well intentioned as lay midwives may be, it takes s lot of exposure and delivery practice to manage complications. Our L&D teams can’t help if the patient isn’t there.

        Posted by Yvonne Treece, MD, FACOG | April 18, 2018, 9:47 am

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