The question of whether the umbilical cord must be cut at birth is part of a larger conversation about the optimal transition for a newborn. The umbilical cord is a temporary organ that physically connects the developing fetus and the placenta, facilitating all necessary life support functions during pregnancy. While separation is inevitable, the timing and method of cord management are subjects of medical debate. Choices range from immediate cutting to a complete hands-off approach, each having distinct physiological consequences for the newborn.
The Biological Function of the Umbilical Cord
The umbilical cord is a conduit between the fetus and the placenta, acting as the primary system for gas and nutrient exchange throughout gestation. It is composed of three blood vessels: two umbilical arteries and one umbilical vein. The arteries carry deoxygenated blood and waste products from the fetus back to the placenta, while the vein delivers oxygenated, nutrient-rich blood to the baby.
These vessels are protected by a thick, gelatinous substance called Wharton’s jelly, which prevents them from being compressed. The cord is genetically part of the baby, but the placenta interfaces with the mother’s uterine wall. Once the baby is born and begins breathing independently, the cord’s primary respiratory function becomes redundant, which is the biological basis for its eventual severance.
Immediate Cutting Versus Delayed Clamping
Historically, immediate clamping—cutting the cord within 15 to 30 seconds of birth—was standard practice. This practice is now widely discouraged for healthy newborns because it prevents the placental transfusion, a significant volume of blood, from transferring into the baby’s circulation.
Delayed clamping, or optimal cord clamping, involves waiting at least one to five minutes after birth, or until the cord stops pulsating, before cutting. This delay allows the transfer of approximately 80 to 100 milliliters of blood, about one-third of the baby’s total blood volume. This extra blood provides a boost in red blood cells and iron stores, which significantly reduces the risk of iron-deficiency anemia in infancy.
The benefits are particularly pronounced for preterm infants, where delayed clamping reduces the risk of severe neurological injury and the need for blood transfusions. For all vigorous infants, this practice supports the transition as the baby’s lungs begin to take over oxygenation. Although a temporary, slight increase in newborn jaundice may be observed, the overall long-term benefits outweigh this manageable risk.
The Practice of Not Cutting (Lotus Birth)
A distinct alternative to cutting the cord is known as Lotus Birth, or umbilical cord non-severance. This practice involves leaving the umbilical cord attached to the placenta until it naturally separates from the baby’s navel, typically between three and ten days after delivery. The philosophy often centers on the spiritual belief that the placenta is the baby’s first organ and should be honored.
This practice is fundamentally different from delayed clamping, which still involves cutting the cord after a few minutes. Since the placenta is essentially dead tissue after birth, proponents must manage it carefully outside the body to prevent complications. Management involves cleaning the placenta, drying it, and often storing it in a breathable container with salt or herbs to minimize odor and aid the drying process.
Lotus Birth is a complete non-intervention, relying on the natural process of separation. However, medical professionals express concern because the placenta, once expelled, contains stagnant blood and is prone to colonization by bacteria. If the cord and placenta are not managed with strict hygiene, the risk of infection, such as omphalitis or sepsis, exists for the newborn.
Current Medical Guidance and Safety
The global medical community has established a strong consensus regarding the appropriate management of the umbilical cord for most births. Organizations like the World Health Organization and the American College of Obstetricians and Gynecologists recommend delayed clamping for all healthy term and preterm infants. This recommendation specifies waiting at least 30 to 60 seconds, and ideally one to three minutes, to maximize the placental blood transfusion.
There is a lack of scientific evidence supporting any medical benefit to the newborn from keeping the placenta attached beyond delayed clamping. Major health organizations do not endorse Lotus Birth due to the risk of serious infection transferring from the decaying placenta to the baby. While immediate cutting is no longer the standard of care, proper cord management involves clamping and cutting after the blood transfer is complete to ensure physiological benefits and infant safety.