A friend of mine is talking about having a Lotus birth. I am pregnant, too, and now interested in it as well. Will not cutting the umbilical cord benefit my baby?
Some media outlets are reporting that the Lotus birth practice is gaining in popularity. A Lotus birth involves leaving the umbilical cord attached to the baby — with the placenta still attached to the other end of the umbilical cord. The cord is then left to fall off the baby’s navel naturally, after approximately three to ten days.
This is in contrast to what usually happens during delivery. After the birth, the umbilical cord is normally clamped and then trimmed, and the small stump that remains at the baby’s navel falls off naturally in three to ten days.
There is no data to support the benefits or safety of the Lotus birth practice. This practice should not be confused with the simpler concept of delayed cord clamping, in which the umbilical cord is clamped and cut a few minutes after birth — instead of immediately — in
order to get the maximum amount of blood into the baby’s circulation.
Recent research shows that when there is delayed cord clamping (a few minutes after birth), the baby receives higher levels of iron, compared with immediate cord clamping. In addition, the delayed clamping may be especially beneficial in preventing complications in babies born prematurely, as it has been shown to prevent bleeding in the fragile blood vessels of babies who are born very early. The exact timing of the benefit and which babies stand to benefit the most is an area of active and promising research.
I would prefer to have a natural birth with my twins. Must I have a C-section if one of the twins is presenting breech?
The presenting part of a baby is the one that is leading and will come out first during a vaginal delivery, and this presentation determines the safest mode of delivery.
Presenting breech means the baby is bottom-down. Presenting vertex means the baby is headfirst. Presenting transverse means the baby is lying sideways. Breech and transverse presentations together are clustered and referred to as non-vertex presentations, and babies presenting in these positions generally are not delivered vaginally if they are the first twin or are from a singleton pregnancy, as they are at higher risk for birth trauma.
In contrast, a second twin, even if breech or transverse, may be allowed to deliver vaginally. With twins, one baby drops lower than the other into the pelvis and becomes the presenting twin.
There are three basic possibilities of combinations of presentations with twins: Both twins are head-down, vertex/vertex (40 to 45 percent); one is headdown and one is not, vertex/non-vertex (35 to 40 percent); and the first twin is not a head-down, non-vertex presenting twin (20
percent). Experts recommend that non-vertex presenting twins or nonvertex singletons undergo a Cesarean delivery due to the risks to the babies of vaginal deliveries.
However, if the first twin is vertex and the second twin is non-vertex (breech or transverse), many healthcare providers would allow an attempt at a vaginal delivery. Talk to your healthcare provider about the best option for your particular situation.
Is it recommended — or even safe — to get a flu shot during pregnancy?
Yes. Pregnant women are at increased risk of serious complications — even death — from influenza. Immunization against influenza is an essential part of healthy prenatal care. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends influenza vaccination for all women who will be pregnant through the flu season (October through May in the United States). The American Congress of Obstetricians and Gynecologists’ Committee on Obstetric Practice supports this recommendation.
No study has ever shown any risk from the influenza vaccine to mothers or babies from vaccination at any stage of pregnancy, including the first trimester. You may have heard concerns expressed in the media about thimerosal causing autism in children. Thimerosal, a mercury-containing preservative, has not been shown to cause autism. There is no scientific evidence that thimerosal- containing vaccines cause adverse effects in children born to women who received vaccines with thimerosal.
Hope Ricciotti, MD, is an Associate Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, and practices obstetrics/ gynecology at the Dimock Community Health Center and Beth Israel Deaconess Medical Center in Boston. She is the Interim Chair in the Department of Obstetrics and Gynecology at Beth Israel, and Residency Program Director.
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