Updated February 28, 2022
The placenta plays a vital role in the well being of mom & baby throughout pregnancy and the immediate post-partum period. “During pregnancy and after birth, the placenta makes maternal and child survival possible. It provides for our nutritional needs and aids in our development. It acts as a barrier guarding us against harmful bacteria and most foreign molecules,” says midwife, Robin Lim .
After the birth, the baby and plancenta will eventually separate. There are several ways to go about this. I like the advice Lim gives in her book Placenta: the Forgotten Chakra. “Remember to choose what is the gentlest path that feels right for your family and the sweetest way you can imagine; your baby cannot choose, but depends on you to be wise” .
The following options are available.
Immediately Clamp & Cut the Umbilical Cord
For many hospitals and birth centers, this is the norm. It may be the “easiest” option for parents as they do not need to have any discussion or mention anything ahead of time. After the baby is born, the doctor or midwife will immediately clamp & cut the cord.
Delayed Cutting of the Umbilical Cord
Just delaying the cutting of the umbilical cord by 3 minutes is so important for giving baby an extra boost from the placenta. In 2012, the World Health Organization (WHO) released a statement recommending delayed cord clamping for all births, stating that early clamping (less than 1 minute after birth) is not recommended .
According to the WHO,
there is growing evidence that delayed cord clamping is beneficial and can improve the infant’s iron status for up to 6 months after birth. For the first few minutes after birth, there is still circulation from the placenta to infant. Waiting to clamp the umbilical cord for 2-3 minutes, or until cord pulsations cease, allows a physiological transfer of placenta blood to the infant (the process referred to as “placental transfusion”), the majority of which occurs within 3 minutes. This placental transfusion provides sufficient iron reserves for the first 6-8 months of life, preventing or delaying the development of iron deficiency until other interventions — such as the use of iron [rich] foods — can be implemented” .
The placental transfusion has been shown to increase baby’s red blood cells by 60% and to increase their overall blood volume by 30% .
The American College of Obstetricians & Gynocologists (ACOG) states that allowing a longer time for placental transfusion after birth helps to ensure the transfer of immunoglobulins and stems cells, which are important for organ and tissue repair. This transfer is crucial for preterm babies .
It is generally not difficult to get your doctor or midwife to agree to delayed cord cutting. However, like the first option, it also involves cutting the cord before the placenta is born.
If you’re birthing without a provider present, cutting the cord is a fairly simple option for separating baby from their placenta. Emilee Saldaya gives these easy instructions in her episode, “What to Do with the Cord?(And Placenta!)” of the Free Birth Society podcast:
“Boil some scissors or a knife, anything you have in your kitchen that’s sharp enough. And then at about 6 inches minimum away from your baby you just cut it. It’s really really simple. And then you clamp it.”
Saldaya states she is “a fan of the sterile clamp because there is no chance with using a clamp on baby’s side that any blood will leak out from your baby’s end, which could actually be quite serious and even fatal” .
The disadvantage of the 3-4 cm plastic cord clamp that is usually used is that it can get between mom and baby during breastfeeding. It will also hurt baby if it twists and pokes into their belly and may be uncomfortable.
Prolonged Delayed Cutting of the Umbilical Cord
Many midwives who receive babies at home practice this, usually waiting about 15 minutes before cutting and clamping the cord. But, sometimes this still means severing the cord before the placenta is born. Lim says, “I strongly suggest that the parents ask the health provider to wait at least until the placenta has been born. Even better is to wait until the baby has had it’s initial feed at the breast. After this, I believe the baby has gotten 99% of the physical benefits of delayed cord severance. Whenever we see the placenta, cord, and baby (root, stem, and fruit) intact, I call this a Lotus Birth” (77).
Burning the Umbilical Cord
This can be done after the placenta has been born and the baby has had it’s first feed. Burning the cord cauterizes it and prevents infection. It also eliminates the need for an uncomfortable umbilical cord clamp. Lim says, “according to Asian medicine knowledge, burning of the umbilical cord moves the Qi (life force) remaining in the placenta into the baby,” . One small disadvantage to cord burning is that it can take 10 to 15 minutes, where cutting is obviously much faster.
The following are instructions for cord burning ceremony.
You Will Need:
• At least two long candles
• A lighter
• Heat guard, two layers of cardboard works well
•A bowl or plate to catch melting wax
As mentioned above, it is best to wait for awhile after the birth of the placenta to sever the cord. Lim recommends 3 hours or more or even waiting until the next morning. There is no rush.
Swaddle the baby and lay them on their side with the placenta sitting opposite to the direction the baby is facing. Use some sort of heat guard to protect the baby. Two layers of cardboard with a slit for the cord works well.
Chose a spot to burn on the cord. It should be about 4 inches (10-12cm) from the baby’s belly. Have someone gently hold the cord steady. Don’t pull on it too hard.
Light the candles and position them on opposite sides of the cord above the bowl or plate to catch the wax drips and begin burning. As the cord burns there may be loud pops and sizzles. This is normal. If the candles go out, relight them and continue burning the cord until you have burned completely through it.
Check the cord on the baby’s side of the heat guard occasionally to make sure it isn’t getting too hot.
Once the cord has burned through, wait for a bit before letting the cord stump touch baby’s skin as it will stay hot for a few minutes.
This process cauterizes the end of the umbilical cord so you do not need to put anything on it. The cord stump will fall off in a few days by itself. Lim says she has has observed that when the umbilical cords are burned, the stump will dry up and fall off more quickly that those that were cut .
Full Lotus Birth
According to Lim, “this is the most patient, spiritual, special way. To allow the cord to release from the baby with no rush, nothing but patience and non-violence,” . This method involves leaving the umbilical cord attached to baby and placenta until it naturally falls off, usually 3-9 days later. “This allows mother, baby, and placenta the time and space to let go gracefully, and only when they are truly ready,” says Lim . During this time, the placenta is wrapped in cloth or a cloth diaper and is kept in a small bowl or basket. It is often sprinkled with salt and aromatic, dried herbs to help prevent odor & spoiling.
This series of photos shows the process of preparing the placenta with salt & dried flowers and adorning it with crystals as part of a Lotus Birth ceremony.
One benefit of full lotus birth is that it encourages mom and baby to bond and rest because baby is more difficult to pass and carry around while the umbilical cord is still attached. It also allows baby to receive full benefits from the placenta, though as mentioned above, most of the physical benefits of the placenta are received by baby within a few hours of birth.
Lim’s book, Placenta: The Forgotten Chakra, has lots more information on lotus birth, including full instructions for how to have one and some beautiful Lotus Birth stories.
Wait to Decide
Another option is to prepare for multiple methods (cutting, burning, and/or Lotus Birth) and see what feels right. There is no rush to decide. “You might change your mind depending on how things go,” says Saldaya. “For example, I thought that I would do Lotus Birth —I liked the idea of it. Or maybe that I even eat a few pieces of the raw placenta in a smoothie if I was feeling like I needed extra nourishment. But, my placenta was born covered in meconium, which was unappealing to me. I felt great, thankfully, and the smell of the herbs on the placenta later that day was actually very off putting to me. And so after 12 hours, we burned the cord and separated the baby from the placenta” .
Regardless of the specific decision you make about how if/how you will sever your baby’s cord, be sure to consider your child & the placenta throughout the process. Saldaya reminds us, “Babies are so wise and so sensitive and they really appreciate being spoken to with respect.” She says, “When it is time to sever the baby from the placenta, should you choose to do that, take the time and thank your placenta. Witness it. Acknowledge it. This is a magnificent organ that you grew and shared with your child. Tell your baby what’s about to happen. Tell your child that it’s time to separate from their placenta and that they will be in a new way now. And they will now be nourished from your breast” .
Your baby’s placenta was vital to their survival before birth. Honoring their separtion from this wonderful organ is a beautiful way to help them transition peacefully from life in the womb to life earthside. In the words of midwife & author, Jeannine Parvati Baker, “Healing Birth heals Mother Earth.”
1. Lim, Robin. Placenta: the Forgotten Chakra. 13, 76-81.
2. WHO. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. Geneva: World Health Organization; 2014. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/148793/9789241508209_eng.pdf
3. WHO. Recommendation: Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants. Geneva, World Health Organization; 2012. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/120074/WHO_RHR_14.19_eng.pdf?sequence=1
4. Delayed Cord Clamping: What Are The Risks And Benefits?” American Pregnancy Association. July 16, 2019. Retrieved from https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/delayed-cord-clamping/
5. Delayed umbilical cord clamping after birth. Committee Opinion No. 684. American College of Obstetricians and Gynecologists. Obstetrics & Gynecology 2017; 129:e5–10. https://pubmed.ncbi.nlm.nih.gov/28002310/
6. Saldaya, Emilee. “What to Do with the Cord? (And Placenta!)” Free Birth Society Podcast. April 5, 2019. https://www.freebirthsociety.com/blogs/the-free-birth-podcast/what-to-do-with-the-cord-and-placenta