Beberapa hari yang lalu, saya melayani persalinan seorang ibu dengan permintaan persalinan dengan Lotus Birth. Persalinan dimana tali pusat dan plasenta (ari-ari) tidak dijepit dan dipotong atau dipisahkan dari bayinya. Ini merupakan kasus pertama saya dengan Lotus Birth. Saya melihat setelah bayi lahir, dua hari kemudian tali pusat dan plasenta sudah mulai mengering. Persalinan ini memberi perenungan yang dalam untuk saya. Untuk sekilas info tentang Lotus Birth saya kutip tulisan dari Wikipedia di bawah ini. 

Lotus birth, or Umbilical Nonseverance, is the practice of leaving the umbilical cord unclamped and intact following birth.

Lotus Birth, Day 3 postpartum, the sinew-like unwrapped cord seen at left side of child, just hours before natural detachment. 2007Rather than intervening upon the normal physiological process of the neonate, Umbilical Nonseverance relies on the Wharton’s jelly changes which produce a natural internal clamping within 10-20 minutes postpartum. The umbilical cord then dries to a sinew and naturally detaches from the umbilicus. Detachment generally occurs 2-3 days after birth.The World Health Organization emphasizes the importance of a unified approach to care of the mother and the baby, and clearly states (in Care in Normal Birth: A Practical Guide, Geneva, Switzerland, 1997)[1]“Late clamping (or not clamping at all) is the physiological way of treating the cord, and early clamping is an intervention that needs justification.” Furthermore, the physiological process of Nonseverance supports placental transfusion in its purest form, as there is no point at which anyone, other than the baby, decides when the placental transfusion is complete.^[1] This will be individual to each baby, based on its physical condition at birthWhen Umbilical Nonseverance or Lotus Birth is practiced, rarely in hospitals but more common in birth centers and home births, maternal-neonatal bonding proceeds uninterrupted, which is beneficial for both mother and newborn WHO’s Third Stage Protocols. While care providers conduct immediate Apgar scoring and any needed neonatal suctioning/stimulation, most further procedures are postponed until an hour after the birth. The baby-cord-placenta unit is swaddled by the mother in-arms, or held by a father or nurse during maternal suturing.Different cultural practices use the preserved placenta in different ways. Some people prefer for the child to have the placenta so that it can be buried with the child at the end of his or her life. Others keep the placenta until it falls off naturally and it is then buried, the Igbo people in Nigeria bury the placenta right after birth and often a tree is planted over it.

Extended-Delayed Cord Severance Care, Intact Umbilicus One Hour Postpartum. 2006For Full Nonseverance/Lotus Births, the excess fluids are wiped off the placenta and it is kept in an open bowl or wrapped in a cloth, in close proximity to the neonate. The cloths used to wrap the placenta or cover a bowl must allow air through, so that the placenta can air and begin to dry out and not become malodorous. Sea salt is often applied to the placenta to help dry it out. Sometimes essential oils, such as lavender, or powdered herbs such as goldenseal, neem, along with lavender are also applied for their additional antibacterial properties. If drying applications are not applied the well-aired placenta will have a distinct, musky scent which can be halted by directly planting it or by refrigerated storage after the first postpartum week.In hospitals and global medical centers, common medical training and practice is “Active Management” of Third Stage Labor: administration of oxytocic drugs, immediate external clamping of the cord at birth, cutting it forthwith, then applying traction to the cord to speed the birth of the placenta ^[2] rather leaving the cord-placenta-baby unit intact to provide for, as proponents of claim, a physiologically gentle transition of mother and baby. The cord blood may or may not be harvested for cord blood banking. The baby’s umbilical cord and placenta are then disposed of as medical waste or sold to laboratories.Early American pioneers, in written diaries and letters, reported practicing nonseverance of the umbilicus as a preventative measure to protect the infant from an open wound infection.^[3]The practice gained notice in the yoga practitioner community when Jeannine Parvati Baker, author of the first book on prenatal yoga in the West, Prenatal Yoga & Natural Childbirth practiced umbilical nonseverance for two of her own births, seeing it as a practical application of the yogic value of ahimsa as well as the core yoga teaching inherent in the primal bonding process that “All attachments will fall away of their own accord.”In the 1990s, Sarah Buckley MD, an Australian family physician and noted parenting advisor for the magazine Mothering, published her personal birth stories in the text Lotus Birth, and has produced numerous scholarly publications of her research on the physiological benefits of Passive Management of Third Stage Labor.^[4]Umbilical nonseverance, or Lotus Birth, is an informed choice option currently practiced by a minority of homebirth and hospital birth families [See the research of Sarah Buckley, M.D. and Int’l Midwife Robin Lim], and an increasingly popular continuing education topic for licensed midwives and certified nurse midwives in publications such as the magazine Midwifery Today and Mothering. Particularly compelling to these professionals is the reported absence of healthy neonatal weight loss and breastfeeding jaundice in lotus birth scenarios, as yet formally studied.

Umbilical Nonseverance, postpartum water immersion shortly after homebirth, 2005Although recently an alternative birth phenomenon, delayed umbilical severance has been plentifully recorded in the cultures of the Balinese ^[5] as well as aboriginal people such as the !Kung. Modern practitioners of Lotus Birth point out that those mammals with whom humans share 99% genetic material, the chimpanzees^[6] leave the umbilicus intact, neither chewing or cutting it, a fact known by primatologists. Therefore, the medical practice of immediate cord clamping and cutting, and its physiological impact is questioned by parents who choose partial or full Nonseverance.In Tibetan and Zen Buddhism, the name “Lotus-Birth” was what described spiritual teachers such as Gautama Buddha and Padmasambhava (Lien-hua Sen), emphasizing their entering the world as an intact, holy child. References to Lotus Birth are also found in Hinduism, for example, the story of the birth of Vishnu.^{[citation needed]}Religious Jews and Christians who choose umbilical nonseverance see it relevant to the strength of Ezekiel who was cast out of his tribe but became a divine visionary, or prophet. Ezekiel 16:4 of the Bible, “As for your birth, the day you were born your navel cord was not cut.”

1. ^ Examination of the Newborn & Neonatal Health, A Mulidimensional Approach, p. 116
2. ^ “Management of the Third Stage of Labor“. Retrieved on 2007-12-29.
3. ^ Leavitt, Judith Walzer. Brought to Bed: Childbearing in America, 1750 to 1950. New York: Oxford University Press, 1986 pp.21-37
4. ^ Buckley, Sarah. “Leaving well alone: A natural approach to the third stage of labour“. Retrieved on 2007-12-29.
5. ^ see Eat, Pray, Love by Elizabeth Gilbert, pp. 252-252
6. ^ see In the Shadow of Man, by Jane Goodall, who was the first person to conduct any long term studies of chimpanzees in the wild, and reported that they did not sever their offspring’s cords.