If you’re a soon-to-be parent, you’ll likely spend the majority of your pregnancy making decisions about childbirth and everything that leads up to it, like whether or not you want to learn your baby’s gender in advance, use an epidural, or work with a doula.

But it can be easy to forget to plan for the minutes and hours immediately following birth, where decisions need to be made around breastfeeding, skin-to-skin contact, and more.

For example, did you know some parents, particularly those who opt for a more natural birth experience, sometimes choose not to clamp (or cut) their child’s umbilical cord? Instead, it’s left to detach naturally, meaning the baby and placenta remain connected to each other until the umbilical cord breaks. This is what’s called a lotus birth.

We sat down with Michelle Welborn, a certified and licensed midwife, to learn more about this birth option.

Lotus birth logistics
In a lotus birth, there’s zero human involvement when it comes to severing the umbilical cord. Instead, it’s left to fall off naturally. “It usually takes three to four days for the cord to dry up and break, but it could take longer,” says Welborn.

Immediately after birth, the umbilical cord is tightly spiraled, thick, blue-colored, and pulsating. (Welborn adds that you can feel the baby’s heartbeat in the cord.) At this point, the cord is still actively transferring blood to the baby, the same way it functioned inside the mother’s uterus. If left uncut, the cord will become flaccid, white, and completely still over the course of the next 15 minutes to an hour; the vessels in the cord have closed, and they are no longer carrying blood to the infant. With a lotus birth, parents take the baby, placenta, and this flaccid white cord home.

But how the heck does this work? And does the placenta — a human organ — start to get a little smelly after a few days?

“Most parents have a pouch or bowl they’ve designed for the placenta, which gets carried around with the baby,” she explains. “They essentially have a piece of meat hanging out with them and their baby at home. Most use a combination of herbs and salt to ‘cure’ the placenta, so it doesn’t start forming bacteria or smelling.”

Welborn jokes with clients that if they’re concerned about having too many postpartum visitors, they should consider a lotus birth. After all, few people are interested in looking at — let alone cradling — a placenta. Need a visual? Check out some of these images.

Why choose a lotus birth?
The parents who choose lotus births often want to keep the birth experience as natural and free of any medical interferences as possible. As this 2015 piece from The Atlantic notes, this growing desire for low intervention, minimally invasive births is causing a number of women to turn to midwives for prenatal, labor, and postpartum care rather than an OBGYN. As the article explains, the midwifery care model is lower-tech, less invasive, and less inclined toward intervention without a clear medical need.

What science has to say
Right now, the evidence pointing to the benefits of lotus births is only anecdotal, and there isn’t sufficient clinical evidence for the medical community to conclusively state whether lotus births are a good or bad idea.

But here’s what science does know: delayed cord clamping — the prolongation of the time between delivery and umbilical cord clamping — is encouraged by leading institutions like the World Health Organization. Keep in mind, delayed cord clamping differs from lotus births; with the former, the cord is clamped by a person and is not left to naturally detach.

The WHO explains that early cord clamping usually happens within the first 60 seconds after birth. Later cord clamping happens after that, or when “cord pulsation has ceased.”

Welborn is a proponent of waiting until the cord completely stops pulsating before cutting it, if a client chooses to have the cord cut by a person. “When we clamp the cord early, we force the baby to make a quick transition, instead of allowing them to make that transition as they naturally would,” she says.

And she’s not alone in that school of thought. This 2007 review of the studies on delayed cord clamping reports that “delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is beneficial to the newborn, extending into infancy.” A 2011 study also found that delayed cord clamping resulted in improved iron levels and neonatal anemia in 400 4-month-old infants.

However, the American College of Obstetricians and Gynecologists says that delayed cord clamping is associated with an increased risk of jaundice. But due to the research pointing to the benefits of delayed cord clamping, the ACOG recommends that practitioners still delay umbilical cord clamping in healthy term and preterm infants for at least 30 to 60 seconds after birth, but have mechanisms in place to monitor and treat neonatal jaundice.

The same aforementioned benefits of delayed cord clamping apply to lotus births, since the cord is not being cut at all. In her own practice, Welborn typically waits a few hours before cutting the cord, if her clients request this. Of course, if there’s an emergency and the cord needs to be cut in order for an infant to be examined — or in extreme cases, resuscitated — the cord is immediately cut.

How to request a lotus birth
It’s always recommended that you voice your wants and needs to members of your pregnancy and birth team, like your OBGYN, midwife, or nurse. If you’re using a doula, they can assist you in advocating for your wishes. This is especially critical if you want to have a lotus birth or delay cord clamping for longer than a minute.

On Welborn’s website, she offers individualized care, professional advice, information, and resources to empower her clients to make autonomous decisions about their pregnancies, births, and babies. She believes this care model ultimately builds confidence in parenting skills. We wholeheartedly agree with Welborn’s philosophy. Whether or not you’re interested in a lotus birth, asking questions and researching your options are key to making knowledgeable, confident parenting decisions — even before your child is born and just moments after they enter the world.

English Taylor is a San Francisco-based women’s health and wellness writer and birth doula. Her work has been featured in The Atlantic, Healthline, Refinery29, NYLON, and Modern Fertility. Follow English and her work at https://medium.com/@englishtaylor or on Instagram at @englishtaylor.