15 Nov Ins & outs of Placenta encapsulation and Placentophagy
By Anchen Verster – Registered nurse and midwife, SA certified perinatal educator
The practice of consuming your baby’s placenta after birth or in the months to follow is known as placentophagy. It would appear that this practice dates back to ancient Chinese practices around the 1500’s but has been practiced routinely in other countries too. What is done with the placenta after birth depends on what a culture or individual believes about the placenta. These beliefs vary from health benefits to the mother and baby to the belief that the placenta provides supernatural protection. Practices range from washing with the placenta, consuming it, burying it in a particular place and growing a new plant there to symbolize new life, preserving it or burning it.
These are but a few placenta ‘practices’.
The common argument given for consuming human placenta, is that other mammals do it – so we should too. As a child I remember watching a nature video and seeing an animal eating the placenta after giving birth. Most mammals (excluding marine mammals) and herbivores practice placentophagy. Zoologists explain that part of the reason for this is that the smell of the after-birth (placenta) attracts predators and so by consuming it, the risk of the new offspring being tracked down and eaten is decreased. Obviously, we can’t apply this reasoning to human placenta consumption although it might make for a good Sci-Fi screen-play.
The placenta is a dense mass of tissue that provides a template for the passing – but not mixing – of maternal and foetal blood. The placenta supplies oxygen (and removes carbon dioxide) and nutrients to the foetus and removes waste (urea, uric acid and creatinine). It also provides a filter, through which larger chemicals, viruses and bacteria cannot pass – although doesn’t protect from all – for example alcohol passes via the placenta to the foetus. The placenta secretes a variety of hormones including oxytocin, oestrogen, progesterone, growth hormone, human chorionic gonadotropin amongst others.
So, back to eating our placentas… there is very little research on the benefits and risks of consuming placentas. Much anecdotal evidence exists from mothers who share their experience and a few small studies show some benefit. The benefits that mothers notice are improved milk supply, improved mood, feeling less stressed and feeling more energetic. Health care providers and studies show benefits such as reduced risk of bleeding after birth and replenishment of iron stores. Most of the articles say there is a reduced chance of postnatal depression. Its important to note that these studies are few and do not include large numbers of mothers.
On the flip side mothers have also reported feeling very unwell (nauseous, anxious, irritable) while they are taking the placenta capsules, which may be attributed to the hormones it contains. Many of the hormones secreted by the placenta are largely hormones of pregnancy so it would be interesting to know what the concentrations of these hormones are – in the tissue at the time of birth. We should also question whether it’s beneficial to increase the body’s dose of pregnancy hormones after birth by ingesting placenta.
We also don’t know what waste products and chemicals are in the placenta at the time of birth. One researcher cautions of the potential immunological and endocrinological risk placentophagy may pose to the mother. She refers to the placenta containing antigens foreign to the mother and hormones that the mother may not need.
Another mother reported an increase in milk supply that was beyond what she or her baby could cope with, but this returned to normal once she stopped the capsules.
A 2015 medical review was able to retrieve 10 research papers between 1950 and 2014 on placentophagy in humans and animals and could not find conclusive health benefits or conclusive risk. This is a strong reminder to us that the practice of placentophagy needs more research before we can confidently give it the green or red light.
In June 2017, the Centre for Disease Control published a report of a baby treated in hospital (in 2016) after birth for a Group B Streptococcus (GBS) infection, discharged and then re-admitted twice thereafter with a recurrence of the same infection. The hospital did various tests including testing the mother’s breast milk and found no signs of the bacteria and reason for reinfection. When they tested the placenta capsules the mother was ingesting, they found exactly the same strain of GBS the baby was infected with. They concluded that the mother was re-colonizing the baby with the infection that she was re-ingesting with each capsule. Although this is an isolated incident it should caution us on the importance of needing standardized protocol on encapsulation and infection control.
Currently there are two methods of encapsulations. The Raw Method dehydrates the placenta over a longer period of time but is said to maintain more of the nutrients and enzymes. The Traditional Chinese Medicine Method first steams the placenta with ginger, lemon and chilli (or other herbs) and then dehydrates it before grinding and encapsulating. This method is said to be safer as the temperatures reached kill more organisms.
If you decide to do placenta encapsulation here are some questions to ask your service provider:
- Do they have training in food safety, infection control and HACCP (Hazard Analysis Critical Control Point)?
- What training do they have in the encapsulation process?
- How are the materials used cleaned and sterilized? (dehydrator, steamer, encapsulater)
- Where do they do the encapsulation?
- What cold chain must be maintained from the birth of the placenta to the point that the encapsulation process begins?
- How can you be sure it’s your placenta you receive back in capsule form?
- What health information do you need to give the service provider for example your health and infection history?
- Is there a contract to sign between you and the encapsulation service provider?
Although we have mother’s reports of the benefits of encapsulation and small pieces of research – some of which is very outdated – there is still too little research to emphatically say it is safe and good practice. According to the South African Human Tissue Act, placentas are supposed to be registered as human anatomical waste (weighed and labelled) and a medical waste removal company issues a Safe Disposal certificate to the hospital at the point of safe disposal. This means that the number of births and registered placentas can be checked against the safe disposal certificates. Because there is a black market for placentas some go missing off the list or registered as one in a bag when there are in fact 2 or 3. If you are planning to encapsulate your placenta you should make sure you have cleared this process with the hospital you are delivering at.
Questions to ask your hospital prior to the birth (for example when on your hospital tour):
- Do they issue an affidavit to complete or should you get your own one signed at the police station in order for the hospital to release the placenta?
- Do you need a clearance letter from your gynaecologist or midwife?
- Do you need to bring your own container/ bag to take the placenta home in?
- Does the hospital provide information on what to do with any parts of the placenta that are not used in the encapsulation process- how to dispose of these?
Remember, if there is a time lapse or travel distance from birth to refrigeration you will need a small cooler box with ice pack to keep the placenta cold in until you get it into the fridge. Even though your partner does not have far to travel home from the hospital he may want to stay a few hours after the birth in which case you will need cold storage.
International guidelines require that any unused parts of the placenta need to be buried or disposed of in medical waste within 8 hours of removal from refrigeration.
The South African Human Tissue Act technically prohibits mothers from removing their placentas from hospital without permission from “The Minister”. However, this contravenes religious and ritual rights so hospitals require an Affidavit from you stating the reason for removal of placenta.
If you are planning to do placenta encapsulation, make sure you know the requirements of ‘your’ hospital so that the process is as simple as possible. Perhaps in five or ten years time we’ll have much more research to reply on but for now you will have to make up your own mind.