Rethinking the Practice of Placenta Encapsulation
Rethinking the Practice of Placenta Encapsulation
Writing for Midwives
As placenta encapsulation gains popularity, more information regarding possible benefits or side effects is available; calling into question its efficacy. The literature reviewed for this report concludes there is not enough evidence to support placenta encapsulation as beneficial, traditional or a safe practice and should be used with caution. Placenta encapsulation is a type of maternal placentophagy, the practice of eating the placenta post-delivery (Hayes, E. H., 2016). Often, the placenta is picked up by a placenta specialist and processed either in their kitchen, or the home of the birthing parent. Proponents of placenta encapsulation boast capsules will provide higher milk supplies, lower chance of postpartum depression, and higher iron levels.
Google is filled with websites claiming that placenta encapsulation is based around Traditional Chinese Medicine (TCM). Encapsulation claiming to follow the TCM method involves steaming the placenta with heat restoring foods, such as peppers, ginger, and lemon, before dehydration. The belief is it restores qi lost at birth. Maternal consumption of the placenta after birth is present in some cultural practices, traditional Chinese medicine is not one of them. There is no mention of maternal placenta encapsulation in the Journal of Chinese medicine, a database of TCM texts, studies and resources. A study on maternal placenta consumption found that the placenta has been used for many ailments, but not traditionally with new mothers (Hayes E. H., 2016). Organizations, placenta encapsulation trainers, and doulas perpetuate the belief that their craft is TCM without data to back it up.
Raw placenta encapsulation involves dehydrating the placenta at 105° F/41° C, grinding it into a fine powder, and placing the powder into capsules. Proponents of raw encapsulation believe that because the placenta is raw, it retains a higher level of nutrients and will be more effective than if steamed. Raw placenta smoothies involve placing small pieces of placenta into a blender with fruit, to be consumed within a few hours of the birth. The placenta is an organ, and therefore meat; meat should be cooked and dehydrated at 160° F/71° C to prevent food borne illness.
In September 2016, an infant in Oregon developed both early-onset and late-onset Group B Streptococcus agalactiae (GBS). At 37 weeks gestation, the mother tested negative for GBS but shortly after birth the newborn developed symptoms of infection; testing showed penicillin-sensitive, clindamycin-sensitive GBS. After being treated with an 11-day course of ampicillin the newborn was discharged. Five days later, the newborn returned to a second hospital and was diagnosed with late-onset GBS. Testing of the capsules revealed the placental tissue contained penicillin-sensitive, clindamycin-sensitive GBS. “Although transmission from other colonized household members could not be ruled out, the final diagnosis was late-onset GBS disease attributable to high maternal colonization secondary to consumption of GBS-infected placental tissue” (CDC, 2017). How the newborn contracted late-onset GBS is up for debate since GBS was not found in the breastmilk but some speculate it could have been from touching the capsules and then touching the baby.
A proposed benefit of placenta encapsulation is increased milk supply, but some lactation consultants like Sarah Hollister RN, PHN, IBCLC advise against it. In her practice, she has found a trend between low milk supply and placenta consumption. Sarah has noted several cases with negative effects related to maternal placenta consumption. She states, “the dominant pregnancy hormone, progesterone, inhibits the dominant lactation hormone, prolactin, from binding to the prolactin receptor sites, thereby inhibiting milk production during pregnancy.” She has found that the sooner a mother discontinues the placenta pills, the sooner the milk supply can be established. Low milk supply can increase stress in the postpartum period.
Postpartum depression (PPD) effects about 20% of new mothers each year (Bennet S. S., Indman P., 2015). The idea that placenta encapsulation may prevent postpartum depression can be very alluring to someone who has experienced PPD in the past. The thought is that the placenta is so full of nutrients and hormones it helps ease the transition from being pregnant to being postpartum. While human placental tissue is full of B-vitamins, Estrogen and β-endorphins, researchers are not sure how much remains after processing (Hayes E. H.,2016). An additional double blind placebo controlled study to test iron levels in placenta capsules and in mothers several weeks postpartum, did not find a significant statistical difference between the placenta capsule group and the placebo group (Gryder, L. K., Young, S. M., Zava, D., Norris, W., Cross, C. L. and Benyshek, D. C., 2017). Encapsulation may allow the retention of some nutrients yet, levels do not seem to cause any documentable effects.
Placenta encapsulation may seem like an integrated part of midwifery care, while in fact, it is not. The evidence reviewed from the CDC revealed a case where placenta encapsulation caused harm to a newborn. This paper discussed the different methods of preparation and the fallacy that placenta encapsulation is TCM. Lastly, it was shown in a reputable experiment, that there was no statistical difference between iron levels of those participants taking placenta capsules and those taking a placebo. Placenta encapsulation may be interesting, but it is not helpful or without risk.
Bennett, S. S., & Indman, P. (2015). Beyond the blues: understanding and treating prenatal and postpartum depression & anxiety. New York, NY: Untreed Reads.
CDC (2017). Notes from the Field: Late-Onset Infant Group B Streptococcus ... September 17, 2017, http://dx.doi.org/10.15585/mmwr.mm6625a4
Hayes, E. H. (2016). Consumption of the Placenta in the Postpartum Period. Journal of Obstetric, Gynecologic & Neonatal Nursing, 45(1), 78-89. doi:10.1016/j.jogn.2015.10.008
Hollister, S. (2017, September 6). A Lactation Consultant's Perspective on Placenta Encapsulation [Web log post]. Retrieved September 17, 2017, from https://www.happygoatproductions.com/blog/2017/9/6/a-lactation-consultants-perspective-on-placenta-encapsulation
Gryder, L. K., Young, S. M., Zava, D., Norris, W., Cross, C. L. and Benyshek, D. C. (2017), Effects of Human Maternal Placentophagy on Maternal Postpartum Iron Status: A Randomized, Double-Blind, Placebo-Controlled Pilot Study. Journal of Midwifery & Women's Health, 62: 68–79. doi:10.1111/jmwh.12549
JCM Journal. (2017). Retrieved September 17, 2017, from https://www.journalofchinesemedicine.com/