A case study by the Centers for Disease Control and Prevention (CDC) is raising questions about the safety of a postpartum practice in the natural health community. According to the CDC, a newborn in Oregon became very ill after the mother, who was kept anonymous, began ingesting her placenta in dehydrated, capsule form. The baby had been born healthy, but returned to the hospital shortly after birth with respiratory problems and was eventually diagnosed with group B streptococcus agalactiae bacteremia, or GBS. The infant was treated with antibiotics and returned home only to contract the infection a second time. This is when the mother brought up the placenta capsules she was consuming, prepared from her own placenta by a company she hired. When she stopped taking the capsules and her child was given a second antibiotic treatment, the baby made a complete recovery. The doctors involved in the case believe that the mother contracted the infection from the capsules and then passed it on to her child, who she was breastfeeding. Although only one case, this story is being used by the CDC to educate on the potential risks of ingesting placenta. The difficulty being faced is the fact that very little literature exists on the topic. We did a little digging around, curious if this story was indicative that all placenta ingestion is risky.
“What’s the point?”
For most mothers, ingesting the placenta after birth is done in hopes of easing the symptoms of the postpartum season. Those in favor of the practice believe that ingesting the placenta reduces postpartum bleeding, symptoms of postpartum depression, increases milks supply, and even boosts the mother’s energy. Placenta encapsulation has become more popular recently, but it’s founded in the idea that mammals have always ingested their placenta after birth. “Hundreds of thousands of women have encapsulated their placentas,” says Samantha Moore, certified postpartum placenta specialist and owner of My KC Doula. “Although there is no scientific evidence, there is mounds of anecdotal evidence that women have shared through that years that says, ‘Yes! It really does work!’” It’s the lack of scientific evidence that gives doctors working in obstetrics, like Ira Jaffe, DO, an OB-GYN at Rosh Maternal Fetal Medicine in New York City, pause. Jaffe isn’t convinced of it’s effectiveness, yet chooses not to discourage his patients from taking their placenta home, instead talking with mothers about safety concerns to keep in mind. “It’s not a subject that’s been very rigorously studied, so a lot of the conversation in the medical community is more about extrapolating from things that are known a little more clearly,” he explains. “What most medical professionals will say is ‘What’s the point?’ because there’s no evidence that says it’s helpful.”
Is placenta encapsulation safe?
While the safety of placenta encapsulation is only recently receiving national attention because of the Oregon case, it isn’t a new conversation. Postpartum doulas have long been having this conversation among themselves, criticizing poor practices and advocating for safer placenta storage and preparation.
“This story has definitely opened a lot of people’s eyes to the scariness that can be placenta encapsulation, but it’s important to realize that it doesn’t have to be this way.”
Opponents of placenta encapsulation have certainly used this single story as a means of questioning the safety of the practice entirely. In the CDC’s case study, mind you, it said that no standards exist for the processing of placenta for consumption. That is true, but it also isn’t the nail in the coffin for placenta encapsulation. In fact, for placenta specialists who prioritize safety, this story is considered a blessing, finally starting a national conversation on what safe handling and encapsulation of placenta looks like. “Clearly something is wrong in this industry that needs to be rectified immediately,” says Moore. “This story has definitely opened a lot of people’s eyes to the scariness that can be placenta encapsulation, but it’s important to realize that it doesn’t have to be this way. With proper protocols and safety, it can be a completely safe option for lots of women.”
“Doctors, the CDC, and the [Food and Drug Administration] need to jump on board with some stringent protocol to keep them safe.”
So what does safe placenta encapsulation look like, exactly? For starters, Moore says that the mother should never send her placenta home with someone to encapsulate. Instead, placenta specialists should work in the mother’s home, where the mother is fully aware of the cleanliness of the environment and can observe the entire process. Additionally, anyone who is working with placenta should be blood-borne pathogen trained, according to Moore, which provides a complete understanding of the right way to care for the placenta being processed. There are also basic safety and cleanliness practices that should be observed. For Moore, this means gloves, footies, a hair net, mask, and apron. She also meticulously sanitizes the environment and tools used for encapsulation. When it comes to encapsulating placenta from moms who are group B strep positive, both Moore and Jaffe agree that additional precautions must be taken. Jaffe strongly urges against the use of the placenta in any instance of GBS, while Moore suggests rigorous safety measures before moving forward. “A person that is GBS positive needs to be very careful that [their encapsulator] is upholding the highest safety standards possible,” Moore explains. “If your encapsulator can’t tell you exactly how they process to ensure that there will be no GBS bacteria left in your placenta, you should not hire them!” Instead of demonizing the practice, Moore hopes that this case study with encourage the CDC to promote safe preparation of placentas. “This is a service that women want,” she says. “Doctors, the CDC, and the [Food and Drug Administration] need to jump on board with some stringent protocol to keep them safe. They are doing a disservice to women everywhere by saying ‘don’t do it,’ because women will still do it, and it will continue to be done by pseudo-professionals who are not following safety protocol because they simply don’t know or don’t care.” Jaffe is one such doctor who has taken the stand that, if a woman has decided this is a good option for her, he prefers she know how to safely proceed. He encourages them to carefully research their specialist, to be familiar with the environment in which the placenta will be prepared, and to be willing to say no to placenta encapsulation if they test positive for GBS.
Are there better options?
Erin Heger, mom of one, had her placenta encapsulated by a trusted doula. She hoped to lower her risk for postpartum depression and to support her body in making milk for her baby. Heger admits that she’s fairly certain she wouldn’t try placenta encapsulation again if she decided to have another child. In her mind, it isn’t safety that gives her pause: She’s simply not sure about the benefits. In her case, she felt the benefits were oversold. She felt the natural community she was involved in online had made out placenta encapsulation as the answer for postpartum depression. So, when she began to experience raging anxiety and depression after her son’s birth, she felt ashamed that her placenta capsules didn’t seem to be work, and actually postponed receiving formal treatment for postpartum depression as a result. According to Jaffe, moms who are worried about postpartum depression should consider engaging in strategies that have been proven to work. Specifically, he recommends exercising one-to-three times a week, doing anything possible to get plenty of rest, and avoiding the isolation that is far too common for new moms. “People are left on their own so much in nuclear families with small children, [and] it really challenges the woman in an extreme way,” he says. “I counsel patients to not be afraid to call on family members and friends. If you’re left feeling isolated, then it’s going to leave you feeling much more vulnerable to a serious clinical depression.” Medication is something that some moms should be open to. It isn’t always necessary, especially among moms who are simply experiencing mood changes typical to new motherhood; women with a history of depression, however, should prepare themselves for the possibility of needing extra support in the form of anti-depressants. It’s important to point out that doulas like Moore are not selling placenta encapsulation as a cure-all for depression. In fact, most take postpartum depression seriously enough to encourage the involvement of an OB-GYN or mental health professional. Moore not only encourages her clients to care for themselves in the postpartum period, she insists they speak with their care provider in the instance that depression or anxiety is becoming an issue. “As a postpartum placenta specialist, it’s a very important part of our training that we never suggest that placenta [capsules] are a postpartum depression medication,” she explains. “I am more than happy to perform the service and help them through the process as they choose, but my role as a postpartum doula and postpartum placenta specialist is very clear … .I am not a mental health professional.”