I saved the best for last.  Asking the hospital staff to avoid episiotomy was a pretty standard request; and to delay cord clamping after birth like I’d asked was becoming more and more common.  The eyebrows arched when it came to keeping the placenta so that it could be taken to the specialized herbalist and encapsulated.

As proof that this was not a gag, I brandished heavy-duty zip-lock bags and a small cooler with cold-packs ready for the storage and transport operation, along with coordinates of the Placenta Encapsulation Service.  The arched eyebrow turned to mild disbelief.  I’d just scored off-the-scale on the Crunch-O-Meter and there was no warning in my medical file.  Obviously no one admitted here had ever requested a lotus birth… (If you don’t know what a lotus birth is, you can read about it here: http://www.lotusbirth.net/)

‘’I’m not sure what our policy is on that,’’ the nurse replied.  ‘’We’ll discuss it and I’ll get back to you.’’  Now my sister, who’s a nurse herself, would have given quite a bit to be a fly on the wall of the station as they discussed that one.  On my side, I was too busy being in pain and puking between contractions to care very much what they thought of the weird granola chick in room 11.  I just had the hospital ombudsman on speed-dial in case they tried to come between me and my placenta.

Ultimately I never did have any trouble getting the mass of bloody tissue released.  The nurse eventually returned and replied that in fail of an official hospital policy on the subject, the attending staff had decided that they would simply ‘’forget’’ the placenta in the room after the birth.  From there we could do what we wanted with it.

For those who are a bit rusty on their human biology, the placenta is the sack that a child is gestated in.  It provides safety and nourishment to the foetus via the umbilical cord and is ejected from the body during the birthing process, usually soon after the baby has been delivered.  In many cultures throughout the world, there is a ritual disposal of the placenta (Kristal 1980; Young & Benyshek 2010) although in America it is most often disposed of with biomedical waste following a short stay in histology.

In the animal world, pretty much all mammals except for humans, camelids and some aquatic species eat the placenta once it’s expelled from the uterus (Kristal 1980; Young & Benyshek 2010; Kristal & Al. 2012).  This is known as placentophagy or placentophagia in case you wanted your Jeopardy word of the week (I doubt you’ll find anywhere else to use it in polite conversation).   There are a number of competing theories as to why animals display the behaviour but long story short, the actual reason behind it remains unknown (Kristal 1980; Young & Benyshek 2010; Kristal & Al. 2012) no matter how much cruel and unusual rat testing is done on the subject (Kristal & Al, amongst too many others).

Contrary to what is implied in the text of some pro-eat-your-placenta sites and forums, there is actually no historical human precedent for such action in the long lost past, save perhaps in some undocumented and speculative prehistory (Young & Benyshek 2010; Ober 1979).  Its use as a potential medicine (not usually for the mother however) is documented in a few different cultures, most notably in China (Young & Benyshek 2010; Ober 1979).  But the fad of a mother consuming her own placenta has only been gaining popularity, and notoriety, since the 1970’s (Selander & Al. 2013; Young & Benyshek 2010).  And just in case anyone objects, being on the placenta-popping band-wagon myself, I reserve the right to call it a fad.

The best-documented use in medicine comes to us from Traditional Chinese Medecine (TCM) where the organ is valued as a Yang Tonic.  Known as Zi He Che, it is specific for ‘’Deficiency of Qi…with symptoms of fatigue…insufficient lactation and Blood Deficiency’’ or for ‘’Deficiency of the Liver and Kidneys with symptoms of infertility, impotence…lower back pain…and vertigo (Tierra & Tierra 1998).’’

When a placenta is prepared for use in TCM, it is usually steamed and then sliced and dehydrated.  The slices can then be decocted along with other herbs (tang) or powdered (san) and made into pills (wan).  Encapsulated powder from placenta prepared in the TCM or in another heat-treated manner is the most popular method of consumption in contemporary human placentophagy, mostly because it results in a significant reduction of the ick-factor (Selander & Al. 2013).

According to survey results on the subject, most women who do engage in the practice find the experience an overwhelmingly positive one and report a multitude of physical and psychological benefits (Selander & Al. 2013).  I personally found this to be true as well, although in my case the placenta supplements were included in a more global post-partum herbal strategy.  This does raise the question of what exactly is in the placenta that makes it effective.

Turns out, not much.

Conclusions of nutritional and hormonal analysis of heat-treated placentae show that the amount of hormones contained are insignificant medicinally (Phuapradit & Al. 2000).  In the nutrient department they show high levels of iron, potassium, phosphorus and sodium, but you have to qualify ‘’high’’: we’re talking well below the usual supplemental level (Phuapradit & Al. 2000).  If you consider potassium for instance, you’ll get about 8.5mg of it per 1000mg dose of placenta (a standard daily dose).  There’s 50 times more potassium in your average baked potato (Nutrient Data Laboratory 2001).  So on a whole, your dehydrated placenta is a pretty good protein powder with questionable taste and smell.  Oh yeah – and a tendency to make you burp.

On a slightly relevant tangent, if one looks at many of the herbs listed in the Chinese materia medica for the purposes of tonifying Yin, Yang and nourishing Essence, there are a great many stranger items that would probably not stand the test of Western-style scientific scrutiny.  Amongst them (Tierra & Tierra 1998):

• Deer Antler (Lu Rong) – tonifies Yang and augments Essence
• Gecko Lizard (Ge Jie) – augments Essence
• Seal and sea lion genitals (Hai Gou Shen) – tonifies Kidney Yang and replenishes Essence
• Sea Horse (Hai Ma) – tonifies Kidney Yang
• Fresh Water Turtle Shell (Gui Ban) – nourishes Yin
• Tortoise Shell (Bie Ja) – nourishes Yin

Like Placenta, they seem to yield results in many cases although it begs to be answered if a double-blind randomized controlled trial would show any of these substances to be more effective than placebo.  One has to wonder if it isn’t simply the placebo effect we’re seeing a very fine example of.  And it is interesting that placebo or no, myself as well as a majority of moms having consumed placenta would be up to replay the experience in future pregnancies (Selander & Al. 2013).

But then, homeopathy is still a lucrative industry with zealous supporters despite rigorous scientific study having proven it no better than an equivalent dose of sugar pill (Goldacre 2008).  In much the same way, useful or not, placentophagy will probably also maintain its devotees.

To a large extent I’m curious about wether it’s the symbolism of the remedy rather than its medicinal properties that makes it work.  It’s worth considering given that the physiology of Yang, Yin and Essence are ”philosophical” or ”conceptual” rather than physical.  They do not have a correspondence in Western Medical vocabulary or thinking, and are far more qualitative and intangible than modern research allows for in quantifiable terms. I am nonetheless aware that this amounts to a purely psychosomatic cure from a scientist’s point of view.

There is precedent for this symbolic type of remedy in many pre-industrial cultures however, where medical and ”magical” or ”esoteric” herbalism are combined into a single functional system (Ober 1979).  Those systems address the culturally-defined physiological understanding of their society which often differs significantly from those terms and principles we take for granted in North America.

But I’ll let Dr. Daniel Benyshek be the Scully to my Mulder and wisely conclude that ”if we are to most fully understand precisely what human placentophagy might and might not do for new moms, it will be by utilizing the epistemology and methodology of science, in ways traditions such as…TCM simply don’t allow.”

 

References:

Benyshek, Daniel C (2014).  Personal correspondence.

Goldacre, Ben.  Bad Science: Quacks, Hacks and Big Pharma Flacks.  Emblem Publishing, 2011. 30-64

Kristal, Mark B. (1980): Placentophagia: A Biobehavioural Enigma. Neuroscience and Biobehavioral Reviews, Vol. 4, 141-150 (http://api.ning.com/files/EfX4**M*LKKhLNZJzSwl7XAdrLgSECTTufJGGhny1N*hdJIIIKz09lI9kEKSt1ajFFxp54pDIaCuW6oyRBzsyrU1cPm7QEDt/Kristal_biobehavioral.pdf)

Kristal, Mark B., Jean M. DiPirro & Alexis C. Thompson (2012): Placentophagia in Humans and Nonhuman Mammals : Causes and Consequences. Ecology of Food and Nutrition, 51:3, 177-197 (http://www.acsu.buffalo.edu/~kristal/placentophagia%20review.pdf)

Nutrient Data Laboratory, ARS, USDA (2001): National Food and Nutrient Analysis Program Wave 5L & 5e.

Ober, William B. (1979): Notes on Placentophagy. Bulletin of the New York Academy of Medecine, 55:6, 591-99(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1807646/pdf/bullnyacadmed00120-0063.pdf)

Phuapradit W., B. Chanrachakul, P. Thuvasethakul, S. Leelaphiwat, S. Sassanarakkit, S. Chanworachaikul  (2000): Nutrients and Hormones in Heat-Dried Human Placenta. Journal of the Medical Association of Thailand, 83:6, 690-94

Selander, Jodi, Allison Cantor , Sharon M. Young & Daniel C. Benyshek (2013): Human Maternal Placentophagy: A Survey of Self-Reported Motivations and Experiences Associated with Placenta Consumption. Ecology of Food and Nutrition, 52:2, 93-115(http://news.unlv.edu/sites/default/files/EFN%20Placentophagy%20Survey%20(Selander,%20Cantor,%20Young%20and%20Benyshek%202013).pdf)

Tierra, Michael & Lesley Tierra. Chinese Traditional Herbal Medecine,Vol. II: Materia Medica and Herbal Resource.  Lotus Press, 1998. 216-17

Young, Sharon M. & Daniel C. Benyshek (2010): In Search of Human Placentophagy: A Cross-Cultural Survey of Human Placenta Consumption, Disposal Practices and Cultural Beliefs. Ecology of Food and Nutrition, 49:6, 467-84 (http://www.lucina.ca/plresearch/In%20search%20of%20human%20placentophagy%202010.pdf)