Attitudes Toward Placentophagy: A Brief Report

No. 378-Placentophagy

Consumption of human placenta has recently been highlighted; however, there is no evidence of benefit from its consumption. In addition, there is potential for harm. Therefore the SOGC does not recommend the practice of placentophagy.

Birth, attitudes and placentophagy: a thematic discourse analysis of discussions on UK parenting forums

BACKGROUND

The post-partum consumption of the placenta by the mother (placentophagy) has been practiced since the 1970s in the global North and is seemingly increasing in popularity. Maternal placentophagy is not known to have been practiced in any other time period or culture, despite being near-ubiquitous in other placental mammals. An in-depth qualitative exploration as to the reasons for the practice, its increasing popularity and how it is narratively incorporated into discourses surrounding "ideal" natural and medical births are given in this paper.

METHODS

1752 posts from 956 users across 85 threads from the parenting forums Mumsnet and Netmums were identified for inclusion. A thematic discourse analysis was performed using NVivo.

RESULTS

Three main themes were identified: women recounted predominantly positive attitudes towards their own experiences of placentophagy, and they were respectful of others' views and experiences; some had negative views, particularly around the concept of disgust, but again, they were respectful of others' experiences. By far the most common method of consumption of the placenta was encapsulation.

CONCLUSIONS

This paper identifies the motivation for placentophagy to almost universally be for medical benefits, most commonly the prevention or treatment of post-natal depression (PND). Whilst disgust is a common reaction, discussion of risks is rare, and positive experiences outweigh negative ones. The increasing popularity of the practice is ascribed in part to the comparative palatability of encapsulation and the use of the internet to share resources and remove barriers. Parenting forums are important spaces to negotiate normative birth practices, including placentophagy, and act to build communities of women who value personal experience over medical evidence and highly value personal choice and bodily autonomy. Placentophagy is discussed in terms of its relation to natural and medical births with arguments being made using both discourses for and against the practice. This paper argues that placentophagy is practiced as a resistance to medicalisation as an assertion of control by the mother, whilst simultaneously being a medicalised phenomenon itself.

Birthing the placenta: women's decisions and experiences

BACKGROUND

Previous research examining the birth of the placenta has focussed on quantitative outcomes comparing active and expectant (physiological) management. However, it is also important to understand women's experiences of birthing the placenta.

METHODS

The participant group consisted of 11 women who had expectant management, eight who had active management and one who was unsure. Participants were interviewed in-depth and the data analysed using thematic analysis.

RESULTS

Seven themes were identified in the data relating to before, during and after the birth of the placenta. Before birth themes focused on making decisions and included 'doing the research' and 'natural birth'. During the birth of the placenta themes were 'boundaries of time', 'focusing on baby' and 'sensations'. After the birth themes consisted of 'looking' and 'keeping'.

CONCLUSION

Most of the women considered a physiological birth of the placenta to be an intrinsic element of natural birth. Active management was considered to be an intervention used if complications occurred. In contrast, women who chose active management did not consider the placenta to be an important element of natural birth, and chose active management in order to prevent complications. Decisions about birthing the placenta were informed by Internet sources and previous personal experiences rather than care providers. During the birth of the placenta care providers managed the boundaries of time whilst women focused on their baby. The sensations women described were consistent across both types of management. Women valued seeing their placenta and having the opportunity to keep it, and placenta encapsulation was popular. The findings of this study contribute the experiences of women to the body of knowledge informing practice during the birth of the placenta.

Placentophagy among women planning community births in the United States: Frequency, rationale, and associated neonatal outcomes

BACKGROUND

Limited systematic research on maternal placentophagy is available to maternity care providers whose clients/patients may be considering this increasingly popular practice. Our purpose was to characterize the practice of placentophagy and its attendant neonatal outcomes among a large sample of women in the United States.

METHODS

We used a medical records-based data set (n = 23 242) containing pregnancy, birth, and postpartum information for women who planned community births. We used logistic regression to determine demographic and clinical predictors of placentophagy. Finally, we compared neonatal outcomes (hospitalization, neonatal intensive unit admission, or neonatal death in the first 6 weeks) between placenta consumers and nonconsumers, and participants who consumed placenta raw vs cooked.

RESULTS

Nearly one-third (30.8%) of women consumed their placenta. Consumers were more likely to have reported pregravid anxiety or depression compared with nonconsumers. Most (85.3%) placentophagic mothers consumed their placentas in encapsulated form, and nearly half (48.4%) consumed capsules containing dehydrated, uncooked placenta. Placentophagy was not associated with any adverse neonatal outcomes. Women with home births were more likely to engage in placentophagy than women with birth center births. The most common reason given (73.1%) for engaging in placentophagy was to prevent postpartum depression. [Corrections added on 16 May 2018, after first online publication: The percentage values in the Results sections were updated.] CONCLUSIONS: The majority of women consumed their placentas in uncooked/encapsulated form and hoping to avoid postpartum depression, although no evidence currently exists to support this strategy. Preparation technique (cooked vs uncooked) did not influence adverse neonatal outcomes. Maternity care providers should discuss the range of options available to prevent/treat postpartum depression, in addition to current evidence with respect to the safety of placentophagy.

The Fascinating and Complex Role of the Placenta in Pregnancy and Fetal Well-being

Existing evidence implicates the placenta as the origin of some common pregnancy complications. Moreover, some maternal conditions, such as inadequate nutrition, diabetes, and obesity, are known to adversely affect placental function, with subsequent negative impact on the fetus and newborn. The placenta may also contribute to fetal programming with health consequences into adulthood, such as cardiovascular, metabolic, and mental health disorders. There is evidence that altered placental development, specifically impaired trophoblast invasion and spiral artery remodeling in the first trimester, is the origin of preeclampsia. Prenatal care providers who understand the relationships between placental health and maternal-newborn health can better inform and guide women to optimize health early in pregnancy and prior to conception. This article reviews the current understanding of placental function; placental contributions to normal fetal brain development and timing of birth; and impact of maternal nutrition, obesity, and diabetes on the placenta.

Perspectives from Patients and Healthcare Providers on the Practice of Maternal Placentophagy

PURPOSE

Placentophagy (maternal consumption of the placenta) has become increasingly prevalent in the past decade among women seeking to promote health and healing during the postpartum period. The purpose of this study was to assess patient and provider familiarity with and attitudes toward placentophagy, as well as patients' willingness to try placentophagy.

METHODS

Two cross-sectional surveys with questions regarding placentophagy practice were distributed to healthcare providers and patients. The provider survey was distributed via email listservers to international perinatal professional organizations and to obstetrics and gynecology, nurse midwifery, family medicine, and psychiatry departments at three urban hospitals. Patient surveys were administered in person at an urban hospital in Chicago, Illinois.

RESULTS

Approximately two thirds (66%; n = 100) of patients and most (89%; n = 161) of providers were familiar with placentophagy. Patients with a history of a self-reported mental health disorder were more likely to be willing to consider placentophagy and to believe that healthcare providers should discuss it with their patients.

CONCLUSIONS

Most providers and patients have heard of placentophagy but are unsure of its benefits and/or risks. Further research examining the potential therapeutic efficacy and/or risks of placentophagy is needed.

A Literature Review on the Practice of Placentophagia

Placentophagia (consuming the placenta) has historically not been a common practice among humans. Over the past few decades the practice has gained attention as more women, particularly educated, middle-class, White American women, choose to partake in this practice. Purported benefits of placentophagia include pain relief, increased breast milk production, and decreased risk of postpartum depression; however, there is a lack of evidence to support these claims. The placenta can be consumed raw, cooked, or encapsulated; it can be used for keepsakes; or it can be used to make topical applications such as dermatologic creams and hair-growth products. Placentophagia has typically been viewed as a personal choice, resulting in little rigorous scientific research on the topic. More research is necessary to determine if the purported health benefits of placentophagia are proven.

Placentophagy: therapeutic miracle or myth?

Postpartum women are consuming their placentas encapsulated, cooked, and raw for the prevention of postpartum depression (PPD), pain relief, and other health benefits. Placentophagy is supported by health advocates who assert that the placenta retains hormones and nutrients that are beneficial to the mother. A computerized search was conducted using PubMed, Medline Ovid, and PsychINFO between January 1950 and January 2014. Keywords included placentophagy, placentophagia, maternal placentophagia, maternal placentophagy, human placentophagia, and human placentophagy. A total of 49 articles were identified. Empirical studies of human or animal consumption of human placentas were included. Editorial commentaries were excluded. Animal placentophagy studies were chosen based on their relevance to human practice. Ten articles (four human, six animal) were selected for inclusion. A minority of women in developed countries perceive placentophagy to reduce PPD risk and enhance recovery. Experimental animal research in support of pain reduction has not been applied in humans. Studies investigating placenta consumption for facilitating uterine contraction, resumption of normal cyclic estrogen cycle, and milk production are inconclusive. The health benefits and risks of placentophagy require further investigation of the retained contents of raw, cooked, and encapsulated placenta and its effects on the postpartum woman.

Origin stories from a regional placenta tissue collection

Twenty-three years ago when women and their children were recruited to a longitudinal genetic epidemiological study during pregnancy, placentas were collected at birth. This paper explores the history of a regional placenta biobank and contemporary understandings of its value for the constitution of a research population. We draw on interviews with some of the mothers and those responsible for the establishment and curation of the placenta collection in order to explore the significance and meaning of the collection for them. Given its capacity to stand in for the study cohort of mothers and children, we argue that the material significance of the placenta biobank as a research tool seems far less important than the work it does in constituting a population. The stories about this collection may be understood within the wider context of developments in biobanking and the bioeconomy.