Shining Light Prenatal Education

Ok, well technically, the placenta is the baby’s since it shares his DNA… but I digress.

Placenta with amniotic sac and umbilical cord

There’s been quite a bit in the news this week about placenta eating.  Mad Men star, January Jones let it be known that she consumed her encapsulated placenta after her baby was born, per her doula’s suggestion.  The original article was in People Magazine “Jones’s secret to staying high energy through the grueling shooting schedule? ‘I have a great doula who makes sure I’m eating well, with vitamins and teas, and with placenta capsulation.’” 

The Huffington Post comments cite both pro and con views of placenta eating.

The Daily Mail UK says, Ayla Yavin, a Chinese herbalist and acupuncturist specialising in women’s health who also used to be a doula told MailOnline: ‘You spend nine months building the placenta and then when your baby is born you lose a huge amount of blood.’ The New York-based specialist went on to say: ‘Eating the placenta is good for a few reasons. ‘The placenta contains high levels of oxytocin – the ‘love’ hormone that stimulates milk production and helps the uterus contract to its normal size again.”

However there are flaws with this statement.  Let’s look at the science for a moment.  “Huge amount of blood loss”.  According to Science & Sensibility “Our body has built up a large store of blood during pregnancy, called by some a vascular reserve.  It is physiologically necessary for us to expel some of it during the time period from right birth into the next few weeks.  If the mother loses around 500 mL, she is likely to feel similarly to how she might feel when giving blood, and will need to sit or lie down, eat, and rest.  If a mother has one or more of the risk factors shared above, though, she might lose closer to between 1,000 – 2,499 mL of blood at birth.  Many experts use a threshold of 1,000 mL for healthy women in affluent societies, noting that they can tolerate blood loss of around 1,000 mL without decompensating.  (Walsh)  Goer shares that, ‘According to William’s Obstetrics, the obstetric bible, healthy postpartum women don’t begin to show actual symptoms of excessive blood loss until they have lost around 1500mL.’”

Hmm… so that means its normal to lose a certain amount of blood at birth, because the body has built up its stores.  The number quoted is usually “a pregnant mother has 1.5 times her normal blood volume with a single baby, or 2 times the blood volume with multiples.”  So, our bodies have already compensated for the blood loss by having more blood to begin with.

The Daily Mail says ‘The placenta contains high levels of oxytocin – the ‘love’ hormone that stimulates milk production and helps the uterus contract to its normal size again.”

Except that prolactin is the milk production hormone, not oxytocin.  Prolactin release is stimulated by birth, and by the baby sucking on the nipple.  There is some prolactin in the body during pregnancy and since it is circulated in the blood, some of it will get to the placenta.  However rates of prolactin rise dramatically after birth so that in a few days colostrum will disappear and mom’s milk will come in.

Yes, oxytocin is present in the placenta… but how much of it is destroyed during the cooking or dehydrating process.  No one knows because there are no studies on this.  How much of any of the hormones or nutrients are destroyed during cooking or dehydrating?  Again, no one knows.

There is talk about the hormone shift postpartum, as if this is a bad thing.  It is mom’s body moving from a pregnant state, where she needs certain hormones to sustain the pregnancy, to the non-pregnant state where she no longer needs the high hormone levels.  This is normal.  Some women will experience the “baby blues”, postpartum depression, or rarely, postpartum psychosis.  This is mostly due to the hormone shift, however, there are compounding external factors such as lack of sleep, improper diet, stress of caring for a newborn and relationship stress, etc.

We don’t want moms to suffer with PPD.  We do know that taking care of the external factors will help alleviate some of it.  We know that having good support at home, whether husband, grandma, postpartum doula, or a myriad of friends can help alleviate some of it.  We know that getting out of the house, being social, and doing ‘normal’ things can help too.  Talk therapy can be helpful, and in severe cases, medication.

Placenta is also used to control postpartum hemorrhage. By cutting off a small piece of placenta and asking mom to suck on it, or eat it, as her care provider is trying to control the bleeding.  However, this is used in conjunction with other techniques, such as uterine massage, to control bleeding.  So where is the bleeding control coming from?  Tough to tell if we use more than one method, and no one I know is going to try to wait to see if just the placenta is working when mom’s life is on the line from hemorrhage!

So, a quick list of the uses of placenta for mother’s benefit:

• Control postpartum hemorrhage
• Reduce or eliminate postpartum depression
• Even out mother’s moods
• Balance hormones
• Restore mother’s iron levels
• Help increase mother’s milk supply
• Increase energy levels

How can placenta be consumed?

• Eaten raw
• Cooked in a stew or stir fry
• Made into a tincture
• Dehydrated and put into smoothies
• Dehydrated and encapsulated in pill form
• I know there are other recipes but these are the most common ones.

Does it really help any of the above things?  The answer… wait for it… wait for it… maybe, but we don’t know.  A bit of a bummer, that.  Show me the science!

The studies we do have are mostly anthropological or animal studies.  We know that certain groups of peoples have consumed placenta.  We know that most of the other groups of peoples do not.  We know that most mammals consume their placentas, but some mammals do not.

We have NO studies on the benefits of human placenta consumption.  None.  There are two studies often cited for this.  The first is “Placenta as Lactagagon” Soykova-Pachnerova E, et. al.(1954). Gynaecologia 138(6):617-627.  Thing one to note is the date… 1954.  This is not what I’d call a recent study.  Thing two… I’ve read it.  Sadly, this isn’t actually a study.  There is no control group of non-placenta consuming mothers.  There is no control within the group for outside factors (1^st baby vs. subsequent, diet, demographics, etc.).  Thing three – very small sample size.  It is inappropriate to cite this as “proof” because, well, it isn’t a study.

The other study cited commonly is “Placentophagia: A Biobehavioral Enigma” KRISTAL, M. B. NEUROSCI. BIOBEHAV. REV. 4(2) 141-150, 1980 is an anthropological study.  It does not look at the benefits or biology of consuming placenta.  I’ve read this one too… all 20 pages of it….

I’ll say it again – there is NO study on the benefits of humans consuming placenta postpartum.  I would LOVE to see a study on human placenta consumption.  If you find one, please cite it for me!  I’d be glad to be wrong on this one.

So, what we have is anecdotal evidence from mothers who have consumed placenta and care providers who witness the effects.  My question then becomes is the benefit we see in the mother after consuming placenta because she has consumed it, or is this placebo effect?  Regardless of which it is, as far as I can tell there is no harm in it (other than grossing out your friends!).  If there is no harm, and there is a potential benefit, whether real or placebo, then I say go for it.  Just have the understanding that this is not an evidence based practice… yet.