Plating up placenta
There is little clinical support for women eating their own placenta after giving birth, but it seems to be growing in popularity. Sarah McClymont explores why that might be and what evidence there is of any benefits.
The placenta is a complex organ that acts as an interface between the mother and the fetus. Rich in hormones and nutrients, the placenta performs respiratory, nutritional, excretory, protective and hormonal functions that the developing fetus is unable to carry out for itself (Wylie, 2005).
Although placentophagy is a common maternal instinctive behaviour among non-human mammals (Adanu and Boama, 2011), human placentophagy – the eating of the placenta to ingest the hormones – is much more controversial (Winson and McDonald, 2005).
Many Western obstetricians discourage placentophagy, claiming that it has no benefits. For example, consultant obstetrician Maggie Blott says there is no need for placentophagy as people are already well nourished, unlike animals who eat their placenta for nutrition (Peck, 2013).
Farr et al (2017) say that the ‘presumed nutrients’ contained in the placenta are not present in sufficiently high concentrations to be potentially beneficial to the mother postpartum and found no scientific evidence of any clinical benefit.
Concern has also been expressed at the risk of spreading diseases such as HIV, hepatitis and other blood-borne illnesses (Hayes, 2016). So why is human placentophagy becoming more popular in the UK, with an estimated 4000 women partaking in this practice between 2009 to 2014 (Maxted, 2014)?
Increased media attention and celebrity endorsement appears to be changing people’s perceptions of placentophagy, and professionals trained in encapsulation are reporting an increased demand for the service (Codd, 2012). For example, Mad men star January Jones admitted to consuming her placenta via encapsulation to help with depression and fatigue (Peck, 2013), as did Coleen Rooney following the birth of her third son (BBC, 2016). Such celebrity attention can influence the practice of placentophagy, with some women readily following the actions of their favourite celebrities.
Another indication of the rise in placentophagy is the increased amount of information available through the internet. For example, a search conducted in June 2012 on YouTube using the phrase ‘placenta encapsulation’ returned 97 results (Selander et al, 2013). The same search performed in October 2017 returned 5340 results (YouTube, 2017). The number of websites offering placenta-based services is also growing.
Research has reported potential benefits for placentophagy in non-human mammals, such as increased mother and infant bonding, a neurochemical increase of pain threshold and enhancement of maternal behaviour (Kristal et al, 2012). But researching the benefits to human beings has been a more challenging undertaking; there is a lack of research within this field involving human participants, possibly due to the complex ethical principles.
Any medical research of this nature must adhere to the Declaration of Helsinki (World Medical Association, 2013), which states that all medical research involving human subjects must be based on animal experimentation, if appropriate. Most of the research regarding placentophagy has been conducted on animals, particularly on rats. Although animal research has informed knowledge of placentophagy, it is not representative of human beings. For example, in the case of postnatal depression there is no adequate animal model for a postpartum human (Beacock, 2012). To achieve a better understanding of the benefits to humans regarding placentophagy, there is a need for further research involving people.
Human placentophagy is an emerging field of study. Researchers who have been studying placentas since 2008 include medical anthropologist Daniel Benyshek, doctoral student Sharon Young and graduate teaching assistant Allison Cantor. With Jodi Selander, founder of the organisation Placenta Benefits, they published the first study of human placentophagy that examined women’s motivations and experiences in consuming their placenta (Selander et al, 2013). The study was conducted using the results of a survey of 189 women over the age of 18 who had ingested their placenta after the birth of at least one child. The results regarding the women’s self-reported perceived benefits can be seen in Figure 1 (see overleaf), with 40% of women reporting improved mood.
Prevented or treated anaemia, improved/accelerated recovery, facilitated bonding, increased/improved duration or quality of sleep, reduced pain and facilitated healing/recovery – all were among some of the reported benefits encompassed under the heading ‘other’.
The majority of women reported no negative effects from consuming their placenta. However, some did experience increased uterine cramping and vaginal bleeding, digestive difficulty, hot flushes, excessive lactation, increased heartburn, skin blemishes and nausea. It is difficult to determine if these issues were due to the consumption of the placenta or would have occurred anyway, as there was no comparison group.
Even with the negative effects undergone by some, 98% of participants indicated that they would participate in placentophagy again. With the majority of women reporting benefits and few reporting negative effects, the study indicates that these women had a positive experience from consuming their placenta. Survey methodology has limitations and it is worth noting that these experiences are subjective, a point accepted by the authors of the study.
Consequently, it is not possible to determine if the reported benefits were due to consumption of the placenta or a placebo effect caused by women believing these benefits would occur. The sample size and lack of a comparison group also makes it difficult to draw any clear conclusions. Further research is therefore needed, especially one that utilises a placebo control element.
A randomised, double-blind, placebo-controlled pilot study examining the effects of placentophagy on postpartum iron status found that encapsulated placenta supplementation neither significantly improves nor impairs postpartum maternal iron status compared with the beef placebo (Gryder et al, 2016).
A controlled randomised pilot study recording differences in salivary hormonal levels, and mood, bonding and fatigue in 27 postpartum women who ingested placenta capsules versus a placebo found no significant differences between the groups (Young et al, 2017a; 2017b).
Although scientific evidence is still lacking in the field of placentophagy, some make the claim that ingesting the placenta can prevent postnatal depression. If this claim is supported by research evidence, encapsulation services may become more accepted and reduce some of the cost for treating postnatal depression. A cost analysis would need to be considered in future research studies.
Despite the many claimed benefits of placentophagy, it is unclear whether consumption is advantageous. The placenta is not sterile and elements such as selenium, cadmium, mercury and lead, along with bacteria, have been identified in post-term placental tissues. The potential adverse effects of these elements on the women consuming the placenta is unknown (Coyle et al, 2015).
Additionally, a risk that has not been considered is the safety of placentophagy for smokers. Will harmful chemicals, such as carbon monoxide, that cross the placenta during pregnancy (Wylie, 2005) still remain in the placenta after birth? Research examining the amount of benzpyrene, which can cause cancer (National Cancer Institute, 2018), within placentas found that it was present in the placentas of women who smoked and not detected in those of non-smokers (Welch et al, 1968). Although this research is dated, it still indicates a potential danger to smokers partaking in placentophagy.
Because of the possible presence of dangerous chemicals, it would be unethical to test the effects of consuming a smoker’s placenta on a human participant and any research undertaken in this field would need to be conducted on animals. In the meantime, midwives must ensure that smokers wishing to partake in placentophagy are made aware of the potential dangers until research demonstrates evidence to the contrary.
A further risk that has been identified is the spreading of blood-borne illnesses such as HIV (Hayes, 2016) so placentophagy is not recommended for women with these diseases.
The Centers for Disease Control and Prevention in the US identified the risk of inadequate eradication of infectious pathogens during the encapsulation process. A warning to avoid the intake of placenta capsules was issued following a case in which a newborn infant developed neonatal group B streptococcus sepsis after the mother ingested contaminated placenta capsules (Farr et al, 2017).
None of the reported benefits of placentophagy are supported by scientific evidence. However, some early research findings of women’s experiences suggest there may be some benefits from ingesting their own placenta, and there is a need to undertake controlled research studies to confirm or refute these women’s views. The negative effects and risks associated with placentophagy need further investigation as well as exploration of the cost implications.
Figure 1: Reported positive effects of placentophagy (Selander et al, 2013)
- Improved mood (40%)
- Increased energy (26%)
- Improved lactation (15%)
- Alleviated bleeding (7%)
- Other (12%)
Sarah McClymont is a midwife at Lagan Valley Midwifery-Led Unit in Lisburn, Northern Ireland
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