Let me start by saying I support my doula sisters who make a few extra bucks by encapsulating placentas. Doulas/Childbirth Educators are always hopefully learning some things from each other, either in real life or this wild world of cyber support via blogs, social media, email forums, etc. We wrap our loving arms around each other in times of need, we offer each other our experiences, suggestions, etc, but we also keep each other in check. We provide accountability for each other. Usually it's done with gentleness and understanding. So I want to be careful because I believe with all my heart that most of us, while we make a little income from our important work with families, truly are in it for the love of supporting moms and babies. I cannot shake this feeling of needing to speak up about something that's been bugging me for a while. I do not mind placenta encapsulators advertising their business, but what I do mind is them stating that there is 'research' supporting the benefits of encapsulation. In particular, regarding the reduction of post partum depression and increase of milk production, though especially the former is really bugging me lately. This is a serious claim, on a serious issue. This can and IS giving moms the impression that there is actually evidence supporting that their dried and crushed placenta taken in pill form can prevent them from getting a PPMD. There is no such evidence that I'm aware of. And I've been told by PE, "YES THERE IS - here's the links! Smiley face" Many times, similar posts show up on these various groups. I've looked at everything they've provided and called 'evidence' before - it was not. It is all based on hypothesis. And I don't think it's an unreasonable one either, I just have a problem with how it's being presented sometimes. I know I'm not the only one thinking it. I know a handful of local doulas, even some who encapsulate or have in the past, who agree with me! I read some of these links and think, "You're kidding, right?" This 'research' says things about women quite possibly lacking iron after the expulsion of the placenta and this is the cause of PPMD. Or similarly, the release of all the hormones in the placenta is the cause of it. But none of these links are studies showing that the consumption of the placenta fixes this hypothetical cause of PPMD, let alone consumption through capsules. Some encapsulators are making a great business out of it, too. Teaching classes to other birth professionals on the how to's - there's one coming to Philly soon. Thank goodness for it, honestly, because initially, women were out there bringing other women's blood products into their own homes with not nearly as much information on safe handling or various processing techniques. What this class is going to cover sounds great. And to be perfectly clear - I support my doula sisters who encapsulate, I refer my clients out for this service if they want it, I have my own encapsulated placenta in my freezer, and I understand the theories and why it makes sense. However, can't we just be more upfront with moms about what this 'research' actually says? When I click through to the educator's beautiful website, I don't see any grandiose claims, but I do notice a some resource links on the left side of her site on 'scientific research' and 'benefits' - however, none of the links open to anything. A recent post on a social media site shows a question from a mom asking if there was any scientific evidence for doing placental encapsulation to prevent PPD. Not to my surprise, again, some PE and maybe some other moms pop in with these links that say nothing of what she's asking. I posted this quote from one of the better articles cited. "Evidence is limited in the areas regarding specific hormones and nutrients a placenta may offer, proposed benefits for nutrition, and prevention of postnatal depression and increased lactation. Interestingly, these are the primary reasons sited to support placentophagy." (Beacock, 2012) - From a British Medical Journal article. Some of these articles, from what I've read of the ones that actually studied something related to placentophagy, seem to say that there are hypotheses and theories based on the components in placenta being able to bridge the gap in terms of hormones lost after expulsion of placenta, however, it is stated more than once that 'evidence is absent'. So, to end, I do not believe there is research that specifically supports placenta ingestion through capsule form being proven to reduce PPD. Anecdotally, amongst my clients and many others I know who've ingested their placenta pills, there are mixed reviews. The reason for that could be many. I just ask that if you are advertising your placenta services, teaching how to encapsulate, or simply commenting on posts like the one mentioned, be very upfront with moms about what research actually says and does not say. Be clear about what is anecdotal, what is theory, what is your opinion, experience, and the limited research there is on anything regarding placental ingestion for treatment or prevention of anything. People will still choose it without having to be led to believe there is scientific evidence supporting it. ~
How's this for informed consent? First time mom says to her favorite doctor at 38 wk check up,
"I'm getting pretty uncomfortable but I really don't want to be induced because I heard it makes things harder" OB response, "1)The nice thing about inductions is you can not only plan your baby's birth into your schedule without the risk of surprise or something going wrong before you make it to the hospital in labor but you also get to assure I'll be the doctor delivering you. (He also reminds her that she won't have to push out as big of a baby either) and 2) We are only giving you the hormone your body makes itself, so it's not going to be any 'harder'. Labor is hard. We have epidurals for that." Mom is surprised how much the answer eases her mind despite everything she's been reading - and feeling much more in control now, says, "As long as it doesn't increase my risk for having a csection, because I definitely don't want that... when is the soonest we can do it?" Doc responds, "The ones coming in with Birth Plans increase their chance of cesarean. (chuckles) You'll be fine. Let's do next Wednesday, you'll be 39 wks and a few days - policy changes - I have to wait until at least 38 wks now no matter how uncomfortable you are."
SO. MANY. PROBLEMS. WITH. THIS. Where to even begin? Now, I feel pretty comfortable in my knowledge base of the evidence as well as ACOG guidelines, etc., so there are a few things glaring at me that I want to JUMP on... big time. But I fear if I start to address each untruth and danger within this OB's responses, I will write a book tonight, not a blog post! And frankly, I don't have the time! Ok, Breathe. In....all things good and right in the world, Out....all things &U#&$$*ed up....ok, again....nice and deep and slow. Repeat.
Ok. If this was your sister, friend, or anyone you cared about - what would you say to keep it short and simple!?!? For you doulas and childbirth educator's out there - what information would you be sure to relay to this client/student?
I tend to think that if I was involved with this woman either professionally or personally I might start with this:
I realize we can't save every woman and baby from similar doctors who are, believe me, absolutely still out there practicing in a hospital near you - but, if you heard a similar conversation being relayed to you, WHAT DO YOU SAY? And why do you speak up or not? I'm curious of the different perspectives on this topic.