Placenta Encapsulation: Myth or Miracle?
Placenta ‘medicine’ has emerged as a ‘remedy’ for all that ails you postpartum (and apparently in menopause too).
Out of curiosity, 13 years ago I encapsulated my son’s placenta. Full disclosure (In truth it was my husband who encapsulated the placenta with a little persuasion as I was busy feeding Cooper). I wanted to see if it did what it says on the tin. The PE industry claims that placenta encapsulation is a preventative measure for PPD so I think it’s something that merits an open discussion especially given the lack of evidence around it but abundance of anecdotal reports. Interestingly in studies most women decided to encapsulate their placenta to improve their mood.
"Reported benefits of placentophagy include prevention of PPD, pain reduction, and increased milk production and energy. Other benefits proposed are the reduction of postpartum bleeding, more rapid uterine recovery, enhanced maternal bonding, and boosting of the immune system”
Along with antibiotics more women are questioning the routine over prescribing of antidepressants for low mood in postpartum but now we seem to be attempting to replace the chemical ‘quick fix’ (antidepressants) with another quick fix - placenta pills. ***Note some women will benefit from antidepressants who have found other treatments unsuccessful).
Every website I visited stated “placenta encapsulation is believed to alleviate symptoms of PPD”. I certainly had no signs of depression… no milk supply issues for my 10lb+ hungry little boy…….but I also had a very different birth experience this time around…lots of great support…no history of depression… It’s almost taboo to put placebo and placenta pills in the same sentence but we need to talk about it as there are no studies to support it’s use and not all mammals consume their placenta and there is some disagreement about it’s use in TCM.
The most common reason given (73.1%) for engaging in placentophagy was to prevent postpartum depression. Our findings also indicate that primiparous women, and those with a history of anxiety and depression, are more likely to engage in the practice. Indeed, the largest proportion of placentophagic women in our sample did so in hopes of avoiding postpartum depression, though no evidence currently exists to support this strategy. (Birth Volume 45, Issue 4Dec 2018 Pages 329-489).
The placebo effect is very powerful.
In a study of asthmatics, researchers found that they could produce dilation of the airways by simply leading people to believe that they were inhaling a bronchodilator, even when they weren’t.
Patients suffering pain after wisdom-tooth extraction got just as much relief from a fake use of ultrasound as from a real one, so long as both patient and therapist thought the machine was on.
Fifty-two percent of the colitis patients treated with placebo in 11 different trials reported feeling better – and 50 percent of the inflamed intestines actually looked better when assessed. (“The Placebo Prescription” by Margaret Talbot, New York Times Magazine).
Even the color of the pill you take has an impact on how effective it will be. Placebos taken four times a day deliver greater relief than those taken twice a day.
Some researchers feel that part of the placebo effect comes from the way the pills are administered i.e. a caring, supportive, attentive doula/midwife. Would placenta pills be as effective if they were bought OTC in your local supermarket?
Does it matter if the effects of placenta pills is placebo?
Not really…… especially if a mom experiences only positive side effects. Jack Newman pediatrician and breastfeeding guru recently suggested that placenta pills may reduce milk supply in women already experiencing difficulties with breastfeeding supply issues. It’s estimated that the placebo effect works about 30% of the time so what about the potential 70% that it doesn’t work for? If we are to provide our clients with unbiased information based on empirical evidence there must be an open discussion of the potential negative side effects (If you are considering this as an option for you notice how the negative side effects are presented on the service provider’s website - how unbiased is it?)
“Thematic analysis of participant responses regarding negative perceived effects of placentophagy revealed the following categories: unpleasant taste or smell of placenta/capsules (including belching); difficulty remembering to take capsules; increased uterine cramping; increased vaginal bleeding; limited supply of capsules (i.e., the amount of capsules did not last through the postpartum recovery period); digestive difficulty (i.e., the capsules caused upset stomach, or other digestive complications); contraindicated with infection (i.e., inability to take capsules while treating an infection); increased frequency/intensity of hot flashes; affected infant (i.e., the baby developed a skin rash); inconvenient preparation process; social stigma (from friends, family or themselves); developed mastitis; affected mood (i.e., increased anxiety or excessive energy); increased nausea; excessive lactation; increased constipation; increased heartburn; increased skin blemishes; cost to encapsulate; no negative effects reported.”**
“Despite the many claimed benefits of placentophagy, it is unclear whether consumption of the placenta is advantageous. Due to in utero or post-birth contamination bacteria or viruses may remain within post-term placental tissues. The potential adverse effects of these components of the placenta on the postpartum consumer and nursing infant are unknown. Despite the amount of information available to the public on the therapeutic benefits of placentophagy, there is no scientific evidence examining its effects in humans, and the data from animals are inconclusive.”***
Current evidence suggests that PPD is more likely to occur if mom has had previous PPD or depression prenatally so it makes sense that we take a ‘big picture’ approach to this debilitating condition and help moms reduce their risk of PPD during their pregnancy. As most of the placenta encapsulators are birth professionals there’s a lot we can all do in our work to support mum’s mental health that is based on solid evidence starting IN pregnancy.
PPD/PND can happen to anyone, but some moms are at more risk than others. The single biggest risk factor in developing PPD is a previous history of depression. Other risk factors include:
· Poor social support
· Additional stressful life events
· Early loss of own mother
· Concern for own health or baby’s health
· Early and/or severe blues
· Traumatic birth
How can birth professionals help mums help themselves in pregnancy to reduce the risk of depression?
Encourage Mom to get support from friends, family and her care provider.
·Mindfulness is associated with a significant reduction in depression relapse.
In one study Moms who were identified as psychiatrically high risk and who participated in a 10-week mindfulness yoga intervention saw significant reductions in depressive symptoms, Mothers-to-be also reported stronger attachment to their babies in the womb.
A 2014 study concluded that even a single session of prenatal yoga reduced both subjective and physiological measures of anxiety.
If mom can’t get to a yoga class get take a free GentleBirth antenatal yoga class and practice mindfulness during pregnancy.
Doulas! Women who hire doulas are more likely to have positive birth experiences and are more satisfied with their partners during labor.
Ensure mom is getting adequate rest and eating a healthy diet whenever possible.
Light exercise reduces stress and changes your brain chemistry.
But Some Animals Eat their Placentas!
“Animal data also do not support claims that placentophagy in humans helps to enhance lactation, reduce pain, facilitate uterine contraction, or replenish hormones (i.e., prolactin, estrogen, progesterone, oxytocin) associated with postpartum recovery since statistically significant findings in animal data do not translate into meaningful benefits for humans.”***
What Do the CDC and ACOG say?
The Centers for Disease Control and Prevention recently issued a warning due to a case in which a newborn infant developed recurrent neonatal group B Streptococcus sepsis after the mother ingested contaminated placenta capsules containing Streptococcus agalactiae. The Centers for Disease Control and Prevention recommended that the intake of placenta capsules should be avoided owing to inadequate eradication of infectious pathogens during the encapsulation process.
Placenta pills are here to stay but let’s not pretend it’s a silver bullet at least not until we’ve got some robust evidence to support it. Anecdotal evidence and women’s experiences shouldn’t be ignored but we need large double blind RCT comparing placebo pills and placenta pills. One small RCT demonstrated no difference in iron levels.
When a mom states that she’s considering placenta encapsulation let’s give her all of the facts and explore evidence based ways to help mom improve mood during her pregnancy as well as after her baby arrives - and not just placenta pills.
(A few years ago a local encapsulator posted on FB asking if a placenta would be ok to process because she had caught her cat licking it). If you’re planning to encapsulate consider having it done in your home - in your kitchen.
Tracy
Resources:
Placentophagy: therapeutic miracle or myth?***
Placentophagy's effects on mood, bonding, and fatigue: A pilot trial, part 2