She was recovering in a postpartum room at Baylor University Medical Center this spring, exhausted from giving birth, when her husband gave her the good news. "We got the placenta," he told her. "It's in the cooler."
Now she just had to get it off the hospital property without being caught. "We were petrified that they were going to realize that we had it," says the mother, who is still too nervous about the placenta-snatching to go on the record with her name, the date she gave birth or how her husband managed to get the placenta into the cooler in the first place.
That placenta was important to her. She wanted to eat it.
She describes herself as a Republican who before becoming pregnant had the type of career that requires a degree and the ability to sell very expensive things to cultured people (she was also fearful of having her field identified). In other words, she was not the stereotypical image of a New Age woman, and her interest in alternative medicine came by chance. She'd woken up from several surgeries in the past suffering all-out anxiety attacks in reaction to anesthesia. So for her child's birth, she sought hospitals that wouldn't try to pressure her into getting an epidural shot or cesarean section. "These are all the things I wanted, that are more in line with a natural, non-intervention birth," she says.
In almost every way, Baylor University Medical Center near her East Dallas home seemed like the best choice. Hospitals in the Baylor system are known for their mother-friendly labor and delivery units, with spacious rooms, iPod docking stations and plentiful baths. "Baylor Dallas has made a really good reputation for being really natural-birth friendly," says Melissa Espey-Mueller, a former child-birth instructor at Baylor who now works in Dallas as a doula, a woman hired to assist women as they give birth.
Placenta-consumption was supposed to be just another routine part of the natural birth experience for this unnamed mother. Worried about suffering from postpartum depression, she'd heard anecdotes that the nutrients in her placenta could return her post-baby body and hormones back to normal. "I'm not interested in being on pharmaceuticals. That was something I wanted to avoid at all costs," she says.
As have other women intent on eating their placentas, she'd mistakenly assumed that getting her placenta out of Baylor would be fairly simple. But at some point in the past few years, Baylor's placenta policy changed. Baylor does not want moms eating their placentas and has been strict about not letting her and others like her have them.
"Baylor's position on this issue is in compliance with Texas law," a Baylor spokesman says, though other hospitals have different interpretations of that same law.
The most Baylor will do is release the placenta to a funeral home at a mother's request. But even then, Baylor's policy dictates that the placenta must stay with the funeral home. It's a policy that's been easily bent in the past -- word got around with mothers, doulas and placenta encapsulators that one funeral home is happy to take placentas off of Baylor's hands and then let mothers walk off with them later. All an expectant mother had to do was inform Baylor that her religion requires the placenta be buried or cremated, as this woman had done.
"We believe the placenta is absolutely sacred," she wrote to the hospital.
But as she approached her due date, she heard a rumor -- not an uncommon occurrence in the rumor-swamped world of placenta-consumption enthusiasts. Some other woman, she'd heard, never got her placenta from the funeral home where it was supposed to go."Between the labor and delivery room and the morgue, the placenta got quote-unquote lost. She feels like they destroyed it, because the nurse at the time was very critical of her decision to take her placenta," says the anesthesia-averse mother, though she didn't hear the story firsthand and has no idea if it's true.
Regardless, she wrote emails to the nursing staff, politely asking for some kind of promise, in writing, that her placenta would be safe. "Who is the person who I hold accountable for this?" she remembers wanting to know. "Because if something happens to my placenta, I'm going to be pissed."
A nurse replied that her placenta could probably go to the funeral home, but it was ultimately up to the hospital's legal team. "We can accommodate your request as long as your placenta goes to the funeral home for final disposition," the nurse explained. There were no promises, but there was a warning.
"If knowledge is obtained that the placenta is to be released outside of a funeral home," the hospital told the prospective mother, "release may not occur due to violation of the Texas Health and Safety Code."
It was not a comforting message.
So, the day she went into labor, she came with her husband, a doula and a cooler filled with ice and hoped for the best.
After her husband did whatever thing he did to get the placenta into the cooler, she texted her encapsulator -- the person who promised to turn the placenta into hundreds of digestible pills. The encapsulator agreed to meet the husband in the parking lot, where he passed the cooler.
Compared with other Baylor patients, her story was a success.
She's secretive about many details because if she has more children, she might want to give birth at Baylor again, she explains. Her experience giving birth there was great, other than having to sneak her own placenta out of the building in an ice chest. "It's completely ridiculous that it has to be like that," she says.
The placenta is an organ with a history of being taken very seriously by some and regarded as trash by most. A few years ago, a patient with the UNT Nurse Midwife Group made an unusual request in her birth plan -- she informed the midwives that she wanted to eat her placenta right there in the birth room, raw, shortly after the baby came out. The midwives, though used to accommodating other placenta-related requests, had never had a patient who wanted to eat it whole, still covered with blood. They doubted the mother would go through with it.
They were wrong. "When that patient consumed her placenta in the birth room, it was a little upsetting to the nursing staff," says Lindsay Griffith, a staff midwife at the practice. Now the group has policy: If you want to eat your placenta raw, that's fine, but you can't do it when any staff is present.
Anywhere from a third to half of the 80 patients Griffith sees each week want to keep their placentas. It's not her first recommendation for curing baby-related health ailments, as the effects of consuming a placenta have not been seriously studied by the scientific community. But she's never heard of a patient getting a negative reaction from ingesting placenta, either.
"I would say that 100 percent of the people in our practice who have encapsulated their placenta find it beneficial," says Griffith, though some patients are more enthusiastic than others. "They usually report more energy, a faster postpartum recovery, less postpartum depression ... and the biggest thing that women report is an increased milk supply." The Maori, the indigenous Polynesian people of New Zealand, believe the placenta is sacred. They call it the whenua and typically bury it, then plant a tree where it was buried. The Navajo and a few other indigenous cultures have also been documented burying placentas and planting trees by them.
Cultures that eat the placenta are less common. Chinese medical instructions from the 16th century, now often cited by modern practitioners, say that mixing the placental tissue with human milk will help the mother recover from postpartum exhaustion. Ancient Chinese texts also say that the whole family should dig in.
Since then, there's been little documentation of humans eating their own placenta, though local doulas say it's been happening for at least the last decade.
Modern placenta-eating became well-known with Jodi Selander, a woman in Las Vegas who since 2006 has been shipping her placenta encapsulation kits and instructions to women all over the country. Selander gained national fame in 2007 when she convinced a squeamish Las Vegas hospital to give mothers their placentas. Since then, more researchers and public health workers have been curious about placentas. In 2013, researchers at the University of Nevada in Las Vegas surveyed 189 women who consumed their own placentas. The researchers found that the women were mostly white, college-educated and middle-to-upper middle class. A vast majority -- 96 percent -- reported "positive" or "very positive" affects from the consumption. (Selander's unproven theory is that the placenta replenishes the mother with important nutrients and hormones.)
The UNT midwives are now working on a similar survey to document why mothers would consume their own placentas. The UNLV researchers are now conducting the first double-blind, placebo-controlled placenta study. They expect it to be published next year. Proponents often point out that most other mammals eat their own placenta right after giving birth. "There are remarkably few species that do not ingest amniotic fluid or placenta at delivery," wrote University of Buffalo behavioral scientists in a 2012 paper.
Getting placenta encapsulation to be nationally legalized is an unlikely feat in a country that has never taken an especially mother-friendly or holistic approach to reproductive health. Texas women continue to deal with more pressing concerns, like Planned Parenthood clinics getting shut down. The infant mortality rate in the United States remains stubbornly high. And around 30 percent of babies in the United States are delivered via cesarean section, despite the fact that doctors say the surgeries are often unnecessary and risky to the mother.
Women who can afford to be picky recognize that the birth care they receive varies widely between hospitals, and many "want to be put at the center of their care," as local doula Kathy O'Brien describes it. Placenta encapsulation is just one small part of that. Hawaii and Oregon have special exemptions in their medical waste guidelines for placentas, allowing mothers to more easily walk off with them. Others states, such as Florida, say placenta pills are drugs and should be regulated as such. Other county healthy departments across the country just ask encapsulators to get permits in handling food and blood-borne pathogens. In Texas, where many local doulas are taking up encapsulation on the side, there are no special exemptions under medical waste guidelines. What that means depends on which Texas hospital you visit.
St. David's Medical Center in Austin instructs its patients online that though placentas are medical waste, they're easy to get with a court order. The hospital even posts sample court orders demanding placentas on its website, instructing patients on the most effective way to threaten a lawsuit so they can get their placenta faster.
Locally, most hospitals don't seem to have a clear policy, with doulas and midwives saying that most nurses on staff have simply allowed it without asking questions. The UNT midwives primarily work at the Harris Methodist Hospital in Fort Worth, which is part of the same Texas Health Resources system that operates 25 hospitals in the region, including Presbyterian Hospital in Dallas. A spokeswoman for the hospital system, citing the UNT midwife group, enthusiastically says via email that "many of our moms that come through labor and delivery have interest in doing this!" She says all hospitals in the system allow parents to keep placentas if they sign a liability waiver.
In absence of specific policies, doulas work from experience and word-of-mouth, and say most hospitals seem to look the other way or even help out.
"I have had births at other hospitals where the hospital quite literally puts it in the cooler and sends it home," says Kiesha Baker, another doula. Afterward, she refers her clients to a high school friend who got into the encapsulation business.
Other hospitals have never been tested. Baker, like other doulas, has no experience attempting to get a placenta out of Parkland. "The doula population, most of us are getting compensated to a certain extent," Baker says, estimating that the average price of a doula in Dallas is $750 per birth, "and most of the people delivering at Parkland can't afford it." At Baylor, where patients can typically afford not just doulas but court orders and attorneys, placentas still rarely make it to the cooler, let alone the morgue.
Baylor staff say they're just following the law. "Under Texas law, a placenta cannot be released by a hospital to a mother," a Baylor spokesman says in an email. Baylor declined requests for an interview with nurses or staff about its policy on placenta consumption, only agreeing to submit a written statement from a spokesperson. "There are exceptions in the law, such as transferring a placenta to a licensed funeral director for disposition, or donating a placenta for research or teaching purposes to an institution of higher learning, a medical school, a teaching hospital, or a research institution."
Mothers aren't included in that list.
The spokesman explains: "But there is currently no exception in the law that allows a hospital to release a placenta to the mother, even if the mother signs a document absolving the hospital of liability for doing so."
Another mother who gave birth at Baylor this year, also concerned about being named, says she offered to get a court order or sign some liability forms if it would make Baylor's legal team feel more comfortable. Baylor said none of that would work. One nurse told her that walking off with her placenta was like walking off with an amputated arm and could never be done. Another nurse was more sympathetic, she said, but told her that the legal department just wouldn't allow it. "This is mine, and they're telling me I can't take it," this mother says, frustrated. The day of her birth, she got her placenta into a cooler with help from her husband, just as the other mom had done.
"I think that my husband knew how important it was to me, and so like the second after this baby was born, and everything was good, that was the goal," she says. She wouldn't say how he did it.
Angie Stewart, a local doula, watched the family of one of her clients fish the placenta out of a Baylor trashcan a few weeks ago. They waited until the nurses and midwives were out of the room. Though trashed, the placenta was stored in a sterile-looking container. "So it wasn't like it got nasty," Stewart says.
In April last year, Kim Greenough-Hodges gave birth to twins at Baylor, not even thinking that taking home her placenta would be a problem. Afterward, she noticed it was missing. She asked the nurses where it went. They looked at each other. A manager came in and said they'd look.
The next day, her doctor told her it was in the lab, covered in formaldehyde. "Because of your age we automatically sent it to pathology," she says he told her. At 48, she's older than most new moms. Doctors often want the placenta to be studied in a lab after unusual pregnancies.
But Griffith, the UNT midwife, says patients should always be warned before their placentas are sent off to be studied. "It would be poor form and unprofessional probably to not say something to the patient about it, but it's not illegal," she says.
O'Brien, who works around Tarrant County, has witnessed arguments between families who demand placentas and Baylor nurses who quickly shoot that request down. "If you attempt to take it, we will have to call security," are among the threats she's heard. Twice, she's seen the private security come up. She now avoids the Baylor system.
A few years ago, O'Brien says she got an out-of-the-blue call from a Baylor nurse, warning her that more hospitals in Texas should be following Baylor's lead. "She was very insistent that anybody else is not accordance with the law," O'Brien says, "that only Baylor is."
Yet the Texas Department of State Health Services doesn't seem to feel too strongly on the issue. "We have not had any sort of emphasis or regulatory action on placentas or anything like that," says DSHS spokesman Chris Van Deusen. He says that placentas fall under other medical waste guidelines stating that all waste needs to be properly tossed, unless a patient gets a court order.
That's why the placenta-friendly St. David's Medical Center in Austin instructs women on how to obtain a form called an "Unopposed Motion to Release Medical Waste," which, once signed by the hospital's risk manager, becomes an "Agreed Order to Release Medical Waste," securing a mother her placenta without even dealing with a funeral home.
Brittany Wackowski's experience at a birthing center was anything but the natural, non-intervention birth she pictured. Unlike hospitals, birthing centers are staffed by midwives rather than nurses. They resemble homes, not hospitals, and offer more privacy. And they're much more relaxed about letting women keep their placentas.
Yet Wackowski says she knew nothing of placenta consumption when she gave birth at the center. During delivery, the midwife at the center instead wanted to give her Cytotec, a drug that hospitals frequently use off-label to induce labor but that's frowned upon by most natural birth proponents. She refused. And on the day her baby was born, she felt rushed, she says. The midwife asked her to try "creative positions" to make the baby come out faster, and asked her to push before she thought the baby was ready.
Weak with pain, Wackowski readily gave in when the midwife offered her an epidural. The baby still wouldn't come, and the midwife eventually sent Wackowski to Baylor for a cesarean, which Wackowski preferred to the midwife experience. "Baylor was a really great hospital," she remembers.
But she felt cheated out of the natural, non-intervention birth she wanted. The birth of her daughter, named Gaia, brought unpleasant memories. She regretted not having hired a doula, and when she was looking for a job six months later, she researched becoming one herself. Then, shopping at a grocery store, she met a man selling natural supplements. She asked him if he had anything to increase her milk supply, and he told her about his wife's placenta encapsulation business.
"I was like, wow, that's really crazy and disgusting and I could totally do that," Wackowski says. In fact, she could. She discovered Selander's Las Vegas program and spent a few hundred dollars to get the food handler's license. Wackowski thought the curriculum wasn't great -- "there was no placenta pathology class," she says -- and she got most of her education from watching other local encapsulators.
Wackowski, like most encapsulators, likes to make the placenta as palatable as possible, rinsing the blood off and steaming it in a pot to kill bacteria before she begins making the pills. "I don't like cutting into a raw placenta," she says. Some enthusiasts say the placenta loses nutrients when it's cooked, but to Wackowski, it looks like a piece of meat.
She slices the organ after it's steamed and then leaves the slices in a dehydrator all night. She works in her clients' kitchens. Twenty-four hours later, she returns. The placenta, now resembling dried meat chips, can be easily ground into powder. Depending on the size of the placenta, a woman can get anywhere from 100 to 200 capsules.
Her first clients were some friends three years ago.
Initially, Wackowski, says, Baylor didn't give her clients many problems. Staff at the hospital, she says, let her patients take the placenta straight home the day of their birth without asking too many questions, a memory also shared by Melissa Espey-Mueller, the former Baylor midwife-turned-doula.
Then a client two years ago had to cancel on Wackowski, saying Baylor told her at the last minute she couldn't have the placenta. It was scary news to Wackowski, whose $250-per-birth business was just getting underway, with many of her clients coming from Baylor. She drove over to the East Dallas hospital.
The nurses, Wackowski says, told her that the legal department was not happy to learn that the mothers were eating their placentas, let alone bypassing the funeral homes that they were supposed to be going to.
"Right there they cut it off," Wackowski says the nurses told her. "They were like, people can't get sick."
Since then, doulas and moms who want to go to Baylor have passed along stories of the best way to get the placenta -- make the religious excuse, pick the right funeral home and don't give Baylor any indication that you intend to eat it. Some nurses, mothers say, seem apologetic and blame the legal department. Others seemed annoyed.
But placenta encapsulation, even without Baylor's polices, isn't an easy way to make money, as Wackowski is discovering. There are legitimate health concerns to handling it and there is no established industry trade group or research for her to turn to when she has questions.
About a year ago, for instance, she had a client at Baylor who got the nurses to give her the placenta after she begged for it in the middle of a contraction and "turned on the waterworks," Wackowski says.
The mother put her placenta in the cooler, seemingly in the clear. Her husband called a friend to pick it up.
They didn't realize that the friend was drunk. At some point on his way home, he opened the cooler to take a look at the placenta. Then he left it in the car that night. Wackowski says the clients told her the story when she went to their house, and asked her if it could still be made safely into pills. Wackowski had no idea.
She began the first step of steaming the placenta. While it sat in the dehydrator, she asked for answers on a Facebook forum called "Placenta Alchemy." Don't let the client eat it, some pill-makers warned. Others said it was the client's choice. People from both sides scolded her for considering the other option.
The next day, Wackowski returned to the couple's home to make the pills. Already, the powder had a funky smell. It seemed like a bad idea. She told the client she couldn't go through with it. The last successful client Wackowski had, a few months ago, was also a Baylor patient. Wackowski, however, got more bad news when she went to the Cavalry Hill Funeral Home to collect the woman's placenta. The funeral home had a reputation for agreeing to let moms take their placentas.
"This is the last time that we're going to be doing this," she says a funeral home employee told her. "We got a call from the hospital, and the hospital would prefer that we not do this." Reached by telephone for comment, an employee at the funeral home had little to say about its placenta policies. "We don't do that," said the staffer, who refused to give his name. "What I do know is, we do not accept that. We do not accept placentas." He quickly hung up.
In August, after a slow stretch, Wackowski finally had another client due, at the Methodist Dallas Medical Center in Oak Cliff. But that case also fell apart. A few days before her due date, the client heard Methodist had adopted a new policy more strictly regulating placentas. Wackowski waited impatiently on the mother's due date. "There's my client, she had her baby," she said, scanning her Facebook page in a coffee shop with her 4-year-old daughter. "It'd be nice if she'd text me to let me know she was not going to need my services."
The lack of clarity from hospitals also doesn't help.
An informal call to Methodist's labor and delivery room to ask if moms could take home their placentas was met with a laugh.
"I'm not sure," said the first labor and delivery nurse who answered. She transferred me to the charge nurse.
"This is Jen," the charge nurse answered.
What's the hospital policy on letting moms take home their placentas?
"Ma'am, I can't talk right now," Jen said. "Can you call public relations please? I'm in an emergency."
The public relations office was also confused. "You were told to call public relations regarding that?" asked one staffer. He transferred me to another press person. "I don't know," said another. He promised to call back. He didn't.
The encapsulators who do stay in business aren't depending on it as their full-time income. Many are doulas, just making placenta pills on the side for a few extra hundred dollars. Wackowski, a single mom, is looking for another job with flexible hours. She just started working part-time as a Lyft driver.
In any case, the nutrients found in placenta aren't unique to placenta. Researchers have long linked postpartum exhaustion and depression with low iron levels. And though the placenta is rich with iron, so obviously are standard iron supplements, some dark leafy greens, meats, nuts and other foods.
Not everyone reports good reactions to placenta pills. "Shortly after my first dose of two pills, I felt jittery and weird," wrote a guest author on The New York Times' Motherlode blog two years ago.
And the celebrities who embraced placenta consumption have subsequently been mocked by the public -- there was January Jones, the Mad Men actress who talked about having her placenta encapsulated, and former Real Housewife Kim Zolciak drank a placenta smoothie in a recent episode of her spin-off reality show.
But for placenta proponents, the rare stories of bad responses or the flaky celebrities are beside the point. One of the mothers who snuck her placenta out of Baylor is well aware that the scientific evidence is scant. For all she knows, her results could be nothing but a placebo effect. But if her placenta pills are placebos, they're the best placebos she's ever had. "On days where I know I'm going to super active," she says, "I just take them, and I have like the best day ever."