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."