Should we accommodate pregnant patients' postpartum placenta requests?

As I reviewed a pregnant patient's birth plan recently, I noticed a request that's becoming more common – the mother wanted to take her placenta home after giving birth. 

 

Until this year, the hospital where I work disposed of placentas in biohazard bags with other blood or bodily fluid-stained medical waste. Now we store each placenta in chemical solution, and send it to pathology to be evaluated after delivery.

 

When I asked the labor and delivery nurse manager if we could accommodate the patient's request, she hesitated. She was concerned about the safety of removing biohazardous waste from the hospital and questioned the patient's intent. 

 

Some patients wish to take their placenta home and bury it in their yard to plant a tree on top of it, as a living monument to the new baby. But more recently, new moms are telling me that they plan to eat their placentas during the postpartum period. 

 

Although the exact percentage of pregnant women who wish to consume their placenta is unknown, I'm not the only one that's noticed this trend. New York Magazine recently published an article about the growing trend of “placentaphagia.” According to that article, these women are hiring “placenta preparers” to dry and encapsulate the organ, creating supplements. Other women prefer to just throw the placenta into a smoothie, or incorporate it into recipes found on the Internet. 

 

As strange as this practice may seem, many animals eat their placenta, and evidence of placenta consumption in humans can be traced back to ancient Egypt. Dried placenta is also used in traditional Chinese medicine. Though no real evidence exists to support benefits, new mothers anecdotally report that consuming placenta improves breast-milk supply, increases postpartum energy levels and results in less postpartum depression. 

 

Many people, including most of my colleagues, find placentaphagia bizarre and unappealing. Although my hospital has agreed to let patients pick up their placentas and take them home, policy still stipulates the organs be soaked in toxic chemicals and examined by the pathologist. Obviously, these placentas will no longer be edible, and this has caused considerable outrage among patients who plan to consume them. 

 

From the hospital's point of view, we must follow processes in line with those set forth by the state and the Joint Commission on Accreditation of Healthcare (JCAHO). From the pathologist's point of view, if we allow the family to take the placenta home without evaluation, we may miss information that could be crucial if the baby develops any problems. 

 

But I can understand where these women are coming from, too. While it's not common in Western Medicine for people to take home organs or tissue after surgery, the placenta has cultural and spiritual significance to many people and cultures. 

 

Asking parents to sign a waiver and developing a procedure for safely transporting the placenta home may help create a happy balance for everyone.  If the provider feels strongly that the placenta needs to be evaluated at birth, this could be the time to negotiate with the parents to develop an alternate plan.  

 

This is not an everyday issue, but placentaphagia is becoming more common. Health-care providers must be prepared to work with families and hospitals to keep both parties satisfied. 

 

Robyn Carlisle, MSN, CNM, WHNP, is a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.

 

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