Ten years ago, requesting no epidural during labor was considered on the extreme end of things when it came to "holistic" childbirth practices. Parents who preferred natural laboring would ask for the least amount of medical intervention possible, and while in the past their requests may have seemed extreme, they have now become fairly commonplace.
But now there is a new set of even more "natural" and eyebrow raising demands that are being handed into obstetricians across the country: "Save my placenta for immediate consumption after birth" and, "Oh, and in the case of a C-section, please wipe down my baby with my vaginal fluid." However strange they sound, these are true-to-life postpartum choices that some parents swear by.
The placenta, which is the organ that feeds oxygen and nutrients to an unborn baby via the umbilical cord, is typically "delivered" after the newborn. Placentophagy, or eating the placenta in some form, is a growing trend among celebrities and holistic-leaning moms alike (it's one of the few things in life that are both Kim Kardashian and Mayim Bialik-approved), under the belief that it can restore hormonal balance, help with postpartum bleeding and pave the way for better breastfeeding. It could be consumed raw, as in blended into smoothies, cooked into a stir fry, or dried and processed into capsule form (for new moms to ingest without the ick factor).
After all, argue proponents of this practice, humans are among the few mammals that don't eat their own placenta, although whether animals do it for the health benefits or to hide their tracks from predators is up for debate.
In a 2013 study from the University of Las Vegas, medical anthropologist Daniel Benyshek and doctoral student Sharon Young surveyed 189 women who consumed their placentas after giving birth. Seventy-six percent of participants said they had very positive experiences, citing better mood, increased energy, and improved lactation. The study couldn't determine whether the positive results extended beyond the placebo effect or were skewed by the population that was surveyed, but Dr. Benyshek is now conducting further research in the potential benefits and risks of this practice.
Oh, and in the case of a C-section, please wipe down my baby with my vaginal fluid.
"Even if it was the placebo effect, I'm good with anything that helps avoid postpartum depression," Ashley Lewis, 29, told me over the phone when I asked how she had benefited from placentophagy. Lewis chose to consume her raw placenta in smoothies after the birth of her fourth child and plans to do the same—along with dehydrated capsules—for her next one, due later this year.
The Tallahassee-based mother, recalling the intense depression that accompanied the traumatic, premature birth of her third child, sought out ways to prevent a similar situation from repeating itself—which is why she chose a home birth instead of a hospital one and decided to try eating her placenta as a natural postpartum treatment.
"Once the placenta was delivered, the midwife put it in several zip-top bags and put it in the fridge," she told me over the phone. "The next day, my husband washed and deveined it, took out the umbilical cord, cut it up into bite-sized pieces, and flash froze it." Each evening, Lewis blended one or two pieces of frozen placenta with strawberries and ice.
With only limited research to rely on, the benefits of placentophagy are mostly anecdotal, as in the case of Lewis and many other women who support the practice. Still, after hearing their stories, it makes sense that even die-hard skeptics can get on board with a woman's right to choose how to deal with her placenta. To each her own, right?
Not so much in the case of 32-year-old British mother and natural parenting blogger Adele Allen, who faced plenty of backlash when she went public with her story of her two children's "lotus births." While it may sound like a tribute to Buddhist symbolism, a lotus birth is the practice of leaving a newborn baby attached to the placenta via the umbilical cord until it falls off naturally. This is different than most conventional births, whether in-hospital or at home, where the umbilical cord is typically clamped (cut), and then the placenta is disposed of as medical waste.
She and her husband washed the placenta, sprinkled it with rock salt and rose petals to cover the odor, and wrapped it in muslin cloths before placing it in a portable cooler bag.
Describing her second child's birth on a parenting blog, Allen wrote that they kept the placenta attached and intact for six days until it separated on its own. She and her husband washed the placenta, sprinkled it with rock salt and rose petals to cover the odor, and wrapped it in muslin cloths before placing it in a portable cooler bag.
"As I had opted for absolutely no medical intervention, lotus birthing made the most sense to me," Allen told me via email, explaining her unconventional choice. "In my experience, benefits included calmer and more peaceful babies at birth, with only a short cry when they took their first breath."
According to The American College of Obstetricians and Gynecologists, most umbilical cords are clamped and severed between 15 and 20 seconds after birth. The World Health Organization, however, recommends delaying the clamping for 1 to 3 minutes after birth, to improve the postnatal health of mother and child. Delayed clamping is now a growing trend, with cords being cut only after they stop pulsating so that they may continue to deliver essential oxygen and nutrients to the newborn.
The lotus birth is essentially an extreme version of delayed clamping, with no medical intervention at all. However, since the umbilical course only pulsates for a few minutes after birth, a days-old placenta is really just dead tissue still attached to a newborn baby. What is the appeal beyond the first few minutes of blood flow?
"With a lotus birth, as soon as the cord falls away, [the babies were] left with a perfectly neat belly button with no redness or soreness," Allen explained. "During the period when the placenta was attached, I was encouraged to stay close, have skin-to-skin contact with my babies, and recuperate and bond properly." While the bonding benefits are achievable even without the placenta being attached to the baby, Allen said she appreciated the "uninterrupted time" that didn't involve any "standard newborn procedures or [the baby] getting passed around for friends and family cuddles until the placenta had fallen away."
It's a rare enough practice that it hasn't inspired many conversations in the medical community, but, in 2008, the Royal College of Obstetricians & Gynaecologists (RCOG) weighed in on lotus birthing with a statement: "If left for a period of time after the birth, there is a risk of infection in the placenta which can consequently spread to the baby." While there are no studies to point to any confirmed benefits or risks, the RCOG simply recommends that babies attached to their placenta be closely monitored for any signs of infection.
When it comes to the topic of postnatal infection, some doctors are now concerned with yet another trend—one that occurs in the operating room rather than the delivery room.
Remember the request about wiping down the newborn with mom's fluids? It's a relatively new trend known as "vaginal seeding." The practice is driven by the belief that being born by cesarean section is tied to higher risks for various health problems in children. There is some evidence that babies born by C-section are more prone later in life to issues like obesity, type 1 diabetes, asthma, or allergies. This could be because babies born by C-section, specifically scheduled surgeries that don't involve labor, miss out on the benefits of traveling down the birth canal, including exposure to vaginal bacteria.
The concept of vaginal seeding was born out of research from Dr. Maria Gloria Dominguez-Bello, an associate professor of the Human Microbiome Program at New York University School of Medicine. Of 18 babies in the study, seven were born vaginally and 11 via scheduled C-section; four of the C-section-delivered babies were wiped with a gauze swab that had been inside their mother's vagina for an hour.
The babies that were swabbed had "microbiome," or complex communities of microorganisms that reside in the human body, closer to that of the babies born vaginally, even a month after birth. This suggests that vaginal seeding gives the "good" bacteria a chance to colonize and multiply in newborns delivered via C-section.
While the long-term benefits of this microbiome in newborns is not yet fully understood, it's believed that early bacterial colonization in newborns can set the stage for immune-system development and digestion, hence the belief that it could combat potential health issues later in life.
"Some vaginal bacteria in mammals is [also] highly relevant to lactation, such as lactobacillus, which we see in yogurt," explained Dominguez-Bello over the phone. "Babies being born vaginally are already furnished with bacteria that will help digest breast milk." Babies delivered via C-section, it seems, may need to be exposed to that same bacteria.
What's not yet clear is whether missing out on early bacteria exposure that helps with breastfeeding actually causes illness later, or if the answer is much more complicated: the fact that the process of labor is so stressful could offer a world of benefits to newborns that we don't even understand. In the meantime, some question whether vaginal seeding is wise without longer-term studies on the effects of the practice.
"The risk is transmission of infection," Dr. Aubrey Cunnington, clinical senior lecturer and honorary consultant in pediatric infectious diseases at Imperial College London, told me via email. "Group B Streptococcus is probably the biggest risk, as it can cause fatal infections." He told me that while babies who are swabbed with their mom's fluids are at no more risk than vaginal deliveries, medical staff should be alerted that the C-section baby has been exposed to this bacteria to be screened for potentially harmful bacteria and viruses.
Testing the long-term benefits of this practice will require following a much larger sampling over at least 3 years. But even at this stage, Dominguez-Bello doesn't discourage women from requesting a vaginal swab after a scheduled C-section, citing that it's a natural exposure to the bacteria. She simply suggests that women talk to their doctors to determine if it's the right choice.
In fact, when making decisions regarding birthing procedures and postnatal care, discussion is always key, as there is no one right way to go about having a baby. And while the research and hard evidence to support each of these postpartum treatments is still in the early stages, each option was conceived with the same intention: to give babies, and their mothers, the best odds from the very beginning to establish a solid foundation for long-term health. But ultimately, whether you want to eat your placenta, or keep your baby attached to it until it falls off, or even wipe your baby down with your own vaginal fluids after they're born, the choice is yours.