What are the risks and is there evidence supporting the post-partum trend?
Over the last few years, placenta consumption has been gaining attention from expectant mothers especially in Europe, North America and Australia. (1) The process known as placentophagy is where the mother’s placenta is either by cooking or drying and then is encapsulated for consumption by the mother after birth. (2) This service is usually offered by doulas or mid-wives to support the mother after giving birth. (2) Placenta is sometimes eaten raw and some women consume the placenta in food (as a meat-substitute or in smoothies) post-partum. (3)
However, it is important that women are aware of the potential risks of placenta ingestion and understand the evidence regarding its said benefits of support.
Potential Risks
The placenta can harbour and transmit bacteria and viruses due to being biological tissue. (2) The processing of the placenta and the potential for contamination also needs to be considered. (1)
Another major point for concern is the level of heavy metals and other harmful substances that may be present in placental tissue. (4) The placenta connects maternal and foetal circulation and along with proving nutrients, one of its roles is to act as a filter, reducing the levels of toxic substances that can pass from the mother to the developing foetus. Despite this, the placental barrier is still permeable and will allow some harmful elements through. (4)
Another topic of consideration is a theoretical increased risk of thromboembolism. (1) Pregnant and post-partum women have a higher risk of a thromboembolic event and because of this, exogenous sources of oestrogen (e.g. oestrogen-containing oral contraceptives) are contraindicated in the immediate post-partum phase. As the placenta is a major oestrogen supplier during pregnancy, if placenta consumption can increase oestrogen levels enough, then there may be a greater risk of thromboembolism. (1)
The above-mentioned risks are all theoretical; more research is needed prior to concluding the safety of placentophagy. (1) There has only been one known incidence of a possible infection due to placentophagy. (5) This was a in which an infant may have been re-infected with group-B Streptococcus bacteria following maternal ingestion of placenta capsules. The placenta capsules tested positive to the bacteria. (5)
In a survey of 189 women who ingested placenta after birth, there were no major adverse effects reported and of those documented, the most frequent were minor- being bad taste/smell and headaches. (3)
Benefits
Nutrient Density
The most common benefits promoted of placenta ingestion, is an increase in energy, improved milk production and improvement in mood. (2) This is proposed as being due to its high nutritional profile.
However, one study found that consumption of encapsulated placenta tablets did not have significant effects on maternal iron stores when compared to placebo (encapsulated beef) and thus shouldn’t be relied on for sustaining iron levels after birth. (6) Encapsulated placebo was significantly higher in iron compared to encapsulated beef although alone it is not enough to meet the recommended daily allowance (RDA) in breastfeeding women. (6)
One study analysed 28 placenta samples that were prepared for encapsulation and tested for their levels of 14 trace elements/minerals. (7) Arsenic, cadmium, cobalt, copper, iron, lead, manganese, mercury, molybdenum, rubidium, selenium, strontium, uranium and zinc were all identified in detectible amounts. Based on the recommended daily intake of placenta capsules (3300mg/day) and the RDA for lactating women, the daily dose of placenta would supply on average, 24% RDA for iron, 7.1% RDA for selenium, 1.5% RDA for zinc, and 1.4% RDA for copper. Mean levels of potentially toxic elements (arsenic, cadmium, lead, mercury, uranium) were well below the set toxicity levels. This study suggests that the daily dose of encapsulated placenta provides small amounts of trace minerals and has only minor amounts of toxic elements. (7)
General Health Benefits
The issue with vouching for the benefits of placenta ingestion is that it is often self-reported benefits, making it difficult to scientifically support. For instance, a survey on 189 women utilised a questionnaire to review the perceived effects of placenta ingestion post-partum. (3) When questioned regarding their reason for placenta ingestion, 34% of women answered to “improve mood”. The most common form of placentophagy was dehydrated-cooked in capsules followed by dehydrated-raw in capsules. It was found that the majority of women reported positive effects and that they would ingest their placenta after subsequent births. The most common benefit was reported mood improvement in 40% of women, followed by reported increase in energy (26%). (3)
Pain Modulation
One recent animal study found that in rats fed placenta, found that placental ingestion has pain modulating and analgesic effects (improving pain tolerance), presumed to be due to placental opioid enhancing factor, compared to controls. (8) This may translate to a pain-modulating effect of placenta ingestion however this has not been studied in other mammals yet.
Lactation
The said benefits of placenta ingestion on lactation are based off a dated study conducted in 1954, which demonstrated improved milk secretion with ingestion. (9) This study had limitations including not having a control group. (10) In the patient-reported outcome study on 189 women, 15% reported improved lactation however, again due to the self-reported nature of the findings, they lack validity. In order to substantiate this, more recent scientific trials are needed. (3)
Hormone Modulation
One of the most touted benefits of placentophagy is improvement of mood in the post-partum period. A recent study aimed to assess if salivary hormones in women who ingested their dehydrated and homogenised placenta (n=12) differed from mother’s who took the placebo (n=15). (11) No significant differences in salivary hormone concentrations were found between the groups after supplementation that were not present pre-supplementation. It was observed however, that there was a significant dose-response correlation between levels of all 15 detected hormones in the placenta capsules and the levels of salivary hormones in the placenta group, not observed in the placebo group. This demonstrates that higher levels of these hormones are present in the placenta capsules compared to placebo. (11)
The above study also analysed the effects of placenta consumption on mood, bonding and fatigue. (12) Again, no significant differences were observed between the two groups however, small decreases were seen in depressive symptoms amongst the placebo group and there was reduced fatigue in the placenta group at the end of the study period compared to placebo. These results were not significant and were time-point dependant (related to the timing of the check-ups) and should be considered preliminary, warranting further investigation. (12)
Lastly, a recent 2019 study found no correlation between placentophagy and improved mood, energy, vitamin B12 levels nor lactation. (13)
The Verdict
Overall, there needs to be a lot more research conducted on placenta ingestion before definitive claims can be made as substantial scientific evidence is lacking.
Of course, it is ultimately up to the mother to decide if they would like to have their placenta encapsulated for ingestion and their choice should be respected. The purpose of this article is to help decipher the current available research on the benefits and potential risks so that we can make informed choices.
Written by Annabel Murray as part of her 2020 internship.
References
1. Hayes EH. Consumption of the placenta in the postpartum period. J Obstet Gynecol Neonatal Nurs [Internet]. 2016 Jan 1;45(1):78–89. doi: 10.1016/j.jogn.2015.10.008
2. Therapeutic Goods Administration [Internet]. Australian Government Department of Health: Therapeutic Goods Administration. ACT: TGA; c2018. Available from. https://www.tga.gov.au/human-placenta-ingestion
3. Selander J, Cantor A, Young SM, Benyshek DC. Human maternal placentophagy: A. survey of self-reported motivations and experiences associated with placenta consumption. Ecology of Food and Nutrition [Internet]. 2013;52(2):93–115. doi:10.1080/03670244.2012.719356
4. Kot K, Kosik-Bogacka D, Łanocha-Arendarczyk N, Malinowski W, Szymański S, Mularczyk M, et al. Interactions between 14 elements in the human placenta, fetal membrane and umbilical cord. International Journal of Environmental Research and Public Health [Internet]. 2019 May 8;16(9). doi:10.3390/ijerph16091615
5. Buser GL, Mató S, Zhang AY, Metcalf BJ, Beall B, Thomas AR. Notes from the field: Late-onset infant group b streptococcus infection associated with maternal consumption of capsules containing dehydrated placenta - Oregon, 2016. MMWR [Internet]. 2017 Jun 30 [cited 2020 Sep 11];66(25):677–8. doi:10.15585/mmwr.mm6625a4
6. Gryder LK, Young SM, Zava D, Norris W, Cross CL, Benyshek DC. Effects of human maternal placentophagy on maternal postpartum iron status: A randomized, double-blind, placebo-controlled pilot study. Journal of Midwifery and Women’s Health [Internet]. 2017;(1):68. doi:10.1111/jmwh.12549
7. Young SM, Gryder LK, David WB, Teng Y, Gerstenberger S, Benyshek DC. Human placenta processed for encapsulation contains modest concentrations of 14 trace minerals and elements. Nutrition Research [Internet]. 2016 Aug 1;36(8):872–8. doi:10.1016/j.nutres.2016.04.005
8. Di Pirro JM, Kristal MB. Placenta ingestion by rats enhances delta- and kappa-opioid antinociception, but suppresses mu-opioid antinociception. Brain research [Internet]. 2004 Jul 16;1014(1–2):22–33. doi: 10.1016/j.brainres.2004.04.006
9. Soykova-Pachnerova E, Brutar V, Golova B, Zvolska E. Gynaecological international monthly review of obstetrics and gynaecology. Gynaecologia [Internet]. 1954 Dec;138(6):617–27.
10. Coyle C, Hulse K, Wisner K, Driscoll K, Clark C. Placentophagy: Therapeutic miracle or myth? Archives of Women’s Mental Health [Internet]. 2015 Oct;18(5):673–80. doi:10.1007/s00737-015-0538-8
11. Young SM, Gryder LK, Cross C, Zava D, Kimball DW, Benyshek DC. Effects of placentophagy on maternal salivary hormones: A pilot trial, part 1. Women and birth: Journal of the Australian College of Midwives [Internet]. 2018 Aug;31(4):e245–57. doi:10.1016/j.wombi.2017.09.023
12. Young SM, Gryder LK, Cross C, Zava D, Kimball DW, Benyshek DC. Placentophagy’s effects on mood, bonding, and fatigue: A pilot trial, part 2. Women and Birth [Internet]. 2018 Aug 1;31(4):e258–71. doi:10.1016/j.wombi.2017.11.004
13. Morris E, Slomp C, Hippman C, Inglis A, Carrion P, Batallones R, et al. A matched cohort study of postpartum placentophagy in women with a history of mood disorders: No evidence for impact on mood, energy, vitamin B12 levels, or lactation. Journal of Obstetrics and Gynaecology Canada [Internet]. 2019 Sep 1;41(9):1330–7. doi:10.1016/j.jogc.2019.02.004