Should Moms Eat Placentas?

It sounds like something straight out of Silence of the Lambs, and it's called placentophagy: the New Age practice by today's trendy moms of eating their own placenta following childbirth. It's widely promoted by a handful of Hollywood actresses (whom I am going to buck the trend by not naming, because who really cares). Proponents claim a wide array of benefits from the practice, including treatment of postpartum depression, improved energy, improved lactation, and any number of hormonal or immunological benefits they believe will be passed onto their baby through nursing. Science, however, isn't quite so sure. Today we're going to have a look at what both sides say, and see where the powdered placenta crumbles.

The history of placentophagy in humans is only very recent; it appears to be yet another manifestation of modern Western esotericism. Popular belief seems to hold that it's an ancient, natural practice steeped in time-honored wisdom. Obviously, this is the appeal to antiquity: it's true because it's old, which is fallacious logic. Witch burning and bloodletting were also things that old cultures believed in, and they're also not efficacious due merely to their oldness.

But when we look at the historical texts, we find that placentophagy as an ancient practice is a faulty assumption. There do not seem to be any cultures, ancient or otherwise, in which placentophagy was commonly practiced by mothers. We find only scattered reports, and usually when we find them, the placentas were eaten by someone other than the mother. A pair of old Chinese texts from the 1500s each make a single mention. In one, the birth of a boy might be celebrated by the mother's relatives cooking and eating the placenta; and in the other, powdered placenta mixed with human breast milk could be placed in the sun until it was spoiled, then consumed by a man to treat premature ejaculation. This was called Connected Destiny Elixir.

The traditional and magical uses of placentas and umbilical cords could fill an encyclopedia. A number of cultures have kept umbilical cords to be chewed or powdered when that person gets sick. One Indian tradition held that a childless mother could eat someone else's placenta to become fertile, but only at the cost of the life of the mother whose placenta it was. Burying the placenta is believed to bring good luck to the child in a number of cultures. We could go on all day with these. Suffice it to say that the consumption of a placenta by a mother to treat the symptoms of childbirth has only a paucity of ancient tradition behind it; it is almost exclusively a modern invention by the trendy New Age crowd who see it as some sort of enlightened natural cure.

One 2010 ethnographic survey looked at 179 societies in search of references to placentophagy. It found a grand total of exactly zero known societies in which mothers ate their own placentas as a matter of cultural tradition.

So then, why are modern western women doing it? A 2013 study at UNLV asked hundreds of women who had eaten their placentas — and who use the Internet — why they had chosen to do so. The single most popular answer, by far, was to improve mood. There was a sharp dropoff from there, with the next most popular answer, "unspecified benefits", being reported by only 12% of women. All the other answers had scattered support: improving lactation, "restoring hormones", recovery from birth, recommendation from a doula, increase iron, and so on. A few even cited their belief that eating the placenta would help with weight loss, or that it was "natural behavior".

The demographics were quite telling. The women who ate their placentas were overwhelmingly white (93%), married (90%), in the United States (92%), college educated (89%), and they skewed heavily toward the highest end of the study's income brackets — the exact same demographic that goes for expensive fashion trends, fad diets, and other outward-signaling behaviors. In fact, much about placenta eating is more consistent with attention-seeking behavior than it is with health practices.

The study also revealed that placentophagy is closely associated with home birth, another fad popular among the fashionable — and equally warned against by medical science. Interestingly, this included a clear trend toward more children. Among women in the study for whom this was their first child, 2/3 had it in the hospital; but when it was their second child, over half did it at home. By the time it was their fifth child, 3/4 had a home birth.

Since this study, celebrity endorsement has been on the rise, and the vague goal to "improve mood" has been refined in later pop messaging into a treatment for postpartum depression, which strikes about one seventh of mothers. This claim has never really been tested on a large scale, primarily because no consistently observable benefit has ever suggested that such a test is worth the expense. But a small pilot study was done in 2017, both randomized and placebo controlled; and while it noted that the the results should be considered preliminary, it did conclude:

No robust differences in postpartum maternal mood, bonding, or fatigue were detected between the placenta and placebo groups. This finding may be especially important for women considering maternal placentophagy as a 'natural' (i.e., non-pharmacological) means of preventing or treating blues/depression.

Another belief that's rising in popularity is that eating the placenta will help restore the mother's hormone balance. This is an odd claim which requires some unpacking. First of all, there are important reasons that a new mother's hormone levels are way out of whack, breast feeding being an obvious one. These changes to a woman's body are largely driven by the endocrine system; and a New Agey mother is probably best advised to allow her body to do what it's trying to do naturally, rather than attempt to interfere with her hormones by taking a non-prescribed supplement.

But for the mother who does wish to interfere with her body's hormones at this delicate stage, it's not at all clear that eating a placenta would be the way to do it. A placenta does indeed have a whole cocktail party of various hormones in it, but there is no science at all saying that the mother would be well served by adding these to her own body. But even if there was, actually eating the placenta wouldn't be the way to get those hormones into her body. The human digestion system generally destroys most hormones in the food that comes in, which is why medical hormone supplementation is usually given via some non-oral delivery, such as a patch, injections, and subdermal implants. When they are administered orally, hormone pills are given with an enteric coating that protects them from the digestive enzymes.

But with today's modern placenta eating recipes, no such precautions are taken. Often the placenta is cooked — which, right there, destroys many of the hormones. Otherwise it's usually dried and powdered, then consumed as a pill or a smoothie or something else that gets digested, and destroyed that way. Either way, very little of the placenta's hormones are going to survive to make it into the mother's bloodstream — a destination which, as discussed, is by no means clearly a useful one in the first place.

Another of the benefits reported by the 2013 study participants was simply that placenta eating is a "natural" behavior, and thus should be done based on that alone. Although we've established that this has never been a natural behavior for humans, it is a behavior observed in most (but not all) other mammals. Why do they do it? Before springing to the conclusion that the reason must be their superior all-natural non-human enlightenment and ancient instinctive wisdom, consider that many mammals also eat their own vomit and excrement. Mammals tend to eat whatever food you put in front of them; and because its purpose is to nourish a fetus, a placenta is indeed both edible and tasty-smelling. It's a big hot meal for a tired mom that just gave birth, a nice perk from Mother Nature.

There is also one other hypothesized reason that placentophagy might be evolved behavior in animals: Eating it makes it go away, and avoids tipping off predators that there's a vulnerable baby around. Over many generations, those animals who did disappear their afterbirths may have been attacked fractionally less often, and gradually those for whom the behavior was instinctive became most dominant in the population. It's just a hypothesis, but a plausible one. In any case, it's an example of animal behavior that doesn't translate well into a suggestion for humans to do the same thing.

Occasionally, science articles that criticize the practice will point out the dangers it introduces. Part of what a placenta does is detoxify the developing fetus, a job the baby's liver and kidneys will take over as it grows. Whatever toxins and pollutants are filtered from the fetus' blood will typically remain in the placenta. For most mothers, this is probably negligible; but for others, it might be a hellacious witches' brew. The fact is that no mother knows. One thing all mothers can be sure of is that the placenta will always contain bacteria.

This is not so much a risk to the mother, with her robust adult immune system, but much more so to the baby, who may receive these bacteria via breast milk. This has happened in several cases — one reason the number is low is that placentophagy is still a new and rare practice. One such case that's been widely reported involved an Oregon mother who took capsules containing her own ground-up placenta infected with group B Streptococcus (GBS) and gave her nursing baby a life-threatening blood infection — twice. GBS infections are fatal to newborns 5-7% of the time.

Part of the reason this will happen is that there are no standards or regulations pertaining to the preparation of placentas. There are a number of companies that offer to dehydrate and grind up your placenta, but they all do it according to their own notions. A 2017 investigation by the Science Based Medicine blog found only one such company cited research demonstrating their process was safe — research funded by a GoFundMe campaign, and performed by themselves on only six placentas, and never submitted anywhere for publication.

The risks might be small, but they are non-zero. Placentophagy is Russian Roulette for no reason. All the few claimed benefits that have been coherent enough to test, all have failed conclusively. There is no soundly theorized reason for any mother to eat her placenta, especially one concerned about the health of either her baby or herself. It is a high price to pay simply to appear fashionable.

By Brian Dunning
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