Advertisement

Human placentophagy: a review

Published:August 28, 2017DOI:https://doi.org/10.1016/j.ajog.2017.08.016
      Placentophagy or placentophagia, the postpartum ingestion of the placenta, is widespread among mammals; however, no contemporary human culture incorporates eating placenta postpartum as part of its traditions. At present, there is an increasing interest in placentophagy among postpartum women, especially in the United States. The placenta can be eaten raw, cooked, roasted, dehydrated, or encapsulated or through smoothies and tinctures. The most frequently used preparation appears to be placenta encapsulation after steaming and dehydration. Numerous companies offer to prepare the placenta for consumption, although the evidence for positive effects of human placentophagy is anecdotal and limited to self-reported surveys. Without any scientific evidence, individuals promoting placentophagy, especially in the form of placenta encapsulation, claim that it is associated with certain physical and psychosocial benefits. We found that there is no scientific evidence of any clinical benefit of placentophagy among humans, and no placental nutrients and hormones are retained in sufficient amounts after placenta encapsulation to be potentially helpful to the mother postpartum. In contrast to the belief of clinical benefits associated with human placentophagy, the Centers for Disease Control and Prevention recently issued a warning due to a case in which a newborn infant developed recurrent neonatal group B Streptococcus sepsis after the mother ingested contaminated placenta capsules containing Streptococcus agalactiae. The Centers for Disease Control and Prevention recommended that the intake of placenta capsules should be avoided owing to inadequate eradication of infectious pathogens during the encapsulation process. Therefore, in response to a woman who expresses an interest in placentophagy, physicians should inform her about the reported risks and the absence of clinical benefits associated with the ingestion. In addition, clinicians should inquire regarding a history of placenta ingestion in cases of postpartum maternal or neonatal infections such as group B Streptococcus sepsis. In conclusion, there is no professional responsibility on clinicians to offer placentophagy to pregnant women. Moreover, because placentophagy is potentially harmful with no documented benefit, counseling women should be directive: physicians should discourage this practice. Health care organizations should develop clear clinical guidelines to implement a scientific and professional approach to human placentophagy.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Romero R.
        Images of the human placenta.
        Am J Obstet Gynecol. 2015; 213: S1-S2
        • Guttmacher A.E.
        • Spong C.Y.
        The human placenta project: it's time for real time.
        Am J Obstet Gynecol. 2015; 213: S3-S5
        • Nelson D.M.
        How the placenta affects your life, from womb to tomb.
        Am J Obstet Gynecol. 2015; 213: S12-S13
        • Selander J.
        • Cantor A.
        • Young S.M.
        • Benyshek D.C.
        Human maternal placentophagy: a survey of self-reported motivations and experiences associated with placenta consumption.
        Ecol Food Nutr. 2013; 52: 93-115
        • Selander J.
        The care and keeping of placentas.
        Midwifery Today Int Midwife. 2009; 35: 67
        • Grunebaum A.
        • Chervenak F.A.
        Out-of-hospital births in the United States, 2009–2014.
        J Perinat Med. 2016; 44: 845-849
      1. Google. Google trends: analysis for the term “placenta encapsulation.” Available at: https://trends.google.com/trends/. Updated May 5, 2017. Accessed May 5, 2017.

        • Kristal M.B.
        Placentophagia: a biobehavioral enigma (or De gustibus non disputandum est).
        Neurosci Biobehav Rev. 1980; 4: 141-150
      2. Wilson DE, Reeder DM. Mammal species of the world: a taxonomic and geographic reference. Available at: http://www.bucknell.edu/MSW3. Accessed May 23, 2017.

        • Young S.M.
        • Benyshek D.C.
        In search of human placentophagy: a cross-cultural survey of human placenta consumption, disposal practices, and cultural beliefs.
        Ecol Food Nutr. 2010; 49: 467-484
        • Hammett F.S.
        • McNeile L.G.
        The effect of the ingestion of desiccated placenta on the variations in the composition of human milk during the first eleven days after parturition.
        J Biol Chem. 1917; 30: 145-153
        • Young S.M.
        • Benyshek D.C.
        • Lienard P.
        The conspicuous absence of placenta consumption in human postpartum females: the fire hypothesis.
        Ecol Food Nutr. 2012; 51: 198-217
        • Menges M.
        [Evolutional and biological aspects of placentophagia].
        Anthropol Anz. 2007; 65: 97-108
        • Duchesne M.J.
        • Thaler-Dao H.
        • de Paulet A.C.
        Prostaglandin synthesis in human placenta and fetal membranes.
        Prostaglandins. 1978; 15: 19-42
        • Nakazawa K.
        • Makino T.
        • Nagai T.
        • Suzuki H.
        • Iizuka R.
        Immunoreactive oxytocin in human placental tissue.
        Endocrinol Exp. 1984; 18: 35-41
        • Blank M.S.
        • Friesen H.G.
        Effects of placentophagy on serum prolactin and progesterone concentrations in rats after parturition or superovulation.
        J Reprod Fertil. 1980; 60: 273-278
        • Kristal M.B.
        • DiPirro J.M.
        • Thompson A.C.
        Placentophagia in humans and nonhuman mammals: causes and consequences.
        Ecol Food Nutr. 2012; 51: 177-197
        • Corpening J.W.
        • Doerr J.C.
        • Kristal M.B.
        Ingested placenta blocks the effect of morphine on gut transit in Long-Evans rats.
        Brain Res. 2004; 1016: 217-221
        • Thompson A.C.
        • Abbott P.
        • Doerr J.C.
        • Ferguson E.J.
        • Kristal M.B.
        Amniotic fluid ingestion before vaginal/cervical stimulation produces a dose-dependent enhancement of analgesia and blocks pseudopregnancy.
        Physiol Behav. 1991; 50: 11-15
        • Surhone L.M.
        • Timpledon M.T.
        • Marseken S.F.
        Placentophagy.
        VDM Publishing, Saarbrücken, Germany2010
        • Schuette S.A.
        • Brown K.M.
        • Cuthbert D.A.
        • et al.
        Perspectives from patients and healthcare providers on the practice of maternal placentophagy.
        J Altern Complement Med. 2017; 23: 60-67
        • Ober W.B.
        Notes on placentophagy.
        Bull N Y Acad Med. 1979; 55: 591-599
        • Young S.M.
        • Gryder L.K.
        • Zava D.
        • Kimball D.W.
        • Benyshek D.C.
        Presence and concentration of 17 hormones in human placenta processed for encapsulation and consumption.
        Placenta. 2016; 43: 86-89
        • Ober W.B.
        Placentophagy.
        Obstet Gynecol. 1973; 41: 317-318
        • Baergen R.N.
        Manual of pathology of the human placenta.
        Springer-Verlag, Berlin2011
        • Sadler T.W.
        Langman's medical embryology.
        Lippincott Williams & Wilkins, Philadelphia2011
        • Huppertz B.
        • Kadyrov M.
        • Kingdom J.C.
        Apoptosis and its role in the trophoblast.
        Am J Obstet Gynecol. 2006; 195: 29-39
        • Brosens I.
        • Pijnenborg R.
        • Vercruysse L.
        • Romero R.
        The “Great Obstetrical Syndromes” are associated with disorders of deep placentation.
        Am J Obstet Gynecol. 2011; 204: 193-201
        • Kim Y.M.
        • Chaiworapongsa T.
        • Gomez R.
        • et al.
        Failure of physiologic transformation of the spiral arteries in the placental bed in preterm premature rupture of membranes.
        Am J Obstet Gynecol. 2002; 187: 1137-1142
        • Ramsey E.M.
        • Houston M.L.
        • Harris J.W.
        Interactions of the trophoblast and maternal tissues in three closely related primate species.
        Am J Obstet Gynecol. 1976; 124: 647-652
        • Kim Y.M.
        • Bujold E.
        • Chaiworapongsa T.
        • et al.
        Failure of physiologic transformation of the spiral arteries in patients with preterm labor and intact membranes.
        Am J Obstet Gynecol. 2003; 189: 1063-1069
        • Mossman H.W.
        Comparative morphogenesis of the fetal membranes and accessory uterine structures.
        Contrib Embryol. 1937; 26: 129-246
        • Page E.W.
        Human fetal nutrition and growth.
        Am J Obstet Gynecol. 1969; 104: 378-387
        • Burton G.J.
        • Jauniaux E.
        What is the placenta?.
        Am J Obstet Gynecol. 2015; 213: S6.e1-S6.e8
        • Spencer T.E.
        Biological roles of uterine glands in pregnancy.
        Semin Reprod Med. 2014; 32: 346-357
        • Medawar P.
        Some immunological and endocrinological problems raised by the evolution of viviparity in vertebrates.
        Symp Soc Exp Biol. 1952; 7: 320-338
        • Mor G.
        • Kwon J.Y.
        Trophoblast-microbiome interaction: a new paradigm on immune regulation.
        Am J Obstet Gynecol. 2015; 213: S131-S137
        • Moffett A.
        • Loke C.
        Immunology of placentation in eutherian mammals.
        Nat Rev Immunol. 2006; 6: 584-594
        • Moffett A.
        • Loke C.
        Implantation, embryo-maternal interactions, immunology and modulation of the uterine environment—a workshop report.
        Placenta. 2006; 27: S54-S55
        • Mari G.
        • Norton M.E.
        • et al.
        • Society for Maternal-Fetal Medicine. Electronic address pso
        Society for Maternal-Fetal Medicine (SMFM) clinical guideline #8: the fetus at risk for anemia—diagnosis and management.
        Am J Obstet Gynecol. 2015; 212: 697-710
        • Norton M.E.
        • Chauhan S.P.
        • Dashe J.S.
        • Society for Maternal-Fetal M
        Society for maternal-fetal medicine (SMFM) clinical guideline #7: nonimmune hydrops fetalis.
        Am J Obstet Gynecol. 2015; 212: 127-139
        • Coyle C.W.
        • Hulse K.E.
        • Wisner K.L.
        • Driscoll K.E.
        • Clark C.T.
        Placentophagy: therapeutic miracle or myth?.
        Arch Womens Ment Health. 2015; 18: 673-680
      3. Ricci BM. Placenta encapsulation tutorial. Available at: http://redandhoney.com/placenta-encapsulation-a-tutorial/. Accessed September 5, 2017.

        • Enning C.
        Smith C.K. Placenta: the gift of life. Motherbaby Press, Eugene (OR)2007
      4. Selander J. Placenta benefits. Available at: http://placentabenefits.info/find-a-specialist/. Accessed May 11, 2017.

      5. Food Safety and Inspection Service. Appendix A: compliance guidelines for meeting lethality performance standards for certain meat and poultry products; 1999 9 C.F.R. Parts 301, 317, 318, 320, and 381. Available at: https://www.fsis.usda.gov/OPPDE/rdad/FRPubs/95-033F/95-033F_Appendix_A.htm. Accessed July 7, 2017.

        • Schwering T.
        • Hoffman C.
        • Laudenslager M.L.
        • Kramer A.
        • Hankins C.
        • Powell T.L.
        Placentophagy: comparison of plausible biologically active compounds that might support this practice.
        Am J Obstet Gynecol. 2017; 216: S527-S528
        • Burns E.
        More than clinical waste? Placenta rituals among Australian home-birthing women.
        J Perinat Educ. 2014; 23: 41-49
      6. Brooklyn Placenta Services. Available at: http://www.brooklynplacentaservices.com/placenta-services.html. Accessed July 21, 2017.

        • Talamantes F.
        • Ogren L.
        • Markoff E.
        • Woodard S.
        • Madrid J.
        Phylogenetic distribution, regulation of secretion, and prolactin-like effects of placental lactogens.
        Fed Proc. 1980; 39: 2582-2587
        • Cox D.B.
        • Kent J.C.
        • Casey T.M.
        • Owens R.A.
        • Hartmann P.E.
        Breast growth and the urinary excretion of lactose during human pregnancy and early lactation: endocrine relationships.
        Exp Physiol. 1999; 84: 421-434
        • Beer A.E.
        • Billingham R.E.
        The embryo as a transplant.
        Sci Am. 1974; 230: 36-46
        • Ober W.B.
        A modest proposal for preventing choriocarcinoma among innocent mothers.
        Obstet Gynecol. 1968; 31: 866-869
        • Kristal M.B.
        • Thompson A.C.
        • Abbott P.
        Ingestion of amniotic fluid enhances opiate analgesia in rats.
        Physiol Behav. 1986; 38: 809-815
        • Kristal M.B.
        • Abbott P.
        • Thompson A.C.
        Dose-dependent enhancement of morphine-induced analgesia by ingestion of amniotic fluid and placenta.
        Pharmacol Biochem Behav. 1988; 31: 351-356
        • Abbott P.
        • Thompson A.C.
        • Ferguson E.J.
        • et al.
        Placental opioid-enhancing factor (POEF): generalizability of effects.
        Physiol Behav. 1991; 50: 933-940
        • Gryder L.K.
        • Young S.M.
        • Zava D.
        • Norris W.
        • Cross C.L.
        • Benyshek D.C.
        Effects of human maternal placentophagy on maternal postpartum iron status: a randomized, double-blind, placebo-controlled pilot study.
        J Midwifery Womens Health. 2017; 62: 68-79
        • Buser G.L.
        • Mato S.
        • Zhang A.Y.
        • Metcalf B.J.
        • Beall B.
        • Thomas A.R.
        Notes from the field: late-onset infant group B Streptococcus infection associated with maternal consumption of capsules containing dehydrated placenta—Oregon, 2016.
        MMWR Morb Mortal Wkly Rep. 2017; 66: 677-678
        • Antony K.M.
        • Ma J.
        • Mitchell K.B.
        • Racusin D.A.
        • Versalovic J.
        • Aagaard K.
        The preterm placental microbiome varies in association with excess maternal gestational weight gain.
        Am J Obstet Gynecol. 2015; 212: 653.e1-653.e16
        • Aagaard K.
        • Ma J.
        • Antony K.M.
        • Ganu R.
        • Petrosino J.
        • Versalovic J.
        The placenta harbors a unique microbiome.
        Sci Transl Med. 2014; 6: 237ra65
        • Lauder A.P.
        • Roche A.M.
        • Sherrill-Mix S.
        • et al.
        Comparison of placenta samples with contamination controls does not provide evidence for a distinct placenta microbiota.
        Microbiome. 2016; 4: 29
      7. US Food & Drug Administration. Available at: http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm488612.htm. Updated June 6, 2017. Accessed June 13, 2017.

        • Sheikh A.U.
        • Polliotti B.M.
        • Miller R.K.
        Human immunodeficiency virus infection: in situ polymerase chain reaction localization in human placentas after in utero and in vitro infection.
        Am J Obstet Gynecol. 2000; 182: 207-213
        • Xu D.Z.
        • Yan Y.P.
        • Zou S.
        • et al.
        Role of placental tissues in the intrauterine transmission of hepatitis B virus.
        Am J Obstet Gynecol. 2001; 185: 981-987
        • Hirneisen K.A.
        • Black E.P.
        • Cascarino J.L.
        • Fino V.R.
        • Hoover D.G.
        • Kniel K.E.
        Viral inactivation in foods: a review of traditional and novel food-processing technologies.
        Compr Rev Food Sci F. 2010; 9: 3-20
        • Dolin R.
        • Blacklow N.R.
        • DuPont H.
        • et al.
        Biological properties of Norwalk agent of acute infectious nonbacterial gastroenteritis.
        Proc Soc Exp Biol Med. 1972; 140: 578-583
        • Estes M.K.
        • Graham D.Y.
        • Smith E.M.
        • Gerba C.P.
        Rotavirus stability and inactivation.
        J Gen Virol. 1979; 43: 403-409
        • Rollins N.
        • Meda N.
        • Becquet R.
        • et al.
        Preventing postnatal transmission of HIV-1 through breast-feeding: modifying infant feeding practices.
        J Acquir Immune Defic Syndr. 2004; 35: 188-195
        • Young S.M.
        • Gryder L.K.
        • David W.B.
        • Teng Y.
        • Gerstenberger S.
        • Benyshek D.C.
        Human placenta processed for encapsulation contains modest concentrations of 14 trace minerals and elements.
        Nutr Res. 2016; 36: 872-878
        • Esteban-Vasallo M.D.
        • Aragones N.
        • Pollan M.
        • Lopez-Abente G.
        • Perez-Gomez B.
        Mercury, cadmium, and lead levels in human placenta: a systematic review.
        Environ Health Perspect. 2012; 120: 1369-1377
        • Piasek M.
        • Blanusa M.
        • Kostial K.
        • Laskey J.W.
        Placental cadmium and progesterone concentrations in cigarette smokers.
        Reprod Toxicol. 2001; 15: 673-681
      8. The Joint Commission. Available at: http://www.jointcommission.org/standards_information/jcfaqdetails.aspx?StandardsFaqId=786&ProgramId=46. Updated June 14, 2017. Accessed June 14, 2017.

        • Baergen R.N.
        • Thaker H.M.
        • Heller D.S.
        Placental release or disposal? Experiences of perinatal pathologists.
        Pediatr Dev Pathol. 2013; 16: 327-330
        • Baergen R.N.
        The placenta as witness.
        Clin Perinatol. 2007; 34: 393-407
        • Hargitai B.
        • Marton T.
        • Cox P.M.
        Best practice no 178. Examination of the human placenta.
        J Clin Pathol. 2004; 57: 785-792
        • Miller E.S.
        • Minturn L.
        • Linn R.
        • Weese-Mayer D.E.
        • Ernst L.M.
        Stillbirth evaluation: a stepwise assessment of placental pathology and autopsy.
        Am J Obstet Gynecol. 2016; 214: 115.e1-115.e6
        • Romero R.
        • Espinoza J.
        • Kusanovic J.P.
        • et al.
        The preterm parturition syndrome.
        BJOG. 2006; 113: 17-42
        • Thornburg K.L.
        • Marshall N.
        The placenta is the center of the chronic disease universe.
        Am J Obstet Gynecol. 2015; 213: S14-S20
        • Kim C.J.
        • Romero R.
        • Chaemsaithong P.
        • Chaiyasit N.
        • Yoon B.H.
        • Kim Y.M.
        Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance.
        Am J Obstet Gynecol. 2015; 213: S29-S52
        • Kim C.J.
        • Romero R.
        • Chaemsaithong P.
        • Kim J.S.
        Chronic inflammation of the placenta: definition, classification, pathogenesis, and clinical significance.
        Am J Obstet Gynecol. 2015; 213: S53-S69
        • Vahanian S.A.
        • Lavery J.A.
        • Ananth C.V.
        • Vintzileos A.
        Placental implantation abnormalities and risk of preterm delivery: a systematic review and metaanalysis.
        Am J Obstet Gynecol. 2015; 213: S78-S90
        • Fisher S.J.
        Why is placentation abnormal in preeclampsia?.
        Am J Obstet Gynecol. 2015; 213: S115-S122
        • Chang K.T.
        Examination of the placenta: medico-legal implications.
        Semin Fetal Neonatal Med. 2014; 19: 279-284
        • Sills A.
        • Steigman C.
        • Ounpraseuth S.T.
        • Odibo I.
        • Sandlin A.T.
        • Magann E.F.
        Pathologic examination of the placenta: recommended versus observed practice in a university hospital.
        Int J Womens Health. 2013; 5: 309-312
        • Curtin W.M.
        • Krauss S.
        • Metlay L.A.
        • Katzman P.J.
        Pathologic examination of the placenta and observed practice.
        Obstet Gynecol. 2007; 109: 35-41
        • Redline R.W.
        Classification of placental lesions.
        Am J Obstet Gynecol. 2015; 213: S21-S28
        • Langston C.
        • Kaplan C.
        • Macpherson T.
        • et al.
        Practice guideline for examination of the placenta: developed by the Placental Pathology Practice Guideline Development Task Force of the College of American Pathologists.
        Arch Pathol Lab Med. 1997; 121: 449-476
      9. US Federal Law. Medical Waste Tracking Act. 42 U.S.C. §§ 6992a-6992k. Available at: https://nepis.epa.gov/. Published Nov. 1, 1988. Accessed May 19, 2017.

      10. Oregon Administrative Code. Exemption for placenta removal from a health care facility. O.A.R. 333-056-0045. Available at: http://arcweb.sos.state.or.us/pages/rules/oars_300/oar_333/333_056.html. Accessed May 16, 2017.

      11. Hawaii Administrative Rules. Exemption for placenta. §1l-l04.1-34. http://co.doh.hawaii.gov/sites/har/admrules/Rules/1/11-104.1.pdf. Published Jan. 1, 2007. Accessed May 16, 2017.

      12. Texas State Legislature. Relating to the possession and removal of a placenta from a hospital or birthing center. 84th Leg., R.S., Ch. 740 (H.B. 1670), Sec. 172.002. http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.172.htm. Published June 6, 2015. Accessed May 5, 2017.

      13. Siemaszko C. Pregnant Mississippi woman wins court fight for her placenta. NBC News, June 6, 2016. Available at: http://www.nbcnews.com/news/us-news/pregnant-mississippi-woman-wins-court-fight-her-placenta-n584846. Accessed May 17, 2017.

      14. US Food and Drug Administration. Herbal Science International, Inc recalls twelve dietary herbal supplements nationwide because of possible health risk associated with ephedra, aristolochic acid and human placenta. Available at: http://www.fda.gov/Safety/Recalls/ArchiveRecalls/2008/ucm112427.htm. Updated July 2, 2013. Accessed May 16, 2017.

      15. US Food and Drug Administration. Available at: http://www.fda.gov/food/. Updated May 15, 2017. Accessed May 16, 2017.

      16. US Food and Drug Administration. Available at: http://www.fda.gov/OHRMS/DOCKETS/dockets/97s0163/97s-0163-let0641-vol19.pdf. Accessed June 6, 2017.

      17. Mesure S. Mothers face ban when taking placenta pills. Independent, June 14, 2014. Available at: http://www.independent.co.uk/life-style/health-and-families/health-news/mothers-face-ban-on-taking-placenta-pills-9537726.html. Accessed May 18, 2017.

        • Chervenak J.
        • McCullough L.B.
        • Chervenak F.A.
        Surgery without consent or miscommunication? A new look at a landmark legal case.
        Am J Obstet Gynecol. 2015; 212: 586-590
        • Chervenak F.A.
        • McCullough L.B.
        The professional responsibility model of perinatal ethics.
        Walter de Gruyter, Berlin2014
        • Chervenak F.A.
        • McCullough L.B.
        • Brent R.L.
        The professional responsibility model of physician leadership.
        Am J Obstet Gynecol. 2013; 208: 97-101
        • Soykova-Pachnerova E.
        • Brutar V.
        • Golova B.
        • Zvolska E.
        Placenta as a lactagogon.
        Gynaecologia. 1954; 138: 617-627
        • Altshuler G.
        • Deppisch L.M.
        College of American Pathologists Conference XIX on the examination of the placenta: report of the Working Group on Indications for Placental Examination.
        Arch Pathol Lab Med. 1991; 115: 701-703