I hope this post serves to soothe some anxieties, and explains how your doula can still support you in this tumultuous time. If you have any questions or concerns, please do not hesitate to contact me!
Encapsulation Methods
When I encapsulate placentas, I offer two different preparation methods. Here is a quick summary of where these methods come from, and why one method may be better than the other for some clients.
Raw Preparation
This method is based off raw foods diet, with the belief that heat destroys important enzymes in food. When processing a placenta via the raw method, the placenta is rinsed and drained of excess blood, then sliced thinly and placed in the dehydrator.
Clients using this option report a greater a burst of energy upfront and great hormone stabilization.
This method is not recommended if the client is GBS+ (group beta strep positive) or meconium is present.
Steamed Preparation
This method is inspired by the Traditional Chinese Method. Since I am not a practitioner of Chinese Medicine, I don't use the term. Also, some who practice this method, sometimes steam the placenta with other ingredients such as lemon, ginger, and/or jalapeno. I am not versed in the effects of these ingredients, so I prefer to simply steam the placenta.
This option provides a more steady release of energy, which is why it is recommended for clients with a history of anxiety, depression, or insomnia.
Some believe this method makes iron more bioavailable. There is some evidence that heating the placenta might affect the stem cells, hormones and B vitamins which are sensitive to heat, but we don't know to what degree they are affected.
Why Bleach?
Some people are curious why we use bleach during placenta encapsulation. To begin the explanation, we need to define a few words in terms of infection control:
Cleaners remove soil, dirt, dust, organic matter, and some germs. Sanitizers reduce the number of germs on a surface. Disinfectants destroy or inactivate germs and keep them from growing. Sterilizing removes all bacteria and other living microorganisms.
As far as placenta encapsulation, one's supplies and work space must be clean and disinfected. There is no need for sterilization.
In my practice, I start by cleaning my tools and work space with antibacterial dish soap. They are then rinsed thoroughly and dried. Next, a 10% bleach solution is prepared as a disinfecting bath. My tools and supplies are submerged and soak for ten minutes to be disinfected. They are then rinsed well and dried before use or storage. For surfaces, the solution is sprayed on, and kept wet for a full ten minutes before drying.
Bleach does not harm the environment, It naturally and quickly breaks down into water and hypochlorite salt. This is also the reason bleach sprays like described above must be made fresh daily. Bleach also does not contaminate ground water, as it does not survive sewage treatment. Bleach has also been studied and found not to cause cancer. Bleach also does not form dioxins when used in this way. Bleach does not cause sensitization.
So why can't I use essential oils when performing encapsulation? Well, essential oils are often added to homemade cleaning products to boost effectiveness. Essential oils do help clean, and can help sanitize, but they can not disinfect. Additionally, many people are sensitive and even allergic to essential oils. OSHA, the CDC, and Servsafe have a small list of approved cleaners, disinfectants, and sanitizers that are proven to work well; and essential oils are not on those lists. Finally, essential oils are much more expensive than the proven safe and effective products I use.
In summary, bleach is cheap (which keeps the cost of services low) and is proven to be an effective disinfection.
Sources:
Biologix Solutions 'Bloodborne Pathogens for Placenta Encapsulation Specialists' Course
OSHA 29 CFR 1910.1030
https://www.clorox.com/our-story/the-truth-about-bleach/
https://www.cdc.gov/niosh/topics/bbp/default.html
Placenta Pills Infect Baby!!! Probably Not...
Recently, a CDC report was released blaming placenta encapsulation for late-onset GBS infection in an approximately 16 day old baby. Yes, this is a scary thought, but there are some gaps in the research and processing of this placenta I want to break down.
So, we'll start with the issues in the report. First, GBS is a transient bacteria, which means it can come and go throughout a woman's life. So even though the mother was negative at 37 weeks, she could have been positive at birth. On the other hand, how many women are told they test positive, receive treatment, but are not actually colonized at birth?
Second, the capsules did test positive for the same bacteria baby was infected with. The mother's breastmilk, the most likely way the bacteria would have been transmitted, tested negative for the bacteria. The report also notes, "transmission from other colonized household members could not be ruled out".
Three of my colleagues raised excellent points and worded them much better than I can.
"You are also dealing with a severely immunocompromised infant who has just come off of a very rough course of antibiotics and was ill which makes that baby much more susceptible to any infection from any source." -Shannon Mitchell
"A logical conclusion is the initial infection wasn't eradicated and the secondary infection was basically a relapse. There was no gbs in the breast milk. I think that's an important part of the puzzle when assuming the placenta was the cause for reinfection. That said, the placenta doesn't seem to have been processed properly and probably shouldn't have been encapsulated to begin with given the immediate onset of the initial infection." -Deanna Norris, APPAC
"Late-onset GBS has generally been attributed to the presence of GBS in the infant's environment. Did they culture the doorknobs in the family's home? The client's nipples? How about burp rags or swaddling blankets? If the client had it on their hands, then they could have quite easily transferred it to the capsules when they were taking some out of the jar. To suggest that the capsules were the *source* of the organism seems like *quite* a stretch." -Wendy Gordon, Midwife
Now onto the problems with the processing of the placenta by 'Company A'. First, "the company does not ask about intra- or postpartum infections". This is HUGE! I absolutely ask this of my clients. Encapsulators never want you to consume infected tissue! In my practice, I will not encapsulate your placenta if you have chorioamnionitis, a confirmed GBS infection (not colonization- in that case your placenta would be prepared by steaming before encapsulation), or GBS infection of the newborn.
Also concerning is the fact that "according to Company A’s website, the placenta is cleaned, sliced, and dehydrated at 115°F–160°F". Any temperature below 160° is NOT safe for dehydration. Below 160° would keep the tissue in the 'danger zone' where bacteria grow rapidly, easily doubling in 20 minutes. When a placenta is dehydrating for 12+ hours, this is simply unsafe, unsanitary, and unacceptable. This is taught in any food handling course, so it makes me wonder if this encapsulator does not follow safe food handling standards.
In summary, in my practice and experience, GBS is only a concern when the mother or baby has a confirmed infection, or the placenta is prepared improperly.