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What are you doing with your placenta? - Page 3

post #41 of 69

Pathology is saying that the only reason they want it is because your doctor ordered it?  And your doctor is saying that he's okay with it not going to pathology if they don't mind?  Maybe forward (or print) out that email from your doctor and tell pathology that it's no longer an order from your doctor?

post #42 of 69

Could you put together a note for your doctor to sign stating that he is not requiring you to send the placenta to pathology. You might give him an out if he hesitates and let him send it if is shows significant signs of problems, like retained tissue or something (ask him what would indicate a significant problem), but having his signature on a form when you head in will shut the L&D nurse down and then you don't have to worry about it. 

 

My OB signed my birth plan in his office and that was what I gave the nurse when I checked in. Made it easy for her to accept that my OB was on board with all my requests. :)

post #43 of 69
Quote:
Originally Posted by withlittlelungs View Post

The person I talked to in pathology said it was per doctor's orders. I'm not sure if she knows what she is talking about, just because both my Dr and the charge nurse said "pathology always takes it". And my doctor has delivered multiples at this hospital plenty of times. 
I emailed my doctor about it and asked if he would be able to help me at all. He said, "if pathology doesn't care, we will release it to you". 

Well great, but how am I supposed to find out beforehand if pathology cares or not?!

This is correct. Pathology can not do any testing without a Doctors order.  It may be that at this particular hospital they have a policy that twin placentas are sent to pathology for testing and therefore there is a standing order for it to be done, but your Dr should be able to over ride this standing order by just giving another order not to send it. Pathology should not care, they just do the testing, they dont do anything with the actual results.

post #44 of 69
Thread Starter 

Thank you for your advice, ladies! I'm definitely going to have him sign off on my birth plan (which includes my placenta). I am going to see if he will write or sign a letter stating that he does not want it sent anywhere. 
I also have the number for the head of pathology at the hospital and I am going to try to get in touch with him on Monday to see if I can get a written exception from him. 

It is so irritating. I want it. I know they don't have any personal preferences towards acquiring it. Just give the damn thing to me!

post #45 of 69
This is slightly amusing because both parties think its the other party who is ordering it. It sounds like somewhere along the line wires got crossed and since no one has ever questioned it (until now) it hasnt mattered who is in charge with this. Its like shedding light into a dusty corner which is helping you clear out the cobwebs to see that you do have options smile.gif. I hope you get this totally cleared up soon so you dont have to worry about it anymore!
post #46 of 69

Ellie, I had a client that had SROM with no onset of labor for over 36 hours and then even with pit and cytotec, she never got into active labor. We ended up having to do a c/s and because of her unusual labor pattern the doc on staff wanted to run some tests on the placenta to rule out some potential complications. The client had intended on doing encapsulation so we talked to her m/w and she called the pathology department and they said that most tests are actually done on the cord and sack so we were able to just send part of the cord and most of the stack to pathology for the testing and took the rest of the placenta for encapsulation. So, even if there WAS a reason to do testing, they DO NOT need the entire thing! Hopefully you can get something worked out <3

post #47 of 69
Thread Starter 

Ladies I appreciate all of your advice and for helping me emotionally deal with this craziness! blowkiss.gif
I am happy to say that it is over energy.gif
I called the director of pathology who sounded a bit scary and I didn't think would be much help. He directed me to the head of placental pathology at the hospital. She told me that as long as delivery goes well she is fine with letting it go and not examining it!

She also explained the reasoning for them routinely testing the twin placentas. Since they are often premies and have a greater chance of medical issues, they want to have the placenta to examine to get answers. 

post #48 of 69

withlittlelungs, that's awesome!

 

i'm really curious now - does anyone know what types of medical issues they'd be able to learn more about by examining the placenta? i'm specifically thinking about the issues that seem to affect preemies and wondering what info the placenta would have to help treat the babies...

post #49 of 69

Just thought I'd share this, which was interesting to me:

 

http://www.sciencebasedmedicine.org/index.php/eating-placentas-cannibalism-recycling-or-health-food/

 

I'm embarrassed to admit that I had not considered the issue of toxins in one's placenta.  People throwing around the word "toxins" in a non-specific way is a pet peeve of mine, but organs do store lots of specific toxins.  Now I'm wondering if it wouldn't be like eating your liver, which I wouldn't want to do, KWIM?  At the same time, the rodent studies are interesting...  and yet, if (if!) the main (medium-term) positive contributions of placenta are A) bioavailable iron and B) prostaglandins, well, I have other sources of those available (food, DH Sheepish.gif ).

post #50 of 69
Quote:
Originally Posted by buko View Post

Just thought I'd share this, which was interesting to me:

 

http://www.sciencebasedmedicine.org/index.php/eating-placentas-cannibalism-recycling-or-health-food/

 

I'm embarrassed to admit that I had not considered the issue of toxins in one's placenta.  People throwing around the word "toxins" in a non-specific way is a pet peeve of mine, but organs do store lots of specific toxins.  Now I'm wondering if it wouldn't be like eating your liver, which I wouldn't want to do, KWIM?  At the same time, the rodent studies are interesting...  and yet, if (if!) the main (medium-term) positive contributions of placenta are A) bioavailable iron and B) prostaglandins, well, I have other sources of those available (food, DH Sheepish.gif ).

I'm so glad you posted that, I will check it out in a minute.  I had this same thought... placenta is organ meat, and it filters out so much crap during pregnancy... I actually asked my midwife this: "isn't eating your placenta like eating a liver?"  and I could tell that she had never thought about that before!

Some more research to do!  Thanks, Buko, for all your interesting links!  I love having a very thorough researcher in the DDC!!!

post #51 of 69
Quote:
Originally Posted by LightForest View Post

withlittlelungs, that's awesome!

 

i'm really curious now - does anyone know what types of medical issues they'd be able to learn more about by examining the placenta? i'm specifically thinking about the issues that seem to affect preemies and wondering what info the placenta would have to help treat the babies...

The placenta is really just a bunch of blood vessels with a big pool of blood in the middle.  It is a really weird organ, haha.  Here is a link to a great video explaining it:  http://www.khanacademy.org/science/healthcare-and-medicine/fetal-circulation/v/meet-the-placenta

 

Anyway... a lot of times, a lot that they look for is obvious just from looking at it in the delivery room.  Like, where the cord inserts (velamentous insertion?  Battledore?) Is it calcifying?  Is it small?  Big?  Do the membranes look healthy and strong?  Is there a two or three vessel cord?  Etc.... You don't need pathology to tell you that stuff, it is simple observation.  

 

It isn't very often that I see a doc at work send a whole placenta to pathology, it is usually just a tiny piece.  They probably look at it under a microscope or something, haha.  

 

And WLL-- I agree with whoever said to have your doctor's orders override the policy... Doctor's are in charge and they can override pretty much any standing order.  A lot of times, if we don't like our policy, haha, we'll (as nurses) ask the doctors if they'd be ok with writing a different order specific to that particular patient.  I mean, it can't be anything too crazy that the hospital wouldn't agree with, but if it is within reason, the doctor can pretty much order whatever they want.  :)   Another reason, to have a supportive doc that you trust!  

post #52 of 69
Quote:
Originally Posted by Chapsie View Post

I'm so glad you posted that, I will check it out in a minute.  I had this same thought... placenta is organ meat, and it filters out so much crap during pregnancy... I actually asked my midwife this: "isn't eating your placenta like eating a liver?"  and I could tell that she had never thought about that before!

Some more research to do!  Thanks, Buko, for all your interesting links!  I love having a very thorough researcher in the DDC!!!

 

Thank you, LOL-- all credit goes to Dr. Mom, who spent 75% of her MD career in lab research and regulatory work.  It rubs off-- I can't help but be curious.  I am actually going to ask her what she thinks right now-- it's one of the few things we haven't discussed in-depth.  The awesome thing about her is that her two biggest values are: 1) First, do no harm (so, low-intervention, more preventative lifestyle stuff, as few drugs AND as few supplements as you can get by with, don't get surgery unless really necessary, etc.) and 2) What does the latest and/or best research say?  Which means she is supportive of things like homebirth once she's done some research, and yet also (really along the same lines) not too keen on some "natural" remedies and procedures and whatnot-- at least not just because they're "natural."  But that means she won't blink an eye at placentophagy (sp?)-- she won't necessarily endorse it, but I know she's 100% open to thinking about it. 

post #53 of 69
Buko, thank you for doing my homework....again! Interesting article and comments and I've read some of the links it referenced too, exactly the kind of information I've been looking for to make a decision on my placentaphagia.
Other mammals do it, often painstakingly, but their reasons aren't clear, maybe nutritional, maybe protective. Why do humans not have this urge (anymore)?
Yes, it is an organ but this is why it appeals to me as it does appear to have high levels of iron, prostaglandins and other hormone precursors. It does filter incoming blood for the foetus but that doesn't mean it stores any toxins. Does processing damage or remove these nutrients? Are the stem cells it contains worth consuming?

Gah, in fact, curse you! I have more questions than ever now smile.gif
post #54 of 69

I know-- me too, LOL!

post #55 of 69
Quote:
Originally Posted by Bena View Post


I'm not in the States but honestly I never questionned taking it home from the hospital. I can't remember if we brought a bag, or if our mw did or if the nurses did, but we just packed it up and took it home. No questions asked!

At our prenatal class the doula said if you are at the hospital and want to take it home make sure you take a bag (as that often proves challenging for the hospital staff).  

post #56 of 69

Okay, Dr. Mom got back to me.  Very interesting.

 

 

Quote:

I read what you wrote and the articles in the link you sent.  As you might expect, I’m looking at this as a risk/benefit proposition. 

 

First, there is the question of whether there are documented scientific benefits; and, if so, what those are.  Although not all mammals eat their placentas, some animal research suggests that there may be nutritional value and (perhaps) pain relief [see the doctoral thesis and the lab observed effect on opioid receptors (read, ‘pain relief’)] with placentophagy.  There are other mechanisms for these benefits in humans: a)  human cortical and hormone function (hypnosis, meditation, oxytocin, etc) which produce reduction in pain perception, and b) nutrition from dietary sources.  It makes sense that iron is ingested from the blood present, but a single ingestion of even a substantial amount of iron would not reverse iron deficiency which might have developed over the course of a pregnancy—that requires supplementation over time.  The placenta also contains other nutritional substances; for instance, protein.  All of this nutrition is abundantly present in modern diets and supplements.   I also think it important to mention that  any potential benefit could be negated by cooking, freezing, pulverizing, or preserving the placenta—if there is an intact hormone or substance producing an effect.  I’ve learned this through reviewing many ‘failed’ studies and examining issues related to Good Manufacturing Practices which are so important to the safety and efficacy of drugs and biologics.   On the other hand, testimonials of women whose prior pregnancies resulted in PPD but who did not have recurrence after a subsequent pregnancy (especially when they had a baby under more ‘natural childbirth ‘ conditions upon subsequent births) do not convince me that eating human placenta prevents PPD—this is the epitome of anecdotal evidence (even if it feels very real to those women).  I conclude that there is no unique and proven benefit from human placentophagy

 

Second, now look at the ‘risk’ side.  [You know me, I don’t even want to take the risk (infinitesimally small in the U.S.) of mad cow disease from beef!  I also have significant knowledge of infectious diseases, from which I understand that very small particles (smaller than viruses) can contain, transmit, and cause disease.]  I would be most concerned about transmission of infection and/or toxins which we know can accumulate in body tissues (these store especially well in blood, brain, and fatty tissue) especially because there are case reports of toxin transmission, infections, and allergic reactions via blood (and even milk) exposure.   (In fact, hospitals typically keep placentas for a few days to examine thoroughly in case newborns show signs of disease or illness.) On the other hand, we do not have absolute proof that this would occur in every case.  Nevertheless, we know that some infectious diseases are latent (Creutzfeldt-Jakob and mad cow) and that even HIV infected babies can appear normal as neonates, so cannot assume that a ‘healthy’ baby means the placenta is ‘o.k.’ to eat.

 

In conclusion, given the theoretical (and completely substitutable in humans) benefits suggested by animal data, and the theoretical (sometimes proven) possibility of harm, eating one’s-baby’s placenta would not be something I would recommend.   However, this does not diminish the fact that the placenta is the mother-fetus’s property and should be utilized as they choose. 

 

Thanks for sharing this with me.  I was unaware that this practice is occurring in the U.S. (even on a smaller scale).

 

 

I am inclined now not to eat it (not that I'm worried about infectious disease-- more toxins, and not seeing great "unique" benefits), but I wouldn't necessarily make that recommendation to everyone.  As she notes, we don't really know, which means... who knows?  Maybe someday we'll find that controlled studies show big benefits.  And even if it is a placebo effect, hey-- as Dr. Mom always reminds me, that's not nothing.  Just thought I'd share.

 

Also, I can see where I get my love of parentheticals (LOL).

post #57 of 69
Quote:
Originally Posted by buko View Post

Okay, Dr. Mom got back to me.  Very interesting.



I am inclined now not to eat it (not that I'm worried about infectious disease-- more toxins, and not seeing great "unique" benefits), but I wouldn't necessarily make that recommendation to everyone.  As she notes, we don't really know, which means... who knows?  Maybe someday we'll find that controlled studies show big benefits.  And even if it is a placebo effect, hey-- as Dr. Mom always reminds me, that's not nothing.  Just thought I'd share.

Also, I can see where I get my love of parentheticals (LOL).

Your mom is awesome!!!! smile.gif. I want to read ALL her reviews on birth practices, haha. What does she think about water birth? smile.gif

Thanks for posting this. I was on the fence about ingesting my placenta, and now I'm also leaning toward not... Just don't know if it is really worth the effort. I'll just keep taking my floradix. smile.gif. I do want to make placenta prints and maybe bury the placenta with a tree over it. That seems like a nice way to "honor" the placenta.
post #58 of 69

Ijoy.gif my mom, too!  (Obviously, LOL.)

 

She thinks water birth is just fine-- not a likely danger, with some small likely benefits in terms of tearing, etc.  (Water labor is a really BIG yes in her opinion, though.)  Off the top of my head, she is very supportive of the following things, based on evidence:

 

-Home/OOH birth for low-risk women with highly-experienced care providers who follow evidence-based practices (good CNMs, some CPMs, etc.)

-Unmedicated birth when possible

-Avoidance of any surgical procedure when possible and avoidance of general anesthesia when possible (these are true of her even when not related to birth)

-Avoidance of AROM, pitocin and other drugs for induction/augmentation, when at all possible

-Avoidance of episiotomy in almost every case

-Avoidance of unnecessary supplements, too!  She is more into nutritionals (things that might be in your diet, like garlic or lower doses of vitamins, etc.), and treats other, even "natural," supplements like drugs-- not to be used if the benefit/risk proposition isn't significantly favorable.

-NPO (nothing by mouth), CEFM, routine lithotomy, requiring bed rest after ROM (when the head is engaged) and purple/directed pushing are all on her sh!t list.  

-She slightly recommends GD testing, but modified in practice (more like Canada's) and with a higher threshold for diagnosis, and also... just not generally freaking out about it.

-She recommends IV abx for GBS, but also not freaking out about it.

 

Ummm... what else, LOL?  She had two unmedicated hospital births herself, and is pretty darned non-interventive for an MD.  I think that's pretty impressive for someone who worked in an ER for a number of years, considering they're not exactly known for preventative, low-intervention medicine.  But again, about 75% of her career was in lab research, and later, drug regulation.  So she's obviously a doctor with an eye towards the evidence, which I think makes you naturally inclined to start with the least invasive solution possible in most cases. 

 

Oh, she does not believe in homeopathy, except its placebo effect, which she actually does support, IYKWIM.  As long as people aren't using it in place of more proven treatments for truly serious conditions, she just kind of shrugs her shoulders at it.  Umm...  and lotus birth, she agrees with me that there's no likely medical benefit and some small risk of harm, so kinda the same position as on placentophagy, where it should be up to the mother-baby dyad, but she doesn't recommend it.  Errrrr...  also, she is pro-vaccination in MOST cases, but also on a slightly delayed/selective/staggered schedule, and, of course, always with respect to patient autonomy.  (FWIW, her boards are in immunology and internal medicine.)

 

I think the only thing where we haven't been on exactly the same page was with u/s.  She is essentially against more than one routine u/s for low-risk women, but she would have liked me to get the 20-week anatomy scan, whereas I felt (after MUCH deliberation and research!) that it was a slightly lower-risk proposition for me to skip u/s entirely.  She is also all for avoiding doppler (also u/s technology, as you know) when possible to do so.

 

Oh, and... circ.  She leans against circ now (though she did have my brother circ'ed ~25 years ago), but not as strongly as I do.

 

If there's something, I've missed, tell me, and I'll be happy to share if we've talked about it... Which we probably have, LOL.

post #59 of 69
Quote:
Originally Posted by buko View Post

I:joy my mom, too!  (Obviously, LOL.)

She thinks water birth is just fine-- not a likely danger, with some small likely benefits in terms of tearing, etc.  (Water labor is a really BIG yes in her opinion, though.)  Off the top of my head, she is very supportive of the following things, based on evidence:

-Home/OOH birth for low-risk women with highly-experienced care providers who follow evidence-based practices (good CNMs, some CPMs, etc.)
-Unmedicated birth when possible
-Avoidance of any surgical procedure when possible and avoidance of general anesthesia when possible (these are true of her even when not related to birth)
-Avoidance of AROM, pitocin and other drugs for induction/augmentation, when at all possible
-Avoidance of episiotomy in almost every case
-Avoidance of unnecessary supplements, too!  She is more into nutritionals (things that might be in your diet, like garlic or lower doses of vitamins, etc.), and treats other, even "natural," supplements like drugs-- not to be used if the benefit/risk proposition isn't significantly favorable.
-NPO (nothing by mouth), CEFM, routine lithotomy, requiring bed rest after ROM (when the head is engaged) and purple/directed pushing are all on her sh!t list.  
-She slightly recommends GD testing, but modified in practice (more like Canada's) and with a higher threshold for diagnosis, and also... just not generally freaking out about it.
-She recommends IV abx for GBS, but also not freaking out about it.

Ummm... what else, LOL?  She had two unmedicated hospital births herself, and is pretty darned non-interventive for an MD.  I think that's pretty impressive for someone who worked in an ER for a number of years, considering they're not exactly known for preventative, low-intervention medicine.  But again, about 75% of her career was in lab research, and later, drug regulation.  So she's obviously a doctor with an eye towards the evidence, which I think makes you naturally inclined to start with the least invasive solution possible in most cases. 

Oh, she does not believe in homeopathy, except its placebo effect, which she actually does support, IYKWIM.  As long as people aren't using it in place of more proven treatments for truly serious conditions, she just kind of shrugs her shoulders at it.  Umm...  and lotus birth, she agrees with me that there's no likely medical benefit and some small risk of harm, so kinda the same position as on placentophagy, where it should be up to the mother-baby dyad, but she doesn't recommend it.  Errrrr...  also, she is pro-vaccination in MOST cases, but also on a slightly delayed/selective/staggered schedule, and, of course, always with respect to patient autonomy.  (FWIW, her boards are in immunology and internal medicine.)

I think the only thing where we haven't been on exactly the same page was with u/s.  She is essentially against more than one routine u/s for low-risk women, but she would have liked me to get the 20-week anatomy scan, whereas I felt (after MUCH deliberation and research!) that it was a slightly lower-risk proposition for me to skip u/s entirely.  She is also all for avoiding doppler (also u/s technology, as you know) when possible to do so.

Oh, and... circ.  She leans against circ now (though she did have my brother circ'ed ~25 years ago), but not as strongly as I do.

If there's something, I've missed, tell me, and I'll be happy to share if we've talked about it... Which we probably have, LOL.


Wow, what a gold mine!!! Does your mom have a blog? Or a book? What a great resource to have in your family. I will definitely have to hold on to your contact info so I can message you later down the road with "what does your mom think about _________?" types of questions!

If I think of something you haven't covered, I will definitely ask! joy.gif
post #60 of 69

Haha, that's awesome!  And yes, I am SO SO blessed that she's my mom, YK?  She's done so much for her family (esp considering she grew up poor-- her parents didn't graduate HS-- so a lot of her family would be SOL when it comes to good medical care)-- including getting people seen at the Mayo Clinic and Johns Hopkins.  I don't know what we'd do without her!  If I can pass anything along from her, I'm happy to.  I asked her before reposting if she minded, and she was all for it.

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