Empowering Disgust: Redefining Alternative Postpartum Placenta Practices

ABSTRACT

This article examines communication practices surrounding the unconventional yet emerging trend of postpartum placenta use: eating, encapsulating, or burying the human placenta. Through interviews with both supporters and nonsupporters of postpartum placenta practices, we explore conceptualizations of placenta consumption and burial within larger mothering, childbirth, and postpartum rhetorics. We argue that placenta practices function rhetorically within a core frame of disgust, which both supporters and nonsupporters initially use to respond to placenta use. Yet supporters rearticulate the literal meaning of disgust to create an empowering rhetorical frame from which to view placenta practices and motherhood. In effect, supporters reframe the meaning of disgust toward the mainstream Western medicalization of birth in order to position placenta practices, natural childbirth, and mothering as empowering.

KEYWORDS:

• Abjection
• childbirth
• disgust
• juxtaposition
• motherhood
• placenta
• placentophagy

Notes

While the terms mainstream/Western and alternative/natural/midwifery are rhetorical on some level, this language is used by interviewees, scholars, and writers in popular and research-based childbirth discussions. The “Western”/“mainstream” medical model of birth emerged over the past century as birth moved from homes into hospitals, managed mostly by Western-trained male doctors (mostly obstetricians), complete with medical interventions. The birthing body is conceptualized largely as a vessel of sorts, meant to usher a baby safely into the world (Ussher, 2006). The emphasis is on obstetricians who monitor and “deliver” babies. The birthing woman is meant to trust the professional to make informed decisions for a safe delivery, especially for the baby. Pregnancy is a medical event, complete with specific positions (lying down or semiseated), pushing routines, and interventions (labor induction, epidurals, episiotomies, and Cesarean deliveries). In contrast, “alternative”/“natural”/“midwifery” techniques have been used throughout human history. After Western medicalized births were introduced in many industrialized cultures, natural birth was less frequently practiced and even looked down on as unsafe. Over the past several decades, however, natural childbirth in industrialized countries has made a small comeback. The natural model sees birth as an empowering life event and something that pregnant women should manage in conjunction with a midwife. Medical interventions (epidurals, episiotomies, Cesarean sections) are discouraged unless necessary. Trained, predominantly female midwives assess the pregnancy and attend the birth. The birthing woman is seen as empowered and capable of ushering a baby safely into the world with limited intervention. The emphasis is on the birthing woman, who is supported by her network and other attendants (such as doulas). Women typically deliver sitting, kneeling, squatting, or standing, with several trusted people in the room.

Traditional Chinese medicine (TCM) practitioners have used dried human placenta for medicinal purposes (Higham, 2009), and people in various cultures have ritually buried the placenta (Cusack, 2011; Metge, 2005; Shepardson, 1978; Young & Benyshek, 2010). Some argue that humans have purposefully evolved away from eating their placentas (Feibel, 2015).

Some question the legality of placenta practices in the United States, where consuming a placenta is not illegal (Cusack, 2011) and policies can influence placenta use and disposal. In home births and birthing centers, providers freely give the placenta to parents when asked. In hospitals, health care providers usually ask patients to sign over their placentas, which they do, often without thinking about it, with some exceptions. Often, though, whether U.S. mothers can take home the placenta depends on hospital policies. In our research, for example, we learned of a hospital where patients’ placentas are delivered to their rooms in a bucket marked “save for patient for human consumption” (personal communication, 2013). Ultimately, however, interpretations of hospital and U.S. Occupational Safety and Health Administration (OSHA) guidelines, rather than regulations or law, create an ad hoc environment around placenta disposal, use, and policy (Cusack, 2011).

This article involves three investigators: one in a southeastern U.S. town, one in a southwestern U.S. city, and another in Copenhagen, Denmark. Because personal experience shapes feminist scholarship (Foss & Foss, 1994), one author’s personal experience is relevant. Five years ago, while she was pregnant, the author decided to encapsulate her placenta after her childbirth. The author was scheduled for a Cesarean delivery due to a breech baby, and the obstetrician told her in a presurgery meeting that she could take the placenta. However, when she arrived for the surgery, the obstetrician told her that taking the placenta violates hospital policy. The author mentioned that her midwife from a birth center would be present during the operation, and the obstetrician then spoke with the midwife, apparently agreeing to look the other way. Following the surgery, the midwife simply took the placenta, which was sitting in a plastic bag on an operating room tray, placed it in her purse, and walked out of the hospital.

Of the six face-to-face supporter interviews, one was in the United States and five were in Copenhagen. One U.S. author conducted all nonsupporter interviews by telephone. Our interview questions for supporters included the following: How did you first come to know about placenta practices? What was your initial response? What research, if any, did you do? Who did the preparing/handling? Why did you choose the practice that you did? What about this is important to you? What did your health care professional think of your decision? Can you recall a memorable/significant experience regarding your placenta practice? Can you recall a conflict with someone who was critical of what you did? Why don’t more people do it? Our questions for nonsupporters included: Did you know about this topic before you saw our advertisement? When was the first time you heard about this? What was your response? What do you know about the placenta, pregnancy, and birth? What do you know about placenta practices? Why do you think people do it? If a family member/friend told you they were doing this, what would you think/say/do? Would it change your impression of them? What information would change your mind? Do you think people should be allowed to do this? What about this practice deters you?

Interviewees who did something with their placentas reported consuming it raw (such as putting a chunk in their mouth directly after birth, or blending in a smoothie) or in capsules; burying it (under a newly planted tree, alongside varying kinds of ceremonies); and doing a lotus birth (i.e., the placenta stays attached to the baby via the umbilical cord until the cord naturally falls off). Several interviewees were professional placenta preparers who encapsulate for a small fee. In addition, several interviewees self-identified as activists, and one was particularly active in U.K. politics surrounding placenta rights.

To get nonsupporter interviewees, we offered, with institutional review board (IRB) approval, a monetary incentive of USD$10 or equivalent for the interview. We paid all nonsupporters $10 for their participation.