Questions to Ask Before Placenta Encapsulation

Start with what the CDC says

Maybe a friend in Greenwich swears her capsules helped, or you saw encapsulation listed next to doula services and wondered if it belongs in your plan. Before the stories, read the one official report on the risks.

In June 2017, the CDC's journal MMWR described a newborn in Oregon who developed a late-onset Group B strep (GBS) infection. The same GBS strain was found in the baby's blood and in the mother's placenta capsules. The report says the encapsulation process does not by itself eliminate infectious germs, that no standards exist for processing placenta for consumption, and that scientific evidence for the claimed benefits is lacking. Its conclusion: placenta capsule ingestion should be avoided.

The report also asks clinicians to ask about placenta ingestion when a baby has a late-onset GBS infection, and to tell mothers who are interested in encapsulation about the potential risks. That is why the next step is a conversation with your own care team. Bring the report with you if it helps; the link is in the sources at the end of this page.

Talk to your OB or midwife and your pediatrician first

Your prenatal provider knows your history and your test results. The CDC report notes that where a mother carries GBS, has an infection called chorioamnionitis, or the baby has an early-onset GBS infection, contaminated capsules could raise the amount of GBS the mother carries. Ask your provider whether any of that applies to you.

Your baby's pediatrician should hear about it too, ideally before the birth. If you take capsules and your baby gets sick, the pediatrician needs to know, because the CDC report specifically asks clinicians to check for placenta ingestion in late-onset GBS cases.

• Ask your OB or midwife: is there anything in my pregnancy, my GBS result or my labor that makes this a bad idea for me?
• Ask your OB or midwife: if I have an infection during or after birth, what should I do with the placenta or capsules?
• Ask your baby's pediatrician: what signs in my baby should make me call right away, and should I avoid capsules entirely?

Ask your hospital how it releases a placenta

Each hospital or birth center sets its own steps for releasing a placenta, so ask yours well before your due date. Write down the answers, because you will not want to sort this out in the hours after birth. If you are giving birth on the other side of the state line from where you live, ask the hospital where you will deliver, since its steps are the ones that apply. If you are still choosing where to give birth, add these to the questions in our guide to choosing a hospital or birth center. Our post on placenta encapsulation in NY and CT covers the logistics in more detail; this guide does not give legal advice.

• Do you release placentas to families, and is there a form to sign?
• How much notice do you need, and who on the labor unit should I tell?
• How will the placenta be packaged, and how quickly does it need to leave the hospital?
• If my care team needs to send the placenta to the lab, what happens to my request?

Questions to ask any placenta encapsulator

These are questions to ask, not standards anyone has to meet: the CDC report says no standards exist. Ask them of any encapsulator you consider, and pay attention to how clearly they answer.

• Where is the placenta prepared, in my home or somewhere else, and who handles it from the hospital to that point?
• How is the placenta stored before processing, and what is the longest you will wait before starting?
• How do you clean and sanitize equipment between clients?
• What bloodborne pathogen training do you have, and can I see the documentation?
• Do you ask about infections during or after birth before you start? The CDC report noted that the company in its case did not ask.
• What written instructions will I get, and what should I do if I or my baby feel unwell?

How Northeast Doulas fits

Northeast Doulas offers placenta encapsulation as one of its three services. Its site describes a process in which the placenta is cleaned, steamed, dehydrated, ground into a powder and sealed in capsules, and says, "We offer this service in your home." The service page itself says the claimed benefits are not established, cites the CDC's advice that capsule ingestion should be avoided, and asks you to discuss it with your healthcare provider before deciding.

Encapsulation is separate from doula care. DONA International's Standards of Practice say that when a doula also offers a service such as placenta encapsulation, it is an additional service outside the doula's scope of practice. You can read more on our placenta encapsulation page.

Reasons to say no, or to wait

Saying no is a reasonable choice, and so is waiting until you have talked to your care team. You never need to explain that decision to anyone, including an encapsulator you have already contacted. If you booked a service and change your mind, ask how cancellation works and get the answer in writing.

Hold off if your OB, midwife or pediatrician advises against it, if you had an infection during or after birth, or if you feel pressured. If you are hoping capsules will help your mood, the CDC says evidence for that is lacking, and real help exists: our guide on postpartum depression and anxiety help lists where to turn. Our postpartum plan guide can help you build support that does not depend on capsules.