Timshel Holistic Collective

Group B Strep & Placenta Encapsulation: Beth’s Thoughts

When I started encapsulating placentae (the plural of “placenta”) eight years ago, I didn’t know of anyone else who offered the service in my area. I raised some eyebrows in Waterloo Region by being up all night encapsulating placentae, but my clients were clearly enthusiastic: I have lost count of the hundreds of placentae that I have lovingly encapsulated over the years, but my repeat clients speak for themselves – this is a service that people are increasingly seeking.

Now, it seems like every doula is rushing to offer placenta encapsulation as one of their services, and there are doula organizations that are eager to cash in on the eager entrepreneurs. Unfortunately, due to the fact that placenta services and education about placenta services are unregulated, there are people who are advertising themselves as placenta service providers (and placenta service educators) who are woefully uninformed about the process of encapsulation, blood-borne pathogens, and safety. Just this past year, I watched horrified as a local organization that offers placenta encapsulation training paid to publish a video on YouTube where they clearly practiced without proper personal protection equipment (PPE) and without taking appropriate measures to ensure that cross-contamination did not take place. This was material that they used for marketing purposes – this tells me that either a) they were uneducated and did not know that they were acting unsafely or b) it was not a priority to them to appear to be practicing safely. If this is a school that is offering placenta service education, think of how many students they will “train” with unsafe practices!

This leads me to an article that I have seen go viral on Facebook over the weekend: “Her newborn kept getting sick because she was ingesting placenta, CDC says” by Peter Holley of The Washington Post.[1] Holley’s article makes the claim that a mother in Oregon was taking placenta capsules, and as a result, her newborn contracted Group B Strep twice. The Center for Controlled Diseases (CDC) thus advises that “placenta capsule ingestion should be avoided”. [2]

First, let’s discuss what Group B Strep is: GBS is a common bacteria (Streptococcus agalactiae) which lives on everyone’s skin, including that of pregnant people. It particularly thrives in mucus membranes, which is why care providers check for active GBS infections during the last weeks of pregnancy by swabbing the vagina and rectum. A colonization of GBS does not mean that a pregnant person has an active GBS infection, but a positive result from a GBS test does mean that there is an abundance of GBS bacteria in the vaginal canal. This is a concern because it could lead to an infection in the newborn if the baby is also colonized during the birth process. Many babies are exposed to GBS during birth, and most of them are healthy and do not become infected. A newborn infection of GBS is very serious: it can lead to pneumonia, sepsis, and meningitis, which is why individuals diagnosed with an active GBS infection before birth are prophylactically treated with antibiotics (or their babies are treated with antibiotics after birth). [3]

GBS can survive in a dry environment for months. It is sensitive (or will start to die) after being exposed to moist heat at a temperature that is at least 131 degrees F (or 55 degrees C) for 30 minutes.[4]

My understanding is that recurring infections of GBS have been studied twice. In one study, the reinfection rate was found to be 0.9%, and the other study showed a rate of 0.4%. We do not know how the reinfections occurred in these cases.[5]

So, if we apply what we know about GBS to the case that the CDC and Holley are referencing, here’s what a skilled placenta service provider should deduce:

1) Due to the fact that the newborn immediately showed signs of infection, the placenta in question should not have been encapsulated. This is simply Placenta Basics 101: if there are any symptoms of infection in the birthing parent or the neonate, the placenta cannot be safely ingested. The placenta service provider in question should have been more thorough in questioning their client.

2) The article from the CDC does not state how the placenta was prepared. According to the CDC, the encapsulator’s website (unfortunately, I do not know who the encapsulator was, so I cannot cite their website directly) states that they dehydrate placentae between 115-160 degrees F. Elementary food handling knowledge would dictate that if GBS survives a dry heat up to 131 degrees F, it would be imperative that it be dehydrated at a temperature much higher than that. The industry standard is 160 degrees F for “raw prep” placentae…and further precaution could have been taken by steaming the placenta for thirty minutes at 151 degrees F prior to dehydration, which would have ensured that the GBS was destroyed. Steaming before dehydration is a common practice among placenta service providers in cases where GBS status is positive or unknown – again, this is Placenta Basics 101.

3) We know that the reinfection of GBS is speculated to occur due to the colonization of mucus membranes. In this case, the CDC is arguing that the reinfection occurred due to the mother consuming placenta capsules that were contaminated with GBS. Now, this could have caused the MOTHER to continue to be colonized, but as her breast milk was tested and was clear of GBS bacteria… why would the BABY be colonized by contaminated placenta capsules? The CDC article itself states that it is reasonable to assume that the baby was immunocompromised due to the primary infection of GBS and that it is also reasonable to assume that initial infection was sufficiently treated to eradication – that means that it is impossible to rule out reinfection from another mode, such as colonized family members transmitting GBS bacteria to the newborn, nor is it possible to rule out prolonged primary infection.[6]

4) This is one, singular case of someone purportedly infecting their newborn with GBS from ingesting contaminated placenta capsules out of many, many, many instances of people consuming placentae that may or may not been prepared appropriately. Unilaterally declaring henceforth that it is unsafe to consume any and all placenta capsules is, in my opinion, rash, especially considering the placenta service provider in question clearly did not follow appropriate protocol and that it cannot be ruled out that the newborn was not infected through other means such as family members.

There is something that the article asserts that I agree with: there is not much information available on the benefits of consuming placenta capsules. This is absolutely true. However, I would go on to state that there have not been many studies conducted on human placentophagy (a fancy, scientific way to say “eating placenta”). We cannot disprove the efficacy of placenta capsules when there is minimal research conducted on the subject. While I am delighted with the anecdotal evidence my clients have provided me with, I fully support scientific research into various methods of placentophagy (raw vs. steamed vs. encapsulated, for example).

I would also go on to point out that if people are going to the extent of eating their afterbirth in the hopes that it could potentially guard them against postpartum depression or at least ease their symptoms, care providers need to step up their game in order to a) build a genuine rapport with their clients so that they feel safe disclosing to them that they have concerns about postpartum depression (or any of the other potential reasons they might have for ingesting their placenta), b) honestly and accurately providing information to their clients about all their options for postpartum support, which may include consuming their placenta, and, c) work more closely with placenta service providers in the community to ensure that their clients (who will seek out placenta service providers whether or not their care providers approve) are receiving care from competent, highly-skilled placenta encapsulators.

Finally, from the bottom of my heart, I strongly encourage those individuals who are seeking to encapsulate their placenta to do their research. Do not be afraid to ask questions of potential placenta service providers. Ask them about their experience, about how they disinfect their spaces, about their protocols for GBS, HIV, etc.

I love placentae. I think they are powerful organs that contain the potential for healing. I have dedicated a great deal of my time, energy, and money to not only understanding the physiological aspects of placentae, but also to ensuring that my clients receive the highest standard of care. It fills me with pride when a client says to me, “you are the one my midwife recommended!” I worked very hard to receive that confidence and that reputation – I’d like to see other placenta service providers have the same ambition and commitment to quality.

Timshel Holistic Collective takes your safety and wellbeing seriously. We invite you to contact Sherri-Lyn or Beth with any and all of your questions about our placenta services. There is never any obligation – we don’t believe in high-pressure sales. Our slogan at Timshel Holistic Collective is “your choice, your voice” because we believe that what matters most is not what we want for you and your family, rather, our priority is what you want. We trust you to know what is best for you.

– Beth Murch

[1] see https://www.washingtonpost.com/news/to-your-health/wp/2017/06/30/her-newborn-kept-getting-sick-because-she-was-ingesting-placenta-cdc-says/?tid=sm_tw&tid=sm_tw&utm_term=.2902be42d800 (Accessed July 2, 2017)

[2] see Notes from the Field: Late-Onset Infant Group B Streptococcus Infection Associated with Maternal Consumption of Capsules Containing Dehydrated Placenta — Oregon, 2016 https://www.cdc.gov/mmwr/volumes/66/wr/mm6625a4.htm?s_cid=mm6625a4_w (Accessed July 2, 2017).

[3] see Pathogen Safety Data Sheet – Infectious Substances: Streptococcus agalactiae http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/streptococcus-agalactiae-eng.php (Accessed July 2, 2017)

[4] Ibid.

[5]  see A. Schuchat’s  Epidemiology of Group B Streptococcal Disease in the United States: Shifting Paradigms. Clin. Microbiol. Rev. July 1998vol. 11 no. 3 497-513.

[6] see Notes from the Field: Late-Onset Infant Group B Streptococcus Infection Associated with Maternal Consumption of Capsules Containing Dehydrated Placenta — Oregon, 2016 https://www.cdc.gov/mmwr/volumes/66/wr/mm6625a4.htm?s_cid=mm6625a4_w (Accessed July 2, 2017).