In an unusual turn of events, I came down with a summer cold in late July. This summer, I had intentionally planned a gap in due dates so I could take some time off, and this well-timed immune dip occurred before I had to attend any labors. Thank goodness.
The cold was tricky for me to kick, however. I rested and drank broth and elderberry tea all day. One of the factors in my slowed ability to fight this cold is my hypothyroid (which approximately ten million Americans also have). Having a slow thyroid makes me run cold, and it’s tricky for my body to build an appropriate fever to kill pathogens. I also tend to be super dry – and this cold definitely exacerbated that for me. When the body produces mucous, it’s actually healing itself. It’s a way your body expels the gunk that’s making you sick. It’s why an herbalist, for a dry cough, may recommend something like mullein (a strong expectorant) rather than cherry bark (a spasmodic cough soother).
I knew what I needed was wet heat. A steam is a way of bringing the medicinal qualities of plants directly to the tissues affected by a cold (mucous membranes in nose, throat, mouth, lungs). After a few days of these steams, I’d kicked the dry cough and was able to move on from my cold.
Included in my steam is fresh thyme from the front porch. Aromatic culinary herbs are very effective as antimicrobial and antibacterial agents. The essential oils come out with heat and perfume the air. I also included some usnea, from my friend’s land in Cape Cod. Usnea is a lichen (algae/fungus combo) that grows on trees in woodsy/seaside/oceany places. It’s known to have herbal antibiotic action, and is especially useful for mucous membranes (such as lungs, sinus, or urinary tract). Its constituent, usnic acid, is one of the more studied herbal extracts because it inhibits gram positive bacteria metabolism, making it potentially affective against tuberculosis, staphylococcus, streptococcus, and pneumococcus.
After a few days of thyme and usnea steams, I added in another before bedtime and focused on gently soothing/relaxing herbs. Pictured here – I added chamomile and lavender flowers. Lavender, like thyme, is also very aromatic and its essential oil has antibacterial action. Chamomile, while gently relaxing, also has some antispasmodic action (mostly when drunk as tea). It’s especially nice to add these if a dry cough (or any cold symptom, really) is keeping you awake at night. Quality sleep is important to healing! Remember: some folks are allergic to chamomile, so it’s not for everyone.
To prepare a steam:
- Heat a pot of water to boil and set yourself up a comfortable spot in the meantime. You’ll probably want a hanky or some tissues handy!
- Grab a towel, and place the herbs in a separate bowl. Because essential oils of herbs can dissipate quickly with heat, it is important to add the herbs to the hot water when you’re ready to breathe them in deeply.
- Once the water is boiling, place the pot in your comfy spot, tent a towel over your head with the steaming water underneath, and add your herbs.
- Breathe deeply, using both nose and mouth and focus on the scents of the herbs. Bring them in to your lungs. Come up for cooler breaths if you need to, but you’ll notice the steam making your nose run and your dry cough more productive.
- After about 15 minutes, the scent of the steam may not be as strong. You’ve absorbed the most medicinal parts – yay!
Steams can also be very kid-friendly, and herbs can be customized depending on the particular manifestation of an illness. To make a kid-friendly steam, build a blanket fort and read stories with a flash light in the fort with your steam water nearby, perfuming the area. This way, the direct heat of the steam won’t be too intense, and a kid is more likely to sit in one place for the duration!
This post has basically been years in the making. Like many folks, I’m constantly learning what works best for my body, and even that is a moving target over time. Things change, strategies get refined, new products are created, and bacteria get smarter and more resistant to antibiotics as time goes on. Many folks know all about cranberry for its urinary tract supporting affects, but I hope to go in with some more depth today.
As some folks know, I have a chronic kidney condition that informs much of the work I do. Heck – it’s what made me want to become an herbalist in the first place. From my intensive self-care practices between client births, daily herbal tea habit, and still frequent visits to doctors offices for lab works and check-ups, my membranous nephritis is never far from mind. In my experience, having kidney disease does not make me more susceptible to urinary tract infections. However, it does mean that if and when I show UTI symptoms, I may only have a day or two before the bacteria is able to spread to my kidneys. This creates a much more serious problem unless I take All The Precautions.
A word about autoimmunity
There are many people who have other ongoing urinary issues – Interstitial Cystitis, “overactive bladder,” and chronic urinary tract infections are just a few examples. In any of these cases, I highly recommend looking into an individual’s medical history (including family members) and see if there could be a link with autoimmune conditions. While medical science separates autoimmune diseases by many diagnoses, making them seem increasingly “rare”, the mechanism of an overactive immune system that attacks it’s own body’s tissues remains the same. At least 7% of Americans have some form of autoimmune disease, and with high rates of mis-diagnoses, the number is likely even higher. For example, chronic kidney disease is almost nowhere to be found in my family history – but autoimmune diseases (multiple sclerosis, rheumatoid arthritis, lupus) are increasingly common, and that link is very important.
With an autoimmune connection, I make no recommendation more strongly than researching the so-called Autoimmune Protocol, and identifying individual triggers. Poor digestion and chronic inflammation can lead to “leaky gut” and molecular mimicry. In terms of an overactive immune system, this means that leaked food proteins can potentially be a big factor in the severity of an autoimmune disease. The triggers I avoid include gluten (and all grains except rice), dairy products (casein), canola oil, soy, nightshades, refined sugars, coffee and getting less than 7 hours of sleep in a night. As a birth worker, I never know when I’m going to need to be up all night, so staying on top of everything that is within my control is absolutely necessary!
A little more background
It has been six years since I began to identify and cut out my allergens, developed a daily nettle infusion practice and slowly have seen my kidney inflammation drop to lower and lower levels. While I’m certainly not “cured” of the chronic stuff, I’m getting pretty good at avoiding flare-ups while coping with an unpredictable work schedule. The longer I meander down this path of improvement, the less severe my urinary tract infections are. Instead of needing to go to the emergency room within 24-48 hours, as I did 7-10 years ago, I now have a week or more to really fight off an infection herbally before it gets as deep as my kidneys and necessitates antibiotics.
Proper alignment is a major factor in repeat UTIs. As Katy Bowman explains in her blog, Nutritious Movement, pelvic alignment is vital for keeping bacteria out of the upper parts of our urinary system. Humans used to walk long distances and have varied movements as we went about our lives. Now, we’re used to tucking our pelvises backwards while sitting in cars in traffic, at office desks, on couches. While this is only one part of the story, chronically mis-placing our urinary tracts can make certain folks more susceptible to urinary tract infections.
Katy also has an excellent post about pregnancy-related balance here.
As one of my mentors, Katja Swift, once told us in class (in so many words)- humans have always had urethras near their anuses. We can take all the precautions with wiping in specific directions we want, but that doesn’t change the fact that the problem really comes down to an imbalance of the wrong kinds of bacteria in the wrong kinds of places. It’s becoming more well known that humans are made of 90% bacteria. Yes, urinary tract infections are most often (but not always!) caused by Escherichia coli. Another major consideration is that the average American consumes 130 pounds of sugar per year. This is absolutely unique to this time in human history – we did not evolve to cope with that kind of calorically-dense, nutritiously-devoid stimulant load.
Probiotics are important, but they’re also not the whole story. We need to avoid sugar and empty grain-based carbohydrates, especially when they’re triggers for flare-ups of a chronic condition. Homemade fermented food is a much more diverse source of happy balancing bacteria than any lab-created capsule (that needed to be shipped in a refrigerator truck, by the way). Many simple recipes for ferments are out there.
Another simple way to “diversify” the bacteria in your urinary tract is to actually go out in nature. Katja has brilliantly called this “naked in the dirt,” and says she’s recommended it to many clients. Yes, it’s kind of seasonally-specific, depending on where you live. However – I was once able to fight off a urinary tract infection while swimming in my local turtle pond. I was feeling a urinary tract infection come on, so I went to my doctor to have a urine test. The test came back without a high enough concentration of bacteria to confirm that I needed antibiotics. The count needed is in excess of 100,000, and with my sensitive system I was capable of feeling symptoms with a bacteria count of only 10,000 or so. As the week progressed, I’d guzzled tons of unsweetened cranberry juice and floated my way through the nearby spring-fed pond. I was still feeling symptomatic, and decided to get tested again. The results? “1,000 colony forming units per ml. MIXED FLORA (3 OR MORE COLONY TYPES).” Having multiple mixed colonies of bacteria present gave my body a leg-up when trying to flush out the E. Coli and I ended up not needing those antibiotics, after all.
Your own experience with diet, chronic illness, stress, movement and lifestyle all have a big impact on your body’s own “host defense” in fighting off any infection, including urinary tract infections.
On to the herbs!
Dandelion leaf (Taraxacum off.) is my favorite diuretic herb of all time. It grows abundantly, costs next to nothing, and simply just works. Part of the mechanism of beating a urinary tract infection without antibiotics is physically flushing it out of your system. Staying hydrated is incredibly important, but when your hydration consists of not just water but a dandelion infusion (tea), it also contains vitamins C and B6, thiamin, riboflavin, calcium, iron, potassium and manganese. Other nutrients present in dandelion leaves include folate, magnesium, phosphorus, and copper. The beauty of diuretic herbs is that they support the urinary system, and help the body avoid excess water retention while simultaneously repleting minerals, rather than depleting them (as pharmaceuticals do). Folks who have a sensitivity or allergy to Asteraceae plants, including chamomile, should proceed with caution.
Goldenrod leaf (Solidago canadensis – but your local variety of Goldenrod should do) is also a member of the Aster family. Its yellow flowers bloom in late summer to early fall, causing it to inaccurately be blamed for ragweed allergies. To the contrary, this diuretic plant actually helps relieve seasonal allergies, and can also relieve urinary tract infections. It is a more gentle diuretic than Dandelion, and is known for being a friend of the kidneys. Daily infusions of Goldenrod leaf and flower can be an important part of an anti-UTI herbal plan.
Nettle leaf (Urtica dioica) is my biggest herbal ally for living with chronic kidney disease. It is another nourishing diuretic herb, best served in a long infusion (think an 8 hour overnight tea). Nettle contains high amounts of calcium and iron (the longer you steep your tea, the more of these get extracted into the liquid), as well as magnesium and vitamins A and K. Nettle is great cooked fresh like any leafy green, but daily tea infusions are part of my years-long practice to nourish my body and kidneys in particular.
Marshmallow root (Althaea off.) is best served as a cold infusion. I’ll often add a pinch of Marshmallow root to a long infusion of diuretic herbs. Because I regularly ingest tea like this, the Nettle, Dandelion, Goldenrod would dry me out unless balanced with mucilaginous moisture. Marshmallow root infusion also plays well with unsweetened cranberry juice, which can be intensely astringent to drink in quantity. This soothing, cooling herb can ease the physical discomfort of a urinary tract infection and is great to include in an herbal protocol.
Kava Kava root (Piper methysticum) can be added to a cold infusion with Marshmallow. The famous anti-anxiety herb is also useful for urinary tract infections because it is mildly pain relieving. A little known urinary disinfectant, Kava works well with any of the above herbs as part of a UTI protocol. Generally speaking, I think it’s important to prioritize practicing with herbs that grow locally. However, when weighing the significance of avoiding antibiotics to my longer-term health, I’m willing to find alternatives that grow a bit farther away.
Cranberry (Vaccinium macrocarpon) is a fairly well studied local-to-me berry. Like any dark berry, Cranberry contains the polyphenol proanthocyanidins. These proanthocyanidins have been shown to help flush out E coli specific urinary tract infections. While I’m a big advocate for using plants in their whole (or close to whole) form, an extract of a sugar in the Cranberry, D-mannose has been shown to be very effective when dealing with an E coli UTI. This study shows that for folks who get frequent urinary tract infections, using D-mannose extract before using antibiotics lead to an almost 4 times longer window before getting another UTI (200 days vs. 52.7 days). I have used this type of D-mannose, which is just a dissolvable powder that is fairly tasteless when mixed with water.
A note about preparation
All of the herbal preparations and products I mention here are water-based. Generally speaking, herbs work best when they can come in contact with the tissues being affected. For a urinary tract infection, herbs may be helpful because they’re astringent, analgesic, diuretic, or anti-bacterial, but they should be drunk as tea or used in a bath in order to reach the urinary tract. For deeper infections, or for folks who are prone to kidney problems, internal use of herbs (and D-mannose) will be the most affective. For folks who get UTI symptoms often, consider lifestyle factors (such as diet, bacteria balance, or other chronic conditions that may be inherited), and a topical bath or steam may be affective.
There are so many herbs that can potentially be used to fight a urinary tract infection. This is just an introduction to what works best for me, as someone who has chronic kidney inflammation and desperately wants to avoid antibiotics. If you’re curious to talk more and get an herbalist’s opinion about your specific situation, check out my herbal consultations page.
Recently, I’ve heard from many clients (and fellow birth workers) about a CDC case of recurrent GBS infection in a newborn whose mother chose to encapsulate and consume her placenta. This rightfully has folks concerned about the process of placenta encapsulation, and curious about the safety of placenta encapsulation in the case of testing positive in pregnancy for Group B Strep.
Here are the highlights of the case, which are important to consider:
- Mom tested negative for GBS at 37 weeks of pregnancy, so was not given the recommended antibiotics in labor for GBS. When given in labor, IV antibiotics quickly cross the placenta. The Evidence Based Birth article states that about 9% of women will test negative but actually be positive during labor (meaning they unknowingly expose their babies to this risk without antibiotics, as the mom in the CDC article did). Also, 16% of women who tested positive will actually be negative during labor, meaning they will receive unnecessary antibiotics.
- Baby was colonized for GBS anyway, needing to spend at least 11 days in the hospital, taking antibiotics. If a baby is born with GBS infection, the hospital should have sent the placenta to pathology to confirm, and then the mother would not have been allowed to release the placenta for encapsulation. This is standard for ANY infection in labor or in the immediate postpartum. I would never process a placenta that was born while an active infection took place in labor, or if a baby had GBS colonization after birth. This is something that all folks who provide placenta encapsulation must check about before moving forward.
- Mom had her placenta encapsulated, method of preparation unknown in this article, and began taking capsules 3 days postpartum
- Baby had recurrent GBS, and was admitted to another hospital 5 days after release from the first
- Mom’s breastmilk tested negative for GBS, but the placenta capsules tested positive
- The CDC case states, “Although transmission from other colonized household members could not be ruled out, the final diagnosis was late-onset GBS disease attributable to high maternal colonization secondary to consumption of GBS-infected placental tissue.”
The doctors came to the conclusion that, because the placenta capsules tested positive for GBS, the mother must have had higher concentrations of the bacteria in her skin or digestive tract, this re-exposing baby to the infection. Group B Strep likes to live in mucous membranes, and there have been a few cases of recurrent GBS that are not-at-all placenta encapsulation related. An adult with an unknown high concentration of GBS could pass it along to a baby with a kiss.
The company this mother used states they dehydrate the placenta for encapsulation between 115 and 160 degrees. In my practice, I dehydrate a steamed placenta at 145 degrees, and a “raw” placenta at 160 degrees Fahrenheit. The protocol I use is the USDA guidelines for safe meat preservation and dehydration. The article also mentions that a temperature of 130 degrees for 121 minutes is long enough to kill salmonella (implying that other bacteria could be significantly reduced in a similar temperature/amount of time). Whenever I process a placenta, I dehydrate it (keeping it between 145 and 160 degrees) for at least 12 hours. Preliminary research shows that steaming the placenta properly and dehydrating it both have a significant impact on reducing potentially harmful bacteria or pathogens. I always use steamed preparation before dehydrating a placenta if my client tests positive for GBS.
This article also says the company in Oregon says storing the placenta capsules at room temperature is ok. I definitely recommend refrigerating the capsules to keep them safe for consumption, because unlike other dehydrated/preserved meat products, the placenta capsules contain no sugar, salt or nitrates to preserve them.
Let’s get one more thing straight: GBS is a common bacteria that humans tend to have in their digestive tracts. About 15-30% of folks will test “positive” for a high concentration in the recto/vaginal area during pregnancy. Human bodies are made up of 90% bacteria – 9 out of 10 of our cells are not actually human DNA but bacteria. Folks are just starting to study how bacteria balance in our guts affects health, and how it varies from culture to culture- especially with our current high usage of antibiotics in the US. In the 1970s and 80s, folks realized a large amount of seemingly healthy babies were getting infections after vaginal births (things like pneumonia and other breathing issues – as this baby in the article did suffer), the CDC realized a high concentration of GBS bacteria in the vaginal canal could “colonize” babies on their way out, thus exposing them to the risk of infection. IV antibiotics in labor became the standard of practice, reducing the likelihood of newborns with GBS infections by 80%.
There are some folks studying probiotics and rates of GBS, either orally or topically: yes, the preliminary studies show we can positively impact healthy bacteria balance with probiotic pantyliners. Early research implies that Group B Strep is kept in check with lactobacillus bacteria, and even garlic. Other studies imply that GBS likes to live in a yeast-friendly environment, so folks who are prone to yeast infections might be more likely to test positive in pregnancy. Either way- GBS does impact a lot of my clients. Folks who hope to avoid an IV in labor often need to accept IV antibiotics to reduce the risk of passing GBS to a newborn.
Krystina Fridlander at Baraka Birth has a lovely thorough blog post outlining a lot of the research available on probiotics and Group B Strep. Read more here.
While this infographic is California specific, it goes to show how an individual person, having a low-risk pregnancy with a first baby, is likely to have a very different birthing experience depending on the norms of the hospital/practice they choose. I know people are limited by location, insurance coverage, and other needs, but doing some research into the intervention rates at local hospitals can make a big difference in setting expectations. So can working with a local doula who knows what the norms of various local birth sites are!
I recently finished Jen Kamel’s class The Truth About VBAC and learned, among other things, how hard it can be for an individual provider to calculate their own rates of cesarean section. While an individual may have a low rate of intervention, those rates may double during the weekends when that particular provider is non on-call. Ideally, any consumer of OB/Midwifery care should get to know the rates of intervention between every provider in a practice they choose.
Herbstalk 2017 will be happening again at the Somerville Armory on June 3rd and 4th. Along with many other herbalists, I will be teaching a class at the event about herbal allies for pregnancy loss. Keep an eye out for the schedule falling into place, and I’ll see you at Herbstalk!
Last week, I had the pleasure of making a little video interview with local acupuncturist, Angela Bell. She often works with folks who are trying to conceive (including with IVF and other fertility treatments), as well as during pregnancy and generally focuses her practice on women’s health. More about her practice can be found on her Facebook and website.
One thing I so adore about Angela is her desire to connect and highlight others who are birth workers in the Boston area. She holds networking events, and has continued to host a video series on her social media pages for other birth workers to highlight their work. She’s chatted with doulas, massage therapists, midwives, yoga instructors, lactation consultants and others about the work we all do with clients.
In our 30 minute interview, we cover what it means to be a “full-spectrum” doula. I talk about why I decided to become a doula, the work I do with the Boston Doula Project, how others doing this work can best support LGBTQ+ families. We also chat about placenta encapsulation, my practice in Western herbal medicine and what it means to be an advocate for folks in all of this work. If you’re interested to get to know me a little better, check out this video interview!
A few folks in my life have recently asked how I feel about the divisive/controversial ProDoula articles that are circulating. Honestly, as someone who chooses not to use any social media, I probably would have missed this entirely if folks didn’t bring it to my attention. I was relatively preoccupied while attending two clients’ 37-week labors, organizing the year’s goals with the steering committee of the Boston Doula Project, and encapsulating another client’s placenta.
Generally, I think there is enough space in Boston (I can’t speak for smaller or more rural communities) for many types of doula practices and their clients. While some doulas have always argued that providing free or very low-cost services devalues doula work as a profession, others continue to provide free or very low-cost services because it is exactly what they are called to do. I absolutely believe folks need to charge a rate for their work that is sustainable to them. On-call support for labor is extremely valuable, and not just because the studies show doulas save thousands of dollars in healthcare costs. We literally prevent trauma (and hold space for trauma that exists) on a regular basis.
The ProDoula founder is right to say that plumbers don’t worry about people who can’t afford to hire plumbers, but birth is not the same as home repairs. Supporting one another in the childbearing year is something that people have always done, and are always going to do. We live in a time and place in human history where folks aren’t all having 15 babies, witnessing 10 younger siblings be born, hanging out around groups who are feeding babies at their chests, and having that community of support built in. We’re giving birth in hospitals, often in big cities far away from family. Most often, the first birth people witness is their own baby’s! We’re needing to pay people out of pocket to create a sense of that lost community support. This used to be culturally built-in, for everyone, for free.
I’m all for folks charging what they need to in order to make their work sustainable – that part’s important and isn’t typically emphasized in many doula trainings. Most doula trainings emphasize what’s normal in birth and postpartum, what’s not, how to be a compassionate and competent helper and how to plug into the extended community of resources for when you need to make referrals. These articles make it sound like ProDoula’s trainings emphasize profits, avoiding the local community (“ProDoula tells doulas to ignore local doula collectives — why fraternize with the competition?”) ostracizing new doulas, and not making referrals because your agency provides The Best And Only care.
- Kara Schamell, at Modern Mama Midwifery has tons of experience, especially in sanitation techniques and lab safety as a midwife. We back up each other’s placenta clients in the case of travel or client birth overlap.
- Jennifer Lynn Frye, at New England Placenta Encapsulation, who has a background in nursing, and has been providing this service since 2014. She was also part of the first-ever batch of Boston Doula Project trainees.
- Jennifer Lewis, at New Life Blessings has encapsulated over 250 placentas in MA, RI and CT.
Here are the answers to some frequently asked questions I receive about placenta encapsulation.
Why would anyone want to eat their placenta? I get this a lot. Usually, I start here: all mammals consume the placenta immediately following the birth, with a few exceptions. These exceptions include whales (who have baleen and generally don’t/can’t eat large pieces of meat), and alpaca-family animals (such as camels). When I asked an alpaca farmer at an agricultural fair why they don’t ingest their placentas, she quickly responded “Their tongues aren’t long enough!” Many domesticated/farm animals have humans who interfere with the postpartum process before they instinctively ingest the placenta. The third exception is humans. While there are a few theories as to why this is, many people are now choosing to consume the placenta in capsule form postpartum. In some circles, it isn’t very popular to consume organ meats, but many folks know they’re some of the most nutrient-dense foods in the world. The placenta contains iron, minerals, high-quality protein as well as hormones (oxytocin, progesterone) that sustained the pregnancy and labor. This helps build parents back up after blood loss, especially if it was more than average. Anecdotally, folks who choose to consume their placenta after birth have fewer bouts of hormone-crashing lows, a strong milk supply, and a little more sustained energy throughout all the sleep depravation.
How many capsules does it yield? Average is about 80-100 capsules. I’ve processed placentas with as few as 53 capsules (when some pieces were saved for Pathology) and as many as 165 capsules. Generally speaking, I’ve found bigger babies have bigger placentas.
How does pickup and drop off work? I’m happy to meet you at your place of birth between 8am and 9pm to pick up your placenta. With some advance notice that you’re in labor (either from you or a partner or doula), I may be able to arrive for pickup quicker. As long as the placenta is kept on ice within two hours after the birth, we should be all set for processing. Processing takes 2-3 days, on my end, and I am happy to return the finished capsules to you when you return home from the hospital.
What if I have medications during labor, or need a cesarian section? That is fine! The medications used during labor generally pass through the placenta or break down quickly. If you had an allergic reaction to any medication given during labor, I would not recommend encapsulation. With a cesarian birth, it is extra important to make sure the placenta is put on ice soon afterward, because everyone tends to be a little busier during that time than with a vaginal birth!
What if I am Group B Strep positive? Group B Strep (GBS) is a normal digestional bacteria that some folks have a high concentration of in the genital area during pregnancy and birth. It is not considered harmful to adult humans (just in rare cases for babies), and I generally recommend steaming the placenta before dehydration for folks who are GBS+.
What if there was meconium in labor? Meconium happens! It is sterile and not harmful to adults. Extra nurses will be present at your birth to check out the baby’s lungs and make sure your baby did not aspirate the sticky meconium. Otherwise, meconium washes off the placenta easily during processing and does not contraindicate placenta encapsulation. If there is prolonged exposure to thick meconium, the placenta may look “stained” upon delivery and providers may want to send it to pathology to have it looked at, but that is much less common.
What if my baby is premature? With premature birth, many hospitals will want to send the placenta to pathology to make sure that it wasn’t the cause of a premature birth. In this case, you can advocate for the placenta being kept refrigerated, frozen and chemical-free. The pathologist should be able to remove a few small pieces from the placenta and leave the rest for you to take home, if no problems are found. Keep in mind that hospital pathologists work M-F, 9-5, so this can delay the process, depending on the time you give birth. With any placenta that has been to pathology (even if it is kept separate), I recommend steamed preparation.
How does my birth site impact my decision to keep my placenta for encapsulation? Great question! I always recommend folks talk with their providers about keeping the placenta ahead of time, just to make sure there are no issues. Every birth site (except for homes) will require you sign a placenta release form after the birth before it is able to leave. Certain hospitals have policies that may further impact your experience. For example, Brigham and Women’s Hospital’s policy is to keep the placenta in the hospital until the family and baby are released. They keep it refrigerated for you, but this will delay my ability to process by a few days. Beth Israel Hospital does not let anyone bring the placenta into the postpartum room with them. This means, if you’re hoping to keep your placenta and you’ve given birth in the middle of the night, you need to keep it in a cooler in your car (or have another family member pick it up and bring it to a refrigerator) until I am able to pick it up. Cambridge Birth Center generally releases patients within 6-8 hours after the birth. If you give birth at the birth center, and it is late at night, I may be able to pick up the placenta in the morning from your home. If you have particular questions about the placenta-related policies at your birth site, be sure to ask your provider.
What about payment? My fee for placenta encapsulation is $250. Cash or check are welcome. The fee is due at the time I deliver the finished capsules. In the off chance that you are unable to keep the placenta, I do not require a downpayment.
More to come..!!
While the World Health Organization states that the ideal rate for necessary cesarian births should be around 10-15% (with more recent studies showing that rates above 10% do not decrease mortality rates for parents or for babies), the US Office of Disease Prevention and Health Promotion (Department of Health and Human Services) sets our goal at 23.9%. Since this goal was set (as 10% lower than the average in 2007), approximately 60% of hospitals in the United States do not yet meet this goal.
Another doula and I were chatting about experiences at a local hospital where a client of mine awaited a planned cesarian for a suspected big baby. This doula mentioned that the birth site we were discussing was on the top of a list of local hospitals who perform medically unnecessary cesarian sections. She shared with me the consumer report on cesarian rates for low-risk babies. The report does not include cesarian statistics from anyone who has a prior cesarian, is carrying more than one baby, or who has a baby in anything but a head-down position. This data also doesn’t include anyone with a chronic health condition, heart problems, high blood pressure or obesity. Truly, this is a thorough compilation of comparative unnecessary cesarian rates, state-by-state.
Some takeaways about Boston-area birth sites:
The lowest cesarian section rates come from:
- Cambridge Health Alliance (which includes Cambridge Birth Center and Cambridge Hospital)
- Mount Auburn (don’t think any Boston-area birth worker is surprised about this)
- Massachusetts General Hospital
The worse-than-average cesarian section rates come from:
- Tufts Medical Center
- St. Elizabeth’s
- Newton-Wellesley Hospital
- Brigham and Women’s Hospital
- Boston Medical Center
The highest cesarian section rates come from:
- South Shore Hospital
- Brockton Hospital
- Melrose Wakefield Hospital (Hallmark Medical System)
Just something else to consider when choosing where to give birth around Boston!