Midwifery Today, Issue 135, Autumn 2020.
Join Midwifery Today Website Membership
As a prelude to this editorial, you might want to read “Lessons from Kitty Birth: Using Placenta to Control Hemorrhage,” my favorite of all editorials I have written. My second favorite is “Kitty Breastfeeding.”
If all midwives and birth attendants had known about using the placenta, membrane, or cord for hemorrhage control, many lives could have been saved. If all midwives learned about this and were willing to use it, so many more would be saved. Hemorrhage is the leading cause of maternal death globally. Think of all the maternal deaths that could be and could have been avoided. These resources are always present at a birth. Membranes and cord can be used if the placenta is not born yet. Gail Hart taught me that. She said that the membranes and cord have even more oxytocin and other useful hormones than even the placenta.
Here are some ideas on how to do it. Start with a small, quarter-size piece of placenta, if it is out, and place it inside the cheek (buccally). If that does not stop the bleeding, use a bigger piece. (This is generally not necessary.) At a conference Tricks of the Trade Circle, one midwife said she had to use many pieces of placenta, amounting to about a cup, to get the bleeding to stop—but it finally did.
If the placenta is not yet out, use as large a piece of membrane as you can get with forceps. If the baby has arrived, membranes will always be available. Place inside the cheek. That should stop the bleeding immediately. If the cord is already cut, you can take a small piece of it—one to two inches—and place that buccally. If it is not cut but it is long enough for mother to reach it to suck on, that would work, too. The idea is to absorb the life-giving hormones that prevent hemorrhage.
We also used a piece of cord to bring out a placenta that did not want to come after a couple of hours. These natural materials, already present at every birth, have even more than one use. If there are taboos against putting it in the mouth, it may, alternatively, be administered rectally. We discussed these tips in our Tricks of the Trade Class at our conferences. Almost everyone said it worked quickly to stop the hemorrhage.
These techniques might not be necessary in a modern facility where medicines are readily available, but may be lifesaving in countries and clinics with low resource availability. Another advantage is that they are completely natural. We do not know all of the dangers of pharmaceuticals.
Because I had stopped practicing when I re-learned this, I have only used it once. But I asked on my Facebook page whether some of our sister midwives had used it. I’ll share a few of their posts here.
I have used the placenta quite effectively to slow down postpartum hemorrhage and also to help nourish and support the mother who has bled a bit during the birth.
I never seem to think of using the membranes, but upon Gail’s advice, I will try that next time. It makes perfect sense, as often postpartum (PP) hemorrhages are caused by some retained trailing membranes—so giving the mother some membranes to ingest would, of course, be the “similar” to cause release of any membranes left inside. Brilliant.
Many years ago, I shared the story of ingesting a bit of placenta to stop postpartum hemorrhage with my own midwife. She made a funny face and expressed some disgust. I proudly let her know that it was my own lola (Filipino grandmother), Vicenta, a traditional midwife in the mountain province of Luzon, who told me the placenta saved lives. My lola practiced midwifery before, during, and after WWII, when there was no hope of transport to a hospital. She was renowned for her skill at safely receiving babies and serving mothers.
At Bumi Sehat, there is always honey in the birth rooms, because a tablespoon or two of real wild honey can give a mother the energy she needs to bring forth her baby. We work with many malnourished mothers and, believe me, honey does help. If the mother is willing to ingest some of her baby’s placenta, we put a tablespoon of honey in a cup, with a cotyledon or two of the placenta. The honey makes it very nice for the mother to eat. So far, no mothers have complained that eating placenta was unpleasant. The Traditional Chinese Medicine way is to dust the cotyledon of placenta with powdered cinnamon, to make it more palatable and digestible.
—Ibu Robin Lim
Once. A client was giving birth to her third baby. She had heavy bleeding with her first birth and very heavy bleeding after her second. All were concerned that her PP bleeding history might mean we were dealing with a hemorrhage with this one. As soon as the placenta was born the husband whisked off the placenta, tore off a few pieces, and added it to the V-8 juice waiting in the blender. In minutes he handed it to his wife, who was bleeding. I had my hand on her uterus while we waited. She drank down the entire glass of placenta-laced juice. I took my hand off her uterus and could feel it contracting on its own. She had a minimal blood loss at that birth. I always say that it doesn’t matter which modality women use, as long as the bleeding stops. Maybe it was going to stop anyway, maybe not; the important part is that life is fine and mom and baby get to bond.
I’ve suggested placing placenta rectally if there is hemorrhage, after watching a doctor give Cytotec to a mother rectally. I remembered all the receptors that are in there. When I had my two planned unassisted births, it was part of my plan if I bled a lot. Placenta was going to go into every orifice.
—Fern Bel Compton
If a woman hemorrhages, I’ve had her eat her placenta in the first 24 hours (or she instinctively does) and have found that it seems to prevent the typical residual effects of the hemorrhage and she makes oodles of milk.
About 10 years ago, I had a client transfer to hospital due to exhaustion after a couple of days of labour. They put her on Pitocin and left us, pretty much “Call us when you want your cesarean.” When baby emerged after several hours of forceful pushing, cord around the neck four times, she hemorrhaged. This vegan couple had decided that they would use the placenta PP, but when she took a piece sublingually, it had no effect. When I went to the Midwifery Today conference in Costa Rica, a doctor explained that placenta alone will not work, because the Pitocin blocks the receptors. We ended up making a soup, which she ate all that day, but she was really in rough shape for several weeks after. They refused transfusion and iron injections. I tell people now, if you have the Pitocin during labour, you’ll most likely need it after—another deterrent to hospital birth.