Ok, this is a weird question but this is the first time I have EVER had a chance to ask someone who might actually give me some real information. Here goes... A few years ago placental encapsulation became the rage in the home birth community. As a midwife, I receive more and more requests for encapsulation of my client's placenta. I pride myself in having an evidence-based practice and frankly, there are no studies (that I am aware of) that show the effectiveness of using placenta pills. In about 2015 I learned the "Traditional Chinese method" of preparation which involved steaming the placenta with lemon and ginger and then slicing the placenta and dehydrating and grinding into a powder. Although I am aware there is no evidence, I still encapsulate it because there is a mountain of anecdotal "proof" of the effectiveness and my clintele request it. Presently I prepare the placenta with a "raw" method which involves dehydration at a low temperature. I use this raw method in the hopes that the lack of "cooking" the placenta may offer some benefits. I also make sure my clients have informed consent regarding my process and that presently there is no evidence of effectiveness. Recently I have been getting requests for tincturing the placenta. This totally makes no sense to me. Especially determining the percentage of alcohol to be used. The few folks who do this use vodka. I can only relate to this as another way for folks to make money on the new thingy"du jour". I have always had great respect for the placenta and am always fascinated by how the placenta is viewed and treated in different cultures. It is my understanding that encapsulation or eating placenta is relatively a modern use of placenta and is not based in any culture. In defence of encapsulation, folks will say, it was used traditionally as Chinese medicine. As a side note, placenta is the only meat that is available without killing a being, just saying, I know you are a vegetarian :). BTW, I love to blast the argument that humans are the only mammal who do not eat their placentas. I usually retort that we also do not eat our dead babies. So for my questions: In TCM (or historically) what are the indications (excess/deficiencies?) for using placenta medicinally? How is placenta used in TCM? How is the placenta prepared - traditionally? Does it make sense to use the placenta postpartum - for physical /emotional support? Can you help me understand how placenta tincture might be useful? You mentioned the use of animal parts in TCM, would this give any insight on preparation of placental tincture? Thanks, Katia

Hi Katia, Thank you for your question. This is a fascinating topic! I agree with you; there is no good research showing human benefit for placentophagy. I am curious and, so, I did a very brief PubMed search. I see a pilot study that concludes placentophagy does not influence maternal postpartum prolactin levels or neonatal weight gain (Young et al., 2019). I see a second study by Benyshek et al. (2018) that surveys American women; 30% consume their placenta without adverse events. This study provides a pertinent rebuttal to the Centers for Disease Control and Prevention (CDC) case report. The CDC cites a case report of a late-onset neonatal group B streptococcal infection. It is good to see that there is research showing lack of harm to this ancient practice! I like the recipe you give that steams the placenta with lemon and ginger. Aviva Romm gives a similar recipe in her book. Is that where you found it? Romm (2002) adds tienqi ginseng for those women who feel particularly weak after birth. With regard to processing: I would imagine, and this is just a guess since I am not well-versed on the topic, that tincturing may concentrate and preserve the remnants of pregnancy hormones left in the tissue. Cooking denatures proteins and may affect the steroidal structure of hormones rendering them less effective. Raw encapsulation may preserve micronutrients and the molecular structure of hormones but may raise the risk of bacterial contamination. The last statement is doubtful if processed properly but I want to put that out there. Additionally, some women may have a gastrointestinal tract that does not process raw proteins efficiently. In that case you could consider giving each dose of raw placenta product with a digestive enzyme. With respect to traditional Chinese medicine, placenta is used historically. In fact, it is not only the mother that might use the placenta as medicine. It is prized as a tonic remedy that nourishes qi, blood, and jing. It is used for children who are not reaching sexual maturity at the appropriate age (late puberty), men for impotence and erectile dysfunction, and men and women for infertility. Chen and Chen (2004) provide a brief entry that says placenta, or zi he chi, replenishes jing, nourishes blood, improves lactation, nourishes qi and blood, and benefits lung qi (chronic respiratory disorders). Properties are sweet, salty, warm; channels entered include kidney, lung, liver; contraindication includes those who have yin deficient heat (Chen & Chen, 2004). The umbilical cord is used for wheezing and night sweats due to kidney yang and jing deficiency as per a classical text written in 741 C.E. (Chen & Chen, 2004). Many modern TCM practitioners will not use human placenta but might substitute cow or pig placenta. As far as use in China, I am not aware practitioners using raw placenta. The use of raw food, in general, is discouraged in Chinese culture and medicine. Additionally, Chinese medicine does not use tincturing extensively but will use alcohol, mostly rice or sweet potato hard alcohol, infused with herbs. In my training, I was taught that the postpartum use of placenta is cooked into a soup with other qi and blood nourishing foods and herbs. The new mother would eat this for several days and the family might share it. Ingredients in this soup usually include things like rice, root vegetables, black chicken, jujube dates/da zao, fresh ginger/sheng jiang, Chinese yam/shan yao, astragalus/huang qi, dong quai/dang gui, red ginseng/hong ren shen, processed rehmannia/shu di huang, cordyceps/dong chong xia cao and other tonics. The herbs selected are usually based upon the clinical presentation of the woman consuming them. There is no generic recipe and the focus is on strengthening the deficiency of fluids, blood, qi, and jing that childbirth can often cause. So, in summary, if I were a woman, I would probably eat my placenta. I would not, however, eat a dead baby. 😊 All my best, Andrew References: Buser G.L., Mató S., Zhang, A.Y., Metcalf, B.J., Beall, B., & Thomas, A.R. (2017). Notes from the field: Late-Onset infant group B streptococcus infection associated with maternal consumption of capsules containing dehydrated placenta. MMWR: Morbidity and Mortality Weekly Report, 66, 677–678. http://dx.doi.org/10.15585/mmwr.mm6625a4external icon. Benyshek, D.C., Cheyney, M., Brown, J., & Bovbjerg, M.L. (2018). Placentophagy among women planning community births in the United States: Frequency, rationale, and associated neonatal outcomes. Birth: Issues in Perinatal Care. https://doi.org/10.1111/birt.12354 Chen, J.K., & Chen, T.T. (2004). Chinese medical herbology and pharmacology. Art of Medicine Press. Romm, A.J. (2002). Natural health after birth: The complete guide to postpartum wellness. Healing Arts Press. Young, S. M., Gryder, L. K., Cross, C. L., Zava, D., Norris, W., & Benyshek, D. C. (2019). Ingestion of steamed and dehydrated placenta capsules does not affect postpartum plasma prolactin levels or neonatal weight gain: Results from a randomized, double-bind, placebo-controlled pilot study. Journal of Midwifery & Women's Health, 64(4), 443–450. https://doi.org/10.1111/jmwh.12955

Dear Andrew, Thank you for the time and information in your in-depth answer. This is why I love this course! So, the bottom line regarding the tinctures - I guess it is not usually done. Do you see any benefit of tincturing the placenta? Even if I do not have rice or sweet potato? And just a note. I am very careful with my processing - making sure the placenta is dehydrated over several hours at 118 degrees. Sure looking forward to the next few weeks where I can make more sense of you the conditions and your answer. Thank you VERY much for your response. Katia

More thoughts. you state, "It is prized as a tonic remedy that nourishes qi, blood, and jing. It is used for children who are not reaching sexual maturity at the appropriate age (late puberty), men for impotence and erectile dysfunction, and men and women for infertility. Chen and Chen (2004) provide a brief entry that says placenta, or zi he chi, replenishes jing, nourishes blood, improves lactation, nourishes qi and blood, and benefits lung qi" It "nourishes jing" and "replenishes jing". Am I misunderstanding this. I thought that couldn't happen. And if this is possible why are placentas, not a black market item? I currently have 40 frozen placentas that are defrosting that are scheduled to be buried in a 4-foot deep trench (to prevent coyotes from digging it up) that will be filled with topsoil for fruit trees. It will give time for the placentas to rot before the roots reach down that far. I feel like I have forbidden substances. Not to mention what the public health department would say. Regarding where I got the recipe - it was taught to me by a midwife who teaches placenta encapsulation. Once I learned the raw method I never went back. It is so much easier to process. One of the things I will add to my informed consent is your comment: "tincturing may concentrate and preserve the remnants of pregnancy hormones left in the tissue. Cooking denatures proteins and may affect the steroidal structure of hormones rendering them less effective. Raw encapsulation may preserve micronutrients and the molecular structure of hormones but may raise the risk of bacterial contamination." With an emphasis on every "may" in this. I guess I am still left with the question of how alcohol would concentrate and preserve the remnants of pregnancy hormones. How does that work? Truly this is a fascinating topic - at least to me. Thank you again for the time you have given to answering my questions. I really hope all the descriptions of how placenta is used that you quoted above will make sense later on. There is so much. . . thank you.

Andrew said: to my knowledge, tincturing the placenta is not done in China. As far as the alcohol you use, energetically sweet potato would be nice because it is slightly nourishing. However, that is not really an important detail. You could use Everclear or vodka and calculate alcohol percentages like any standard tincturing protocol. You will have a class series on medicine making in this program, so I leave the details on this topic until then! Thinking about dehydration at 118 F, I don't know how temperature would affect hormone degradation. This may be one reason to tincture the placenta since no heat is applied. Please note that I am only making educated guesses as far as chemistry and placenta preparation methods. I do not know how you might tincture the placenta. Should it be pureed in a blender first to break down the cells? Do you have to steam it first to prevent bacterial infiltration? If so, there might not be a point to tincturing it because steaming it will break down hormone molecules. I think I have more questions for you than answers on the topic! Alcohol is lipophilic. Hormones are highly fat soluble, which is why sex hormones are stored in our fat tissue. As far as nourishing vs replenishing. Many things can get nourished or "tonified" (Qi is tonified, blood is nourished; more on that to come in class). However, the traditional thought is that placenta replenishes the jing. Some practitioners believe replenishing can occur by ingesting certain substances and others say that it can happen only through breathing/qigong/meditation. Think of nourishing/tonifying similar to sanding a piece of sawed wood. You can "tonify" or smoothe out the edges to make it more functional or more pretty. However replenishing would be like adding more wood to the block. The idea is that if we run out of jing, we die. If we have more jing, we live longer. Tonifying helps preserve the jing we have while replenishing increases the total amount. This is a big topic out for debate in the TCM community. To your point, in China human placentas ARE often a black-market item and very expensive if you can find one. Often animal placentas are used instead.