'More than clinical waste? Placental rituals among Australian home-birthing women'

One of the most interesting papers that I have read this month is Emily Burns’ ‘More Than Clinical Waste? Placenta Rituals Among Australian Home-Birthing Women‘, which was published in the Journal of Perinatal Education. The articles from this journal aren’t freely available online, but I want to take the opportunity to review and share my favourite bits from this paper, as this is a topic that is very close to my heart and I am always delighted when people research and write about this area…

Emily begins by comparing the different discourses that exist in relation to the placenta (quoting, as a very cool aside, Nadine Edwards, with whom I wrote Birthing Your Placenta):

‘The “definition” of the placenta depends on the particular discourse being employed. Experientially, it is an electric, sensual thing, and medically, it is an endocrine organ that acts as the transfer agent of oxygen and nutrients between a mother and her fetus’. (Burns 2014: 41)

As in many other Western countries,

‘The Australian standard on which most current hospital policy is based refers to the placenta as human waste, but when discussing how to implement the standard notes cultural, religious, and spiritual sensitivity should be recognized as part of the “patient needs” regarding disposal. As such, should a woman wish to take her placenta home, she may do so; however, it is double-wrapped in clinical waste bags and placed in a sealed container which is not to be opened on hospital premises. Callaghan (2007) notes that the symbolism of the clinical waste bag used for the placenta ” . . . with its official label, the Health Department and the medical profession through the actions of the midwives, are demonstrating their power by shaping the communities world view of the placenta” (p. 15). (Burns 2014: 42).

I find this really sad, and I was particularly touched by the way in which this paper focuses on the sense of loss that some of the women felt about the way in which their placenta was treated during or after their hospital birth,

‘…and their missed opportunity to respect or honor it in some way. Tania, who has two children, the first born via cesarean surgery and the second born at home, spoke about sharing her homebirthed baby’s placenta with her older child:

I don’t have [baby girl’s] because she was a cesarean and they just threw it away so I am going to give half to [baby girl] and half to her.‘ (Burns 2014: 43).

The three placenta rituals that are considered within this paper are placenta burial, placentophagy (which is where the placenta is eaten as food or consumed, for instance as medicine), and lotus birth (where the placenta remains attached to the baby via the umbilical cord until it falls off naturally, usually after a few days). No-one is suggesting that this sample of women is representative of a wider population or that numbers were the goal … nonetheless, I found it completely fascinating to read the breakdown of what the women planned to do with their placentas

‘Of the 54 participants, 15 were pregnant and planning a home birth at the time of our interview. When I asked them about their plans for their placentas, 11 planned to bury it, 2 planned a lotus birth, 1 planned to consume it, and 1 did not know what to do. Of the 39 participants who had already had a home birth, 30 buried it, 3 had a lotus birth (two of which were later dried and buried, and 1 was later consumed), 3 consumed it, 2 gave it to their midwives, and 1 could not remember.’ (Burns 2014: 44)

Those readers who know me or have heard me speak are unlikely to be surprised to hear that I felt compelled to do a few quick sums to see what this meant in terms of percentages … overall, around three quarters of the women planned to bury their placentas, about ten per cent planned a lotus birth and just under ten per cent of women planned to consume their placenta. It is important to note that it is often possible to do more than one of the above.

(This makes me want to go back through my records now and see what this breakdown is in the women that I have attended!)

I was really interested in the fact that:

‘All participants who spoke about placenta burial chose a specific tree or shrub in their yard or bought a specific tree or shrub for it (Burns 2014: 44) … The tree or shrub chosen was commonly fruit bearing, specifically so the placenta could contribute to the nourishment of food that would in turn nourish the family.’ (Burns 2014: 45)

All in all, this is a great article and I truly agree with the hope expressed in the conclusion of this paper that it will serve to challenge the disposal-focused culture that surrounds the placenta in many areas where babies are born and to let more women know that they actually have a choice.

‘The women in this study have created alternative ways of knowing and appreciating their bodies and what comes from them, and this has far reaching implications for women in all birth settings, including the majority of women who birth within the hospital system.’ (Burns 2014: 48)

If you’d like to know more about the birth of the placenta and the options that are available, you might enjoy the book I co-authored with Nadine Edwards, Birthing Your Placenta.

Burns E (2014). More Than Clinical Waste? Placenta Rituals Among Australian Home-Birthing Women. Journal of Perinatal Education 23(1): 41-9.

photo credits: Nebojsa Mladjenovic and TCL 1961 via photopin cc and cc

Abstract: The discursive construction of the human placenta varies greatly between hospital and home-birthing contexts. The former, driven by medicolegal discourse, defines the placenta as clinical waste. Within this framework, the placenta is as much of an afterthought as it is considered the “afterbirth.” In home-birth practices, the placenta is constructed as a “special” and meaningful element of the childbirth experience. I demonstrate this using 51 in-depth interviews with women who were pregnant and planning home births in Australia or had recently had home births in Australia. Analysis of these interviews indicates that the discursive shift taking place in home-birth practices from the medicalized model translates into a richer understanding and appreciation of the placenta as a spiritual component of the childbirth experience. The practices discussed in this article include the burial of the placenta beneath a specifically chosen plant, consuming the placenta, and having a lotus birth, which refers to not cutting the umbilical cord after the birth of the child but allowing it to dry naturally and break of its own accord. By shifting focus away from the medicalized frames of reference in relation to the third stage of labor, the home-birthing women in this study have used the placenta in various rituals and ceremonies to spiritualize an aspect of birth that is usually overlooked.