Debate over placenta rules continues to grow

Some moms want the tissue; some hospitals’ policies force delay.

A Dayton birthing center is part of a national debate over mothers’ rights to retrieve certain tissues after giving birth.

A policy instituted earlier this year at Miami Valley Hospital’s Berry Birthing Center requires families to wait 72 hours before they can take home the placenta from babies born at the center.

Mothers and some health practitioners say the new policy denies women access to their own and their babies’ body parts. Some women use the placenta in cultural practices or for dietary supplements.

“It belongs to the moms, and the hospital doesn’t have any right to keep it,” said Denise Easthon, a Dayton nurse-midwife and doula, or birthing coach. “It’s the moms’, and they should be able to walk out of the hospital with it.”

Hospital officials say the waiting period is necessary in case pathologists need to conduct tests on the tissue to answer questions about the babies’ or mothers’ health. The new policy was implemented at the request of the hospital’s pathology department, said Beth Tabor-Cruea, nurse manager of the Family Beginnings program and the birthing center.

The debate over whether mothers are entitled to the tissue is becoming more common nationally as more women utilize placenta encapsulation, the practice of making supplements from placental tissue.

The placenta connects the developing fetus to its mother’s uterine wall and allows it to receive nutrients, breathe and eliminate waste via the mother’s blood supply.

Placental tissue is rich in hormones and other substances believed to alleviate postpartum depression, bleeding, fatigue and mood imbalances. Some women choose to have the tissue dehydrated and made into capsules or tinctures, which they ingest.

On average, about 30 babies a month are delivered through the birthing center. Families request the placenta “about once or twice a week,” Tabor-Cruea said.

“We’ve always had a few requests for it, like one or two a year,” she said. “But in the last year, we’ve seen an increase in patients requesting to take their placentas home for various reasons.”

Jessica Blizzard will deliver her third child in November at Miami Valley’s birthing center. Blizzard, who lives in Riverside, asked for the placenta after her second child’s birth last year and was given it immediately. She had planned to have it encapsulated, though ultimately, she didn’t.

This time, she worries the new policy will prevent her from having capsules made: Most sources recommend having them made within 48 hours of delivery. “It wasn’t an issue before with my second child. But now it is an issue. I don’t understand it,” Blizzard said.

Nancy Thickel, a spokeswoman for Miami Valley Hospital, said the pathology department will freeze the placenta if families request it, and the tissue should still be usable for encapsulation.

There’s another change Blizzard doesn’t like: Hospital staffers want to know why families want the placenta. She doesn’t think it’s anyone’s business.

But the placenta, like any tissue, could breed bacteria if it isn’t handled properly, said Tabor-Cruea, and the hospital’s legal department requires them to ask how they plan to use it. “The legal department has drafted a consent form for families since we’re allowing human tissue to leave the hospital,” she said. “Part of the process is asking how they plan to use it.”

Kettering Health Network doesn’t have a policy on giving families the placenta, though it has policies on how the tissue is handled and stored if it has to go to pathology for testing, said Miriam Cartmell, administrative director of women’s and children’s services at Kettering Medical Center.

“It’s not addressed one way or another,” she said. “It’s been about 20 years since I had somebody ask for it, so it’s not common. I believe we would work with the patient if they wanted it, unless the lab needed it. The clinical request would override the family’s request, or maybe we could return it to the patient after the testing.”

Catholic Health Partners’ policy would be to give the placenta to families on request, said Mike Boehmer, a spokesman for the network, but no one’s ever made the request.

While states regulate disposal of medical waste, few have laws addressing if families are entitled to healthy placental tissue for use in cultural ceremonies or for encapsulation, said Pamela Laufer-Ukeles, an associate professor at the University of Dayton’s School of Law.

Ohio law doesn’t address the issue, she said. Indiana prohibits hospitals from giving families the tissue, but Hawaii allows it once the tissue is examined for signs of disease or defect.

New York recently changed its law; until 2010, placental tissue was treated as human remains and had to be retrieved from hospitals by a funeral director, who then gave it to families. Now, hospitals can give healthy placenta tissue directly to families.

But some families still have to fight for it, said Grace Rice, program manager for Choices in Childbirth in New York City. “It’s kind of on a hospital-by-hospital basis, and even within hospitals, it depends on who your doctor is, who your nurse is, who your midwife is,” she said.

Much of the debate centers on whether individuals have property rights to their own organs and tissues, Laufer-Ukeles said. It’s a gray area, she said. In 1990, a California court ruled that a patient who sued a hospital for the return of cancerous tissue had no property interest in the tissue, which was used for research.

“But on the other hand, you do have property interests in some body parts,” she said. “Sperm and eggs can be sold. Blood and other organs can be donated. We do think of our bodies as belonging to us.”

Families routinely ask for their babies’ cord blood to be banked, she pointed out.

And if placental tissue is considered human remains, families have a right to those remains, she said.

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