How hospitals handle placenta release (or non-release!)

[TO Doula]

I know we've talked about this in various ways, and in one thread someone even talked about setting up a database or registry of hospitals and what they do, but I couldn't find that thread. I'm hoping the title of this thread will make it easier to find in the future.

Can anyone think of a reason for not naming hospitals here?

Anyway, I wanted to share my most recent experiences.

Mt Sinai, Toronto
-asked clients to sign a placenta release form they had - dad was able to do it
-provided a round plastic bucket and plastic bag big enough for the bucket to go in
-printed out label with client's info (same as for records) and put it on the bucket, which would have been very helpful if it was staying in a hospital fridge for a day or two
-clients had stated in birth plan that their placenta was to be given to their doula and no one batted an eye (the release form stated that if the placenta was to be released to a third party that the patient should provide written authorization, but no one asked her to do it)
-someone asked (during labour) what they were planning to do with it, which initiated an interesting conversation with the nurse, gp and various students in room who did not seem familiar with the encapsulation concept
-overall, very cool and very positive

Sunnybrook & Women's College, Toronto (Women's College campus)
-nurse looked slightly confused, attempted to find a suitable container, was relieved when I provided ziplock bags and offered to take care of it
-nurse suggested careful labelling of placenta and told parents which fridge was okay to keep it in - only one fridge was acceptable for this purpose
-parents were taking charge of this one, so I don't know if they would have had an issue with releasing it to me

[earthgirl]

The main hospital I frequent has patients sign a form releasing the placenta for "religious reasons". They double bag it, and refrigerate it until the client takes it home.

[cali4niachef]

From Jodi Sealander:

Hospital Release of Placentas
by Jodi Selander
Women who give birth at home have the luxury of being in complete control over the care and handling of their baby's placenta. A woman who births in a hospital has to adhere to the guidelines and policies in place at their facility of choice. In some cases, there is no written policy, and mothers are then subjected to the whim of the staff on duty at the time they deliver. If you want to take your placenta home after its birth, you must have a plan before you walk through the doors in labor. Your chance of success will increase greatly.
Hospitals vary in their willingness to give women their placentas. Start by talking with your doctor. You do not need to share with your OB what you intend to do with the placenta, just that you would like to have it after your baby is born. Doctors do not always know the details of hospital policies - nurses spend the majority of time with patients, and they will be the ones who can best help you with your request. Call the hospital and ask to talk to a charge nurse. Express your desire to have your placenta, and ask about the hospital's policy for releasing them.
I have a liability waiver that was written by a lawyer and is now available for download here. If you run into resistance with the nursing staff, tell them you have this legal document that you are willing to sign, releasing them of any liability should they give the placenta to you. Each hospital should have their own version of a form called the Consent to Relase Products of Conception (or something similar); the placenta applies under those guidelines, so ask if they would release the placenta were you to sign that form.
If they still say they will not give you the placenta, state the fact that you have a "profound belief" in the sacred nature of the placenta. You only have to have a profound belief in something to have it fall into the category of a spiritual/religious belief. So, if you have a profound belief that the placenta will help you postnatally, that counts. Again, you don't have to say what you will be doing with it - it's a private matter. A request based on a spiritual belief is more likely to be honored than one based on your desire to ingest it for its purported health benefits, which hospital staff will probably view with skepticism.
As a last resort, it may also help to mention the recent court victory here in Nevada, in the case of Swanson vs. Sunrise Hospital. A judge declared that the baby's placenta was the property of the mother, and should be released to her.
Enter your negotiations with a spirit of friendly cooperation. Understand that your request may be the very first time the other person has ever heard about someone wanting to take a placenta home. Keep in mind that resistance may just be an initial reaction to something new and unusual, and probaby fear-based. Knowledge and preparation help eradicate fear. Have a plan for your intial conversation, call in advance and be willing to cooperate with the hospital policies (some hospitals need to hold the placenta for a number of days before releasing it, for example). If you are completely unsuccessful with your attempts, I am happy to help you, particularly if you are told that they cannot release the placenta due to state guidelines on releasing biohazard material. That was often cited as a reason for refusal in Nevada, and there was actually no state law that applied to the release of placentas.
Have a plan, a spirit of open communication, and be empowered. You give birth to your placenta just as your baby. You have the right to take them both home.
Originally appearing in the August 2007 edition of the PBi Newsletter

[TO Doula]

Quote:

Originally Posted by earthgirl The main hospital I frequent has patients sign a form releasing the placenta for "religious reasons". They double bag it, and refrigerate it until the client takes it home.

Would you feel comfortable naming the hospital? That might be helpful for other doulas.

[TO Doula]

Quote:

Originally Posted by cali4niachef From Jodi Sealander: Hospital Release of Placentas by Jodi Selander Women who give birth at home have the luxury of being in complete control over the care and handling of their baby's placenta. A woman who births in a hospital has to adhere to the guidelines and policies in place at their facility of choice.

Thanks for this. Useful for doulas in the US. I'm really looking for specific experiences however. What do the hospitals in your area do?

[raeben]

Quote:

I know we've talked about this in various ways, and in one thread someone even talked about setting up a database or registry of hospitals and what they do, but I couldn't find that thread.

i brought up the idea in this post - #6. i think it's totally fine to discuss here but i'd love to have a searchable database exclusively for this at some point.

it's all over the map here in portland:

providence hospital systems -they are the most difficult. ostensibly they all have similar policies but i am most familiar with portland providence. they are generally the hardest to negotiate with (although, the more placenta requests they get, the more they are a little easier to deal with). they keep the placenta for 8 to 15 days (longer than anyone else). their normal policy is to refrigerate them but if you advocate to the care provider and the nurses (mostly the nurses) you can get them to put it in the freezer for the duration of the holding time. they will kind of freak out if you tell them it is for medicine (so don't!) and may try to make the clients jump through a lot of bureaucratic hoops. they will have to sign a release waiver but they do not have to petition the board and they do not have to say why they want it - "religious or philosophical reasons" will suffice. providence st. vincents has a similar policy but since they have more high-risk babies they will be even more reticent to give it up. the staff does not seem to know if there is a freezer option available there and placentas have been misappropriated to the refrigerator for their 2 week stay :-( i haven't dealt with providence milwaukee but assume they have similar policies as far as length of holding. they put all of their placentas in larger (like 10'x12'x2) rectangular blue tupperware and tripple bag it. they often include a bunch of examination gloves - so the family doesn't come into contact with their own blood, i guess ;-)

kaiser sunnyside has a stated policy of keeping the placenta for 5 to 7 days but i have found them to be pretty flexible. best bet is to get an ob (mw's don't seem to have this power) to sign off on their placenta so it can be released when the baby goes home or released day of birth. they do not have a freezer which may lead to their greater willingness to accommodate. i'd love to hear if others have similar experiences with kaiser facilities.

OHSU is really good about placentas. they have no policy of holding it and will let doula, family, or anybody take it after the birth. they won't let it come up to the recovery floor though so you've gotta grab it off the counter before they move rooms. they generally will just wrap it up in a garbage bag so you might want to bring your own ziplock bags.

legacy good samaritan didn't used to have any placenta holding policies and would let it go as easily as OHSU. this may have changed to a 5 to 7 day hold but they still seem pretty flexible if you talk to the right person at the right time. legacy salmon creek seems a little more strict about holding it for 7 days. they will freeze it if you advocate for that and won't look at you funny for asking. i think they use the medium (like 10' round by 2' deep) round blue containers.

adventist hospital & SW medical center - cant remember... i'll look into that for ya.

haven't had one from tuality yet either.

oh, and obviously alma birth center, both anduluz birth centers and the natural childbirth and family clinic are really great about respecting families wishes for their placenta. and they consistently have really nicely cared for, well drained placentas!!

[DoulaMegz]

How can we go about setting up such a database? I can't imagine it would be difficult to do...we would start with just the info we can gather here (being more specific about what questions to answer) then as more placenta ladies find out about the database, they can submit their experiences as well...

Brie is particularly good with this kind of webb-y stuff...Brie? Do you have any thoughts?

[Brie+3]

Quote:

Originally Posted by DoulaMegz Brie is particularly good with this kind of webb-y stuff...Brie? Do you have any thoughts?

No idea. I am far from a programmer.

[DoulaMegz]

I don't think it's gotta be complicated, just a chart for each state. :-)

[raeben]

and it would be good to have a fillable form so that mamas or others who have individual experiences could put in their info.

[TO Doula]

Quote:

Originally Posted by DoulaMegz I don't think it's gotta be complicated, just a chart for each state. :-)

But someone has to gather or receive that information and put it into that chart and commit to doing it or passing along the passwords and protocols needed to do it to someone else if they can't do it any more. I don't know if there's anything out there in the free website world that can support this. If not, then someone has to be willing to take on purchasing a domain and paying yearly hosting fees, as well as doing all the data entry.

If we can find a free website thingy that can support this, we'll be a step ahead. I think one of the pieces of data needs to be the date someone submitted the info. Then if you see that someone reported on your hospital two years ago you'd be prepared for the fact that the information might no longer be valid.

If someone started a cert organization (cough, cough) this could be a section on that website. I think it might need some professional assistance to set up, but I'm not sure.

[TO Doula]

North York General Hospital, Toronto

*Parents sign placenta release form and receive an information sheet.
*Placenta was removed from room for packaging and was to be placed in a hospital freezer. (We asked about refrigeration, but weren't assertive enough about it.)

In this case, the placenta could not be found a couple of days later when the parents wanted to take it home. It was very upsetting, but the hospital was very willing to send people all over looking for it, and even called the nurse who'd been at the birth at home to see if she knew anything.

I'd recommend having someone take it home right after the birth if possible. The info form said the placenta could only be released to the mother, but all staff stated that anyone could pick it up.

[thorn]

I didn't encapsulate my placenta, but I had it released to me (I donated it for search and rescue dog training)

Emory University Hospital Midtown, Atlanta GA - had to sign a form for release. I had a ziplock bag and cooler to put it in and they insisted that I then place it in a red biohazard bag.

[the janet]

I have yet to attend a birth, so I have no experience with placentas and hospital policies...but my first client just sent me an email saying "The placenta belongs to the hospital, [the midwife] doesn't know what they do with it."

Sooo...it seems to me that the placenta belongs to the mother and the baby, actually. But I'm not surprised to hear that about a hospital. I will see if there is a release she can sign when she gets there but still...I'm surprised the midwife didn't know what would be done with it. Or perhaps didn't want to tell her for some insidious reason?

[earthgirl]

I just wanted to share something regarding placentas and hospitals.
My neighbor used to work as a L&D nurse many years ago at a hospital that, today, refuses to release placentas stating bio-medical waste, and epa regulations. She said that one of the doctors would take all of the placentas home to plant in his garden, and that the nurses would actually save placentas for him if they weren't from his patients. She was shocked when I told her this hospitals new policy.