Speaking of eating placentas . . .

When some folks I know started talking about having their babies' placentas made into pills so the mother could ingest them, I asked the obvious question - why would you want to do that?

Answers were passionate and certain, full of bare assertion and lacking all but the slightest actual justification:

"prevents post partum depression and helps with milk production!"

"give you back your energy too"

"all the hormones that your body needs...its like your own specialized concoction of vitamins and hormones that are made especially for you"

"I think that every mammal eats the placenta after birth... the placenta holds all the vitamins that the... body is depleted of during pregnancy, so it makes sense to put those back into the body after birth"

One person linked to a blog post that had this citation:

"181 out of 210 women who were given dried placenta to increase milk supply had positive results and saw an increase in their milk supply.
Placenta as a Lactagogon; Gynaecologia 138: 617-627, 1954"

Now, first let me say, if you would like to consume your baby's placenta on the off chance it will do you good, I suppose you should go for it. I don't see much harm. If it does nothing, you'll lose some money to a professional encapsulator. Of course safe handling is important, just like with raw beef or chicken or whatever. But really, whatever floats your boat.

I'll also grant that it's possible that placentophagy could have some benefits. It's not completely ridiculous, the way homeopathy is. It's at least feasible that recouping iron and hormones could be beneficial.

But here's my problem - this is at best a hypothesis. It's testable, but hasn't really been tested (as far as I can tell, that study didn't use a control group, and the sample is small to boot). It's a pretty big leap from "animals do this" and "it contains hormones" to "ingesting dried placenta prevents depression and low milk supply."

And why are people so eager to make that leap? Because it's "natural." You won't see this wide-eyed credulity when it comes to vaccines, for damn sure. People who avoid ingesting acetaminophen or corn syrup jump at the chance to chow down on placenta, because that's what sheep do. It just doesn't make sense to me. And I'm worried about the general mentality because it leads to distrust of science-based medicine and encourages faith in altmed woo.

The Constitution doesn't apply to pregnant people in Florida

I . . . just don't know what to say. As a civil libertarian, birth choice activist, and abortion rights supporter, I don't know if I'm more stunned or furious about a Florida court's unlawful imprisonment of a woman and removal of her right to refuse medical interventions, all in the name of protecting her fetus (by means that aren't even supported by evidence)!

A little example of faith versus science - in an unexpected place

This is not a post about religion at all. It is about warring approaches within the field of medicine. Specifically, how we in the U.S. deal with birth.

There are two layers of faith involved. First, and more obviously, is the faith people have in doctors. Sure, one should "have faith" in one's doctor in the sense of feeling trust and believing that the doctor knows what they're doing - the sense of "having faith" that refers to trust or dependability based on prior observation and evidence. However, (and yes, it was the homeopathy discussion that prompted this) many people seem to "have faith" in a more religious sense, i.e., they believe doctors are infallible authority figures, and promptly turn their critical thinking and confidence off when in one's presence.

The second layer is even more disturbing, especially combined with the first. In the field of obstetrics at least, doctors practice medicine by faith. And I mean "faith" in the full-on "believing things contrary to evidence, and stopping your ears and singing 'lalalaIcan'thearyou' when presented with such evidence" way. It all starts out very reasonably - giving birth is an uncomfortable, sometimes painful experience. It would be nice to alleviate the discomfort. Also, sometimes moms and/or babies are injured or even die during the process. It would be terrific if we could prevent that.

To this situation, add new technology. For instance, electronic fetal monitoring. It makes perfect, rational sense that EFM, which allows doctors to constantly monitor fetal heart rate during labor, would improve outcomes for babies. Babies that might have suffered hypoxia and brain damage or even death during labor could be identified and quickly rescued via c-section. All of this is perfectly reasonable, and I agree with the reasons EFM came into use. Of course at that time, there was no research available on actual outcomes with EFM - doctors went on logical deduction that it would be helpful.

Except, once research was done, it became clear that EFM is associated with poorer outcomes for mother and baby. The main reasons seem to be twofold - first, having constant information on heart rate means a very high "false positive" incidence for fetal distress. Scientific study indicates that intermittent readings with a hand-held doppler device actually result in more healthy moms and babies, perhaps because troubling trends that can be identified with this method are much more likely to be indicative of real trouble, versus isolated decelerations that are picked up by the always-vigilant EFM.

The other big factor is that EFM requires the mother to be lying in bed, stationary, so she can be strapped to the machine. As far as I know, every single study of labor and delivery has found better outcomes when mothers can stand, squat, walk, and otherwise remain upright and move around. Looking at the mechanics of birth, this makes perfect sense.

The story is similar for many other technological interventions - from epidurals to inductions to ultrasound estimates of size, it would seem that the innovation would improve birth outcomes, but they actually result in lots of pain, fear, and unnecessary surgery, injury and side effects to mothers and babies, and often disruption of breastfeeding, which has ill effects for both as well.

So it makes me cringe when I hear mothers blithely say, "Oh, my doctor said this is a big baby, so I have to be induced next week," or "Why wouldn't I get an epidural - the doctor says it's perfectly safe!" These people are handing over their intellect to a person who is a product of a system that rejects evidence-based practice in favor of authoritarian received wisdom and perceived infallibility.

Gee, that reminds me of something.