That Time I Was In A Viral Story

In early March, I had a client who wanted to consume her placenta, but could not swallow pills. So, we discussed putting all of her placenta powder into chocolate, rather than just an 'extra' to pills like most of my clients who want chocolates.

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After receiving the call that she had given birth, we made plans for me to come to their home and start the process that evening. As usual, I arrived and began cleaning, sanitizing, and setting up. My client and her mother wanted to watch the whole process, so they set up camp at the breakfast bar above my work area. As I began working, my client began taking photos, and let me know she was posting them on her SnapChat. I thought it was a fun idea, and figured it might reach 20 or 30 people.

Little did I know, the snaps were also posted to Facebook, and quickly began being shared. The first time I knew this was going to be a crazy ride was when I saw the post had 8,000 shares. I shared this with fellow placenta professionals, and we celebrated and wondered what this would turn in to. Little did I know, in just a few days, the original post would reach 100,000 shares. I began receiving private messages and comments that weren't so great, and had to lock down my personal page and carefully monitor my business page. I have received some great encouragement and support, but have also learned that people can be incredibly hateful when hidden by a screen.

The content was soon picked up by an agency and was posted on the Daily Mail, the Sun, Metro, and the Mirror! I'm not sure exactly how far this little video reached, as it has been re-posted in other formats, on pages, in groups, on websites, and who knows where else! I could not have imagined this happening, in my mind it was just little ol' me doing my job! I look forward to helping mothers consume their placentas however they desire for years to come.

1820s Motherhood

Last week, while a friend was in from out-of-town, we were able to tour the Isaiah Davenport House here in Savannah, GA. I was immediately intrigued by this photo:

This is a silhouette of Sarah Davenport, given to her as a gift after delivering her 10th child (7 survived infancy). It was done in 1828 by a silhouette artist by the name of Master Hanks. The thing that blew me away is that this piece was made when she was one week postpartum!

This and some of the other artifacts (pictured below) made me wonder, what was it like to be a mother in the 1820s.

With further research, I have compiled some interesting tidbits about birth in the 1820s.

1. It was deadly.

If a woman were to survive the birth itself, she was susceptible to childbed fever, now known as puerperal fever. The quick-progressing symptoms of this bacterial infection of the reproductive tract consisted of extreme abdominal pain, fever, and weakness. It took many years for doctors to learn the cause of the disease, which was eventually found to be caused by the lack of sanitation at the time. Doctors would often go directly from autopsies to births, with no hand hygiene between. The idea of doctors spreading the disease was first proposed in the early 1790s by Alexander Gordon, but was not accepted until 1885. It remained a problem due to carelessness in antiseptic routine, until sulfa and penicillin were introduced as treatments in the 1930s and 40s. We also cannot neglect the fact that deliveries were much more traumatic in this time, causing more wounds and a greater opportunity for infection to set in.

If women did not succumb to the fever, there were of course other deadly complications such as postpartum hemorrhage or obstructed labor. In fact, women wrote their wills upon finding out they were pregnant. Non-deadly, but life-altering, complications also occurred. These included damage from untreated infections and venereal diseases (antibiotics were not widely used for nearly another century),  uterine prolapse, and fistulas.

Cornelia Augusta, Isaiah and Sarah's ninth child, died of childbed fever in 1853 at age 29.

2. Pain relief

Ether was first used in 1847, and chloroform shortly thereafter, but obviously were not available for Sarah's births in the 1820s. These medications also made the use of forceps more common, as they made it difficult for women to push effectively.

3. Doctor or midwife?

Before the 19th century, all births were attended by midwives. In the 1820s, most births were still at home (only 5% of deliveries occured in hospitals by 1900), but began to be attended by doctors as well. Sarah most likely had a home birth with a midwife, but we can't be certain.

 

Sources:

http://www.davenporthousemuseum.org/

https://www.bellybelly.com.au/birth/why-women-used-to-die-during-childbirth/

https://www.fitpregnancy.com/pregnancy/labor-delivery/checkered-history-delivery-room

http://www.loyno.edu/~kchopin/new/women/bcabortion.html

Birth: The Surprising History of How We Are Born by Tina Cassidy

Lying-In: A History of Childbirth in America by Richard Wertz & Dorothy Wertz

 

Placenta Pills Infect Baby!!! Probably Not...

Recently, a CDC report was released blaming placenta encapsulation for late-onset GBS infection in an approximately 16 day old baby. Yes, this is a scary thought, but there are some gaps in the research and processing of this placenta I want to break down.

So, we'll start with the issues in the report. First, GBS is a transient bacteria, which means it can come and go throughout a woman's life. So even though the mother was negative at 37 weeks, she could have been positive at birth. On the other hand, how many women are told they test positive, receive treatment, but are not actually colonized at birth?

Second, the capsules did test positive for the same bacteria baby was infected with. The mother's breastmilk, the most likely way the bacteria would have been transmitted, tested negative for the bacteria. The report also notes, "transmission from other colonized household members could not be ruled out".

Three of my colleagues raised excellent points and worded them much better than I can.

"You are also dealing with a severely immunocompromised infant who has just come off of a very rough course of antibiotics and was ill which makes that baby much more susceptible to any infection from any source." -Shannon Mitchell

"A logical conclusion is the initial infection wasn't eradicated and the secondary infection was basically a relapse. There was no gbs in the breast milk. I think that's an important part of the puzzle when assuming the placenta was the cause for reinfection. That said, the placenta doesn't seem to have been processed properly and probably shouldn't have been encapsulated to begin with given the immediate onset of the initial infection." -Deanna Norris, APPAC

"Late-onset GBS has generally been attributed to the presence of GBS in the infant's environment. Did they culture the doorknobs in the family's home? The client's nipples? How about burp rags or swaddling blankets? If the client had it on their hands, then they could have quite easily transferred it to the capsules when they were taking some out of the jar. To suggest that the capsules were the *source* of the organism seems like *quite* a stretch." -Wendy Gordon, Midwife

Now onto the problems with the processing of the placenta by 'Company A'. First, "the company does not ask about intra- or postpartum infections". This is HUGE! I absolutely ask this of my clients. Encapsulators never want you to consume infected tissue! In my practice, I will not encapsulate your placenta if you have chorioamnionitis, a confirmed GBS infection (not colonization- in that case your placenta would be prepared by steaming before encapsulation), or GBS infection of the newborn.

Also concerning is the fact that "according to Company A’s website, the placenta is cleaned, sliced, and dehydrated at 115°F–160°F". Any temperature below 160° is NOT safe for dehydration. Below 160° would keep the tissue in the 'danger zone' where bacteria grow rapidly, easily doubling in 20 minutes. When a placenta is dehydrating for 12+ hours, this is simply unsafe, unsanitary, and unacceptable. This is taught in any food handling course, so it makes me wonder if this encapsulator does not follow safe food handling standards.

In summary, in my practice and experience, GBS is only a concern when the mother or baby has a confirmed infection, or the placenta is prepared improperly.

 

References:

https://www.cdc.gov/mmwr/volumes/66/wr/mm6625a4.htm?s_cid=mm6625a4_e

http://placentaassociation.com/group-b-strep-placenta-encapsulation-safety/

https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/safe-food-handling/danger-zone-40-f-140-f/CT_Index

Standards & Scope

There is no one, single definition of the scope of a doula. Each doula training organization defines these for themselves. These are the standards, scope, and other information from the organizations I have trained and certified with. I am proud to be a part of these organizations, and honored to hold myself (and be held) to these standards.

 

New Beginnings

Statement of Professionalism

Scope and Standards

Code of Ethics

 

Stillbirthday

Principles of Service

 

Rebozo Workshop with Gena Kirby

I am so happy I finally got to do this training! While I was at Stillbirthday Homecoming, Gena posted on Facebook asking if anyone would want to come to a workshop in Tampa. That's only 4 hours away (the closest she's been to Savannah), and I knew she was taking next year off! So I contacted a colleague and we decided to split the gas and drive time and go!

We learned more than just rebozo techniques, we learned about truly connecting with and loving a woman in labor. I recommend this workshop to anyone working with pregnant and laboring women.

Gena is an amazing, passionate teacher. When explaining what true undisturbed birth is, and what birth can look like, her voice cracked and tears welled up in her eyes. That moment, I knew this was the woman to learn from. This is a woman making a difference in the birth world. This is a woman I can look up to, and want to learn every possible tidbit from.

I had a blast and made some truly amazing friends! I can not wait to use what I have learned with my clients.

Also, Gena's books, Rebozo Me Mommy and How to Sell Your Client a Bridge are incredible and so worth reading! Learn more about Gena, her books, and workshops at: http://genakirby.com/