Happily Ever Afterbirth

Meet a former massage therapist who found her true calling turning postpartum placentas into tinctures, pills and the most intimate of keepsakes.

Chirping birds flit through the yard of a suburban ranch home in the foothills of Los Angeles County’s San Gabriel Mountains. Afternoon light bounces off the industrial-sized stainless steel sink in Sara Pereira’s home laboratory. The petite 36-year-old brunette, clad in a facemask and lab coat, methodically cleans the counter with medical-grade antiseptic wipes. With gloved hands, she opens a dorm-sized refrigerator and removes something meaty from a plastic storage tub, then holds it up to the light. “This is the side that was attached to the mother,” she says, offering a bumpy slab of what looks like it could be a rump roast, “and this is where the baby was housed.” She turns the orb while extending her fingers to open the white balloon-like amniotic sac around its magenta cave.

Sara's workshop is a little room in the backyard of the house.
Sara Pereira’s workshop is in the backyard of her main house.

The fetal side of the organ is a bloody cloud; its vascular universe reaching toward the umbilical cord makes it easy to see why the placenta is known as “the tree of life.” Placenta’s Latin root translates to “flat cake” – accurate, considering that for nine months this provided all of the nutrients and oxygen needed for human life while carbon dioxide and other waste were whisked away down the cord. We all lived here once.

Later, Pereira peeks inside a cherry Le Creuset-style pot on a hot plate, where that cleaned placenta, from a baby born in the wee hours of the morning, has been steaming in water for thirty minutes. It was delivered via cooler directly from the hospital to Pereira’s home. After the steaming, she’ll slice it into strips and place it in a food dehydrator for twelve hours. Placentas from other births that took place the previous day sit in nearby dehydrators – the brand label dubs the machines “jerky makers” – awaiting phase two of their process to encapsulation. Each is marked with a handwritten tag bearing the client’s name. A slightly fishy smell emanates from within. Soon the crispy pieces will be blended into powdered form and distributed into vegetable-based capsules. Most placentas yield between 67 and 275 capsules; Pereira estimates the size of this new one will result in roughly 160. (She’s just about on target: The final count is 162.) When every last crumb is captured, the pills are delivered to the respective mothers for consumption.

Most mammals practice maternal placentophagy – mothers eating the placenta of their young after birth. And while celebrity endorsement has recently placed placenta eating front-and-center in Western media, the practice dates back thousands of years.

Dr. Ray Rubio, 54, is the Executive Director of the American Board of Oriental Reproductive Medicine (ABORM) and has been practicing Chinese medicine with a specialty in reproductive medicine and infertility for over two decades. He asserts that placentophagy – women eating their own placentas or those of animals – has been recognized in traditional Chinese medicine “since about 700 AD,” citing its first appearance in a pharmacopoeia (a journal of medicinal drugs).

Sara Pereira briefly attended school for Chinese medicine before deciding on a first career as a massage therapist. She’d heard of placentophagy in school and thought it sounded logical, something she’d like to do when she had a baby one day. Later, she prepped her first one after a pregnant friend, who’d been a vegetarian for twenty years, mentioned wanting to try it. “So I figured out how to do it by researching online and asking questions of my old teachers and did it for her and it benefitted her so much,” Pereira says.

Pereira claims her friend experienced no postpartum issues after consuming the placenta. “I was already working with pregnant women at the time offering massage, so she encouraged me to start offering it to my clients.” She took an online course to become certified, and soon her twelve-year practice as a massage therapist was eclipsed by requests for placenta preparations.

Sara uses a laboratory mask and tight latex gloves to keep a sterile lab space while manipulating the raw placenta.
Pereira dons her mask and gloves.

Pereira was one of the first to offer the service in the Los Angeles area and has been a Placenta Preparation Specialist – certified by the Association for Placenta Preparation Arts, or APPA – for eight years.

Practitioners of Western medicine often scoff at the supposed benefits of placenta eating. Dr. Jen Gunter, an OB/GYN and author of the book “The Preemie Primer,” a guide for parents of premature babies, says, “There is no science that either supports any health benefits of eating placenta and no science to say it is safe.”

Pereira seems unfazed by the opposition. “This has been practiced in other cultures for centuries. It works. They don’t question it. We question it here, and there’s not a lot of research or studies done because who is going to financially benefit from doing this?”

Dr. Rubio agrees. “Data is driven by sales,” he says. “The most robust research is conducted at big university research centers, which are essentially in bed with pharmaceutical companies, so who’s going to do a randomized controlled trial on placenta when you can’t turn around and sell it in a jar? You can’t patent someone else’s organ. The lack of data doesn’t mean the effectiveness is not there.”

Left: The placenta steams in its pot. Right: The umbilical cord attached to the fetal side of the placenta.
Left: The placenta steams in its pot. Right: The umbilical cord attached to the fetal side of the placenta.

He adds that the “jing tonic” made from the placenta has traditionally been used in Chinese medicine, not by postpartum women, but by patients who “might have delayed development in puberty, or sexual development, periods, ovaries, etc.”

Rubio says patients use it nowadays because “it helps with insufficient lactation, aside from latching-on issues. It helps prevent postpartum depression and with recovery from labor and delivery, especially secondary infertility.” While he doesn’t perform the prep himself, Rubio recommends it to all of his patients and refers them to preparers. “Not all choose to follow my recommendation because it’s ‘too weird,’ but eighty percent do.” Pereira and Rubio have both noted a spike in popularity of the practice. “More people are talking about it and there’s less stigma,” Rubio says, “like breastfeeding in public.”

While there’s no governmental certifying body for Placenta Preparation, there are several international boards attempting to regulate and educate. (Pereira sits on the board of APPA).

Each preparer’s services are slightly different. In addition to the capsules, Pereira offers a tincture made with vodka and drops of umbilical cord blood, a Shrinky Dinks-style keepsake of the dehydrated cord fashioned into the shape of a heart, and prints of the placenta pressed onto acid-free stock paper. “I do about three or four of them. The first is kind of sloppy because there’s a lot of blood,” she says. The results look like heart-shaped Rorschach tests, ready for framing.

She does not offer smoothies. “I think that’s a dangerous practice,” Pereira says. “If [new mothers are] having a home birth and preparing it at their house then that’s fine. Some are going into the hospital to do it, or doing it in their car with a blender, which is not cool.” She says that can easily lead to bacterial contamination in the placenta smoothie. “How do you have a clean field in your car?”

Thank you cards from Pereira’s clients.
Thank you cards from Pereira’s clients.

Alison Larmee Born from Wilmington, North Carolina, drank part of her placenta in a smoothie while still in the hospital after her daughter’s birth in 2014 and later took the rest in capsule and tincture form. Her preparer also made her a placenta-based balm, which was supposed to help with diaper rash, though she didn’t find that particularly useful. “I take all kinds of weird herbs all the time so it’s no big deal to me,” Born, an acupuncturist, says. “My breast milk did come in quickly and I didn’t have any issues. It’s hard to say if the placenta had anything to do with that but it does contain oxytocin, which can help. I was a little anemic and [my red blood cell count] came back up pretty quickly, too.” Born keeps brochures for the local placenta preparer in her acupuncture office and shares her experience with patients, stressing, “It’s a personal choice, like having a doula.”

Pereira carries a dehydrated placenta.
Pereira carries a dehydrated placenta.

Pereira sends her tinctures and pills off in a brown bag labeled with her MommyFeelGood logo and general guidelines for the mothers about listening to their bodies. “If you think about it, a woman in her third trimester has three times the amount of normal hormones than the average woman who isn’t pregnant,” Pereira points out. “After she delivers, it usually takes a few days for the body to recognize [the enhanced hormone levels]. You’re sort of high off of the oxytocin. After a few days, suddenly your body recognizes it has below the normal amount of hormones.” Pereira says the placenta capsules help even-out hormone levels, and she advises her clients to save some for the three-month, six-month and nine-month transition points when women go through hormonal fluctuations that sometimes cause post-partum depression. “The baby’s needing more milk and going through growth spurts, too, so it’s a good time to start up again,” Pereira says. The tincture has what she calls a “forever shelf-life” because it is taken in drops and more high-grade alcohol can always be added.

The placenta with umbilical cord attached; The dehydrated placenta; Powdered placenta is encapsulated; A finished capsule.
The placenta with umbilical cord attached; The dehydrated placenta; Powdered placenta is encapsulated; A finished capsule.

As far as legalities go, Pereira says, “It’s actually illegal for a hospital to not allow you to take it home.” She notes that the State of California and Los Angeles in particular have been welcoming to professionals. Hospitals are generally agreeable, although she tells the tale of one new mom who was told by one of the nurses “that she couldn’t keep it – that it was illegal – and she believed [the nurse] and let her take her placenta away. She was so upset and I was upset that this woman lied to her.” Pereira adds that there have been lawsuits after the mother was denied access to her placenta. In recent cases from Hong Kong to Las Vegas, mothers usually win the right to have their placentas, but by the time the courts resolve the issue, sometimes it’s too late for them to consume them.

Pereira working.
Pereira working.

Pereira’s introductory email to potential clients explains that her services include pick-up of the raw placenta and drop-off of the products – with a discount offered to those who transport the fresh placentas themselves, usually the father of the baby, a close friend or a family member. The email also warns of potential biohazards:

If for any reason [hospital employees] say [the placenta] needs to go to pathology, just make sure that they do not use any solutions, that they keep it refrigerated, they use sterile equipment and a sterile workspace if they are dissecting it and that you get it back within 2 to 3 days. 

A few fathers have partaken, Pereira shares, “to have mom and baby’s DNA in them, which is sweet.” Still, Pereira stresses that this process “is for the woman.”

A molded umbilical cord that will be dehydrated to make a keepsake.
A molded umbilical cord that will be dehydrated to make a keepsake.

She’s heard all of the negatives and naysayers who write the practice off as unnatural, even cannibalistic. “You came from your mother’s vagina. You lived in your dad’s balls and grew in your mother’s uterus, so get over it,” she laughs.

Business is booming lately, keeping Pereira perpetually on-call, making it hard to plan vacations and maintain a social life around due dates. She recently hired an assistant. Things are about to get even more hectic as Pereira and her husband of seven years have just learned that they’re expecting twins.

“I always knew I would be a mother,” Periera says. She won’t be preparing her own placentas though. The twins are fraternal, so the two birth sacs mean twice as many capsules to ingest afterward. “I’ll probably have my assistant prep them.” Obviously Pereira’s hands will be pretty full.

Left: Pereira takes a placenta out of its pot. Right: A keepsake print of the placenta hangs to dry.
Left: Pereira takes a placenta out of its pot. Right: A keepsake print of the placenta hangs to dry.

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Shawna Kenney is the author of “I Was a Teenage Dominatrix” (Last Gasp), “Imposters” (Mark Batty Publisher) and “Book Lovers” (Seal Press). Her work has appeared in The New York Times, Playboy, Creative Nonfiction, Vice, The LA Weekly, The Rumpus and more. Find her on Twitter @shawnajkenney or follow her veganish adventures on Instagram @shawnasafari.

Gema Galiana is La Mujer Tranvía, a photographer based in Los Angeles. She is an observer running around, sometimes upside down.