natural birth

Ask Her Anything: Placentas, Pushback, and “The Poop”- with Rebecca Roosma, CPBD

In a lot of ways, Rebecca Roosma is a one-stop shopping powerhouse of birth work. A certified doula who takes care of her clients prenatally, during birth, and during the postpartum period, she is also a State-Licensed Placenta Encapsulation Specialist, and a trained Bereavement Doula with Stillbirthday. In this “Ask Her Anything” interview, Rebecca tackles a really marvellous range of questions, from whether or not vegetarians and vegans can encapsulate their placentas, to which Delaware hospitals give birthing mothers the most pushback, and – perhaps the ultimate question in the whole wide world of birth anxieties – “what if I really do poop in front of everyone when I have my baby?”

Relax, everyone. This doula will tell you about ‘the poop’, and everything else our followers wanted to know!

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1. I want to have my placenta encapsulated, but I’m a vegan. What’s the deal with that? Is it against vegan guidelines to consume my own placenta? (I know that sounds crazy, but I honestly can’t figure it out!) – JF

Good question, and one close to home for me as I was a strict vegan myself for several years. 

If you look at the various intentions behind veganism, I think you’ll feel completely comfortable and confident with the idea of placenta consumption, just like my many vegan and vegetarian clients have in the past.

One motivation for veganism is, of course, avoiding cruelty to/exploitation of animals, but nothing along those lines is happening here. The body generates this organ during pregnancy, then naturally discards it afterward. Therefore, nothing has been harmed, and the organ serves no other purpose except to be discarded. Perhaps you’re planning to raise your children as vegans or vegetarians as well, but you intend to breastfeed. It’s the same idea. Your body creates your breastmilk for your baby, in the same way that it creates the placenta for both you and baby.

Another reason many people (myself included) choose veganism is because of the lack of safe, quality animal food products in our society. We wonder where our meat came from, what antibiotics and hormones are in it, how sanitary the processing plant was, etc. When consuming your own placenta, you can rest easy because you know exactly what foods and medications you’ve put into your system during your pregnancy.

In this same vein, whether you’re vegan or not, I would strongly advise against anyone consuming their placenta if it was taken to pathology. Once it leaves your sight, you cannot be sure of how long it was left sitting out. Labs may also use harmful chemicals like formaldehyde. There is also always a slight risk of getting back the wrong placenta! Therefore, I do not encapsulate placentas that have gone to the pathology lab.

(Pro Tip: if your physician has any cause to send your placenta to the lab and you wish to encapsulate, ask them to just send a piece. They don’t need the whole thing. That way, if the results indicate that your placenta is still safe for consumption, you have the majority of it in your possession on ice in your cooler).

As for the cleanliness of the processing space, I am fully trained in safe handling and processing of placentas, trained in OSHA standard precautions, blood borne pathogens, and safe food handling. I always review every client’s full bloodwork report to ensure that they are healthy before bringing their placenta into my workspace.

It’s super important to inform your placenta specialist if you are a vegetarian or vegan, however, because I will know to process it using vegetarian capsules instead of gelatin ones. Also, keep in mind that there are a multitude of ways to consume your placenta or to use it topically. I offer chocolate placenta truffles, placenta tinctures, smoothies, balms, salves, and many other remedies. I am happy to accommodate your dietary preferences with non-dairy smoothies, a salve that does not contain beeswax, vegan truffles, etc.

2. I’ve heard that everyone poops when they have a baby, but I’m terrified of pooping in front of my husband! Is that really unavoidable? (And do husbands ever really get over it?!) – KC

I’m right there with you! It seems like as long as I can remember hearing about birth, I’ve heard expectant mothers worry about pooping while they’re pushing – more specifically, pooping in front of their husbands. It’s a very common fear – in fact, it can be such a huge concern that it can even slow down or stall labor if a woman is focused on it, because she is trying to keep her body from doing what it has to do: let go!

I’ve got some reassuring news for you. One of the early signs of labor is that your body begins to clean itself out in preparation for birth. We all hear about starter contractions, losing the mucous plug/”bloody show,” etc., but many women don’t know that things like back aches and diarrhea can be early labor signs, too. More than likely, you will experience some diarrhea or at least a lot of pooping in the comfort and privacy of your own bathroom, with no audience, as your body begins to go into labor. The pressure from baby descending in the pelvis tends to “clean you out,” so to speak, so by the time you come ’round to the pushing phase and you’ve got a handful of people staring intently into your lady parts, there won’t be very much left in there, anyway. 

I have attended 30+ births, and I have only seen poop at 2 or 3 of them. Even then, we are talking about tiny pieces of poo, not a full-on turd (I’m sorry—I tried to find a poetic way to put this, and failed!). If you are birthing in a birth pool/tub, the midwife or nurse will sweep it up with a little fish net before anyone aside from the professionals notices. If you are birthing in a bed/stool/other dry location, these tiny messes are wiped away with the warm, wet washcloths that are already being held against your bottom to support your perineum during pushing. The nurse or doula will throw any messy washcloths right into the laundry bin, so hubs will never know! Even if he did see it, he probably wouldn’t process it–kind of like when we expect them to recall details about the amazing outfit we had on at a recent event (“Honey, what did you think of that new dress I wore yesterday?”/“Ummmm….”).

I would be surprised if any of the partners even noticed, to be honest. Obviously, they are very focused on you, your breathing, and providing you with the calming and comfort techniques they practiced in birth class or with your doula. They’re completely distracted by the anticipation of meeting their child for the first time! You’ll be focused internally, so you would be completely unaware too. And let’s face it: even if you did have a full-on poop, your husband will be so amazed by what an incredible goddess birth warrior you are, he wouldn’t care!

3. Have you ever caught a baby if the midwife didn’t make it in time for the birth? – NR

No, I’ve never had to do this, although I have attended some extremely precipitous labors! There were even a few that were so quick that I missed them, despite getting to the birth location within 20 minutes of the call. One time, the nurse, birth photographer, and I all missed an arrival, and the birth tub only managed to be filled a few inches!

In these instances, I was concerned that the clients would wish that they hadn’t “wasted money” on doula services. However, the parents told me afterward that if she hadn’t used the coping strategies for avoiding bearing down that I covered with them in our prenatal visits, the baby would have been self-delivered by mom in the passenger seat on I-95! 

While I feel confident that I could do it, for liability reasons I wouldn’t—as long as someone else were there. I would be happy to talk a partner through it if need be, while we waited for the pro to arrive. I would definitely coach the woman through those anti-pushing techniques I mentioned earlier. I also think it’s pretty fierce when women catch their own babies! I watched with absolute pride as one of my clients stood beside the bed and pushed her baby out and caught him with her own hands, bringing him to her chest to cradle him. Yes, she was surrounded by birth professionals and her husband, but she could have also done this at home if she’d had an insanely fast labor. (Labor rarely moves that quickly, though – despite what we see in movies and on TV.)

4. Have you experienced more pushback from medical staff about natural births at specific hospitals? Which ones have you had good experiences in? – SL

Honestly, it’s not so much about the hospital – you want to hear an insider’s secret? A lot depends on which nurse you get! Hospitals don’t have a problem with natural birth, they just don’t see it very often. The truth is, they get a lot of people coming in saying “I want to go natural,” but who haven’t prepared for it, and end up getting the epidural anyway – therefore, they may assume you’ll do the same. 

Almost all Labor & Delivery professionals at every hospital in Delaware want to see women supported and satisfied with their birth experience, but there can definitely be challenges for expectant mothers and fathers when it comes to communicating their hopes and needs to their L&D staff during those intense and emotional moments of labor – and those gaps in communication can often cause what can be perceived as “pushback” – another critical reason to have a Doula with you for your birth. 

(Pro Tip: We doulas tell our clients when they check in at the hospital to ask, “Is there a nurse on shift who has experience with/enjoys natural childbirth?” Be proactive. This is a lot easier to do than to ask for a different nurse mid shift when you realize you aren’t jiving (although you certainly CAN do that).

5. I know that most doulas go to their clients’ houses for visits throughout the pregnancy, but going into other people’s personal space can sometimes be weird. Have you ever gone into a client’s home for a visit and felt kind of weirded out, or like you wanted to leave? – RJ

No, never! I think common sense practices help me to avoid getting into a situation like that. First, I have several interactions with potential clients via email and/or telephone before I meet them in person. Then, I always meet both the mother and her partner for a consultation/interview in a public place. (The truth is that not only are they interviewing me, but I’m interviewing them, too!) It’s crucial that everyone feels comfortable and connected in order for this to work. If something doesn’t feel right, I’ll decline the couple and offer them resources where they can find a better fit.

If it IS a good fit and I’m hired by the couple, I do the first prenatal visit in a public place (a library, a Panera, once even at a brewing company!). The first prenatal is a lot of getting to know how the couple interacts, what their concerns are, what their birth plan wishes are, etc. This is conducive to a public space.

However, the second prenatal is a lot of hands on and labor position practice. (People tend to look at you funny if you do that in a coffee shop!) I do the second prenatal visit at their home, not only so that we can get comfy and practice breathing, pushing, and comfort techniques like hip squeezes, but it is also important that I know how to get to the house in case I end up laboring with the couple there in the middle of the night. I need to know the layout too, in case mom needs anything. I get to meet the pets so that they know who I am. But I ALWAYS tell a trusted family member or friend the address of where I’ll be, because I’m cautious.

By the time the postpartum visit rolls around, we are so well bonded that I’m totally comfortable in their space and make myself at home! (And by the way, we WANT your house to be a mess at the postpartum visit!) Your job is to be healing and bonding with your baby– not doing dishes, laundry, and vacuuming, so don’t worry about that. I think if I did have any uneasiness, I would just take along one of my wonderful doula colleagues and play it off as an observation, but I’ve never had to do this. My clients have all been so amazing and lovely.  I have even been in their homes well after my contracted services are over—for birthday parties and other celebrations, which is such an honor.

6. I’ve had so many friends encapsulate their placenta and I know that I’d like to, but my wife is super weirded out by it. (We’re first time parents!) Do you have any advice about encouraging partners to be more open-minded about placenta encapsulation? What do you think are the most evidence-based reasons that it should become more mainstream? How can I help get her past the “ick!” reaction? – MD

Believe me, there was a time when I thought it was disgusting, too! However, once I realized the many potential benefits that placenta consumption can provide a woman, I got over it quickly.  Likewise, your wife would not be the first partner I’ve encountered who expressed hesitation.

Placenta consumption has been in practice by many cultures for thousands of years.  This may have come about because humans observed other mammals eating their placentas after birth. Of course, in the natural world, this is partly to keep predators from sniffing out the birth location and attacking the young and the recovering mother, but it also replaces many nutrients that are lost during the delivery. Encapsulation is definitely becoming more mainstream in Western culture, thanks in part to celebrities who have been touting the benefits. My phone has definitely been busier since Kim Kardashian had her placenta encapsulated, which I like to joke may be one of the most positive things she’s done for society during her career!

There aren’t many research studies on ‘placentophagy’ (the act of consuming one’s placenta), because no one who can afford to do the research would stand to benefit from it. Obviously, pharmaceutical companies wouldn’t want this done, and encapsulation specialists like myself certainly can’t afford to do it, so most of the evidence is anecdotal.

What I do at my placenta consultations is provide the couple with a list of references of my past clients – including partners – who are more than happy to respond to an email from someone who is interested but has hesitations.  There are several partners on that list who, after agreeing to placenta services with the second child, have seen the drastic difference in postpartum experiences for their wife/girlfriend, and would shout it from the rooftops! Some women have told me that their partner (who originally wasn’t keen on the idea) would notice them being emotional or hormonal and say, “Honey, you need to take a placenta pill!”

I divide my reference list up by service—each encapsulation method, people who have used the salve, or gotten smoothies, or done the postpartum belly binding, etc.—so that you can contact people who have a first-hand experience with whichever services you’re interested in. I also have plenty of extremely convincing reviews about placenta services on my Facebook page (Wilmington Doula) and my website, which is  nearing completion (www.hatchlingsdoulaandplacenta.com)

I also bring along a small jar of placenta capsules (I did a friend’s encapsulation as a gift, and she agreed to let me keep a handful as a demo for clients) so that you can see that they are totally not as gross as you’ve been imagining! They actually look like Echinacea supplements because the placenta is completely dehydrated and then ground into a fine powder before being put into the capsules. If someone is still squeamish, I can do flavored pills (like wild berry) which are opaque and fun, bright colors.  I also provide a few extremely relatable web articles, which I will link below.

In the end, I find that partners always come around to whatever the mother wants to do, because her body has done so much work, and they want her to be as happy and comfortable as possible during the postpartum. Besides, I’m doing all the ‘dirty work’ anyway!  All your partner has to do is bring a cooler to the birth location. By the time any placenta products arrive at your door (within 72 hours of delivery), they are completely innocuous looking and attractively packaged!

http://rhythmofthehome.com/benefits-of-placenta-encapsulation/

http://www.phillymag.com/be-well-philly/2013/09/05/why-ate-placenta/

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In addition to being a certified doula and licensed placenta specialist, Rebecca also offers specialised services such as prenatal belly-casting, postpartum belly-binding, V-Steams, Accupressure, Cord Art & Keepsakes, and ceremonies such as Mother Blessings, Cord Burnings, and Rebirth Ceremonies that help women heal and overcome from previous Birth Trauma.

You can read Rebecca’s professional profile on her LightHouse page, right here – there you’ll also find her contact information, which you should put to good use immediately by reaching out and scheduling your consultation for one of her many fantastic services (or all of them!) that help new mothers thrive throughout the childbearing year.