Nsg Intervention: Improved Maternal Post-partum Health

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An evaluation of the current practice of placentophagy to reduce maternal postpartum anemiaWomen are trying to take care of their own health. A trend has been to go back to nature and attempt to use a more natural source of nutrients vs synthetic compounds that may or may not be beneficial, and in some case could be harmful. The pp period has been a special concern where women face increased vulnerability to pp hemorrhage depression anemia fatigue, etc. This puts NB at risk with new mothers with pp moms who cannot care for their infants due to poor health. One effort that has gained popularity in recent years is placentophagy, quite literally the practice of consuming one’s own placenta. Reasoning behind this practice includes the retention of beneficial hormones and nutrients, indeed, all mammals perform placentophagy throughout the animal kingdom. This natural practice is nature’s way of ensuring this instinct behavior this behavior is an adaptive advantage for animals to maintain their nutritional status during times of famine. Women and some hcp in industrialized have observed this since the 1970’s and support placentophagy. Nursing care includes the a critical function of education and esp during pp education is a critical function of the nurse to prevent unnecessary poor health care outcomes-fatigue/anemia/ iron deficiency, hormone imbalance, pp depression and overall homeostasis. Some researchers have indicated that since the placenta functions to filter out contaminants bacteria and harmful microorganisms to protect the fetus there may be risks associated w placenta. and it is the nurses job to understand this critical act to understand this emerging practice to help inform them of making informed decisions.

The prevalent thinking in the US is that the pp placenta is unimportant as it no longer serves its purpose for fetal oxygenation, nourishment, etc. the importance of the placenta is on the rise as seen on page 343 of Pilliterri. The role of the nurse should include asking the mother if she would like to keep her placenta, as many Asian cultures believe in burying the placenta after delivery. In some areas of China an ancient practice includes the placenta being cooked and ground into powder and then consumed. This approximates the relatively new fad of placentophagy which has been an increasing trend in the United States since the 1970’s. Pregnancy necessitates the growth of new blood vessels and increased demand for blood, with its need for additional iron to form hemoglobin for the fetus and mother. A critical postpartum health outcome is iron deficiency and iron deficiency anemia which has been linked to emotional instability and postpartum depression. Thus, pregnant women are prescribed iron supplements due to this increased demand for iron. Insufficient dietary iron and iron supplementation often results in deficiencies during pregnancy greatly affecting the postpartum period. The World Health Organization (WHO) has identified the rate of iron deficiency in women shortly after giving birth. “In Western industrialized countries, iron deficiency is estimated to affect 25-40% of pregnant women and 14-24% of women one week postpartum”.

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One major reason women choose to engage in placentophagy is to replace or supplement the dietary iron that was depleted during pregnancy since the placenta is highly vascularized or full of blood vessels. The aim of the study conducted by Gryder et al was to determine whether the relative effect of consuming iron from one’s own placenta compared to encapsulated beef. This was done using the gold standard of clinical trials, that is, it was a randomized, placebo controlled, double blind study. It was conducted as part of a larger study that evaluated the effects of eating consuming one’s placenta on maternal postpartum hormonal and emotional status. This particular study addressed only pre and postpartum iron status. All participants were healthy pregnant women over 18 who had already made the decision to eat their placentas postpartum. The study excluded individuals who had pregnancy complications, had ingested placenta after prior births, drank alcohol or used recreational street drugs. Participants were informed that since it was placebo controlled double blind study, they had a 50% chance of receiving a placebo. Participants’ blood hemoglobin concentrations were determined at four distinct points: during late pregnancy, within 4 days of parturition, one week postpartum and again at the third week postpartum.

Participants ingested encapsulated placenta or beef in this double-bIind study. While the encapsulated placenta had significantly more iron (0. 664 mg/g vs. 0. 093 mg/g) it still only provided 24% of the RDA for iron among lactating women. The study results show that there was no benefit nor impairment in the group that took encapsulated placenta over the group taking encapsulated beef. Coyle et al’s article, published in the Archives of Women’s Mental Health (2015) reviews the practice of placentophagy, weighing the data supporting this practice. Forty nine 49 peer reviewed journal articles between 1950 and 2014 were analyzed. Having a broad focus was on multiple health benefits which included postpartum depression, pain relief and the consumption of vital nutrients. Only 10 articles were selected for inclusion in the study which addressed important aspects of cultural beliefs and that perception in developed nations by women who believe that eating one’s own placenta can alleviate postpartum depression and improve recovery. Animal research addressing placentophagy’s role in improving uterine contractions, estrogen cycle recovery and lactation, were all inconclusive with no scientific evidence to support this practice. Supporting the information published in textbook, Coyle et al have found that cultural beliefs play a large role in the practice of placentophagy. Certain cultures embrace the practice, while others view it as unclean and harmful. Indeed, in Nigeria, sheep placenta is fed to mothers to induce labor. This review article addressed multiple aspects of placentophagy including its effects on lactation, hormone levels including oxytocin, prolactin and progesterone. To date, this practice remains low, with just 4% of practitioners and patients endorsing placentophagy.

One key role of the nurse is to provide education about practices and behaviors their patient may engage in. Interventions may be necessary with the practice of placentophagy to ensure patient safety as certain toxins and bacteria are known to be present in raw placenta. These interventions should include principally sound patient education about this practice if the patient expresses an interest in eating her own placenta. Patients should be educated about the potential risks of consuming raw placenta and be informed about other food and dietary sources available to gain the necessary nutrients to maintain the mother’s and infant’s health. As part of postpartum care, nurses should address the importance of safety in patients who chose to eat their placentas, with special focus on nutritional deficits, especially iron levels. Caution should be provided if the patient comes from a culture that practices placentophagy respect the wishes and beliefs of the patient. Although the practice of placentophagy is common in the animal world as a way to enhance survival, the research as to whether the practice is beneficial among humans is inconclusive. Patient and healthcare professionals need to be educated about this growing trend to assist in making decisions that will support healthy patient outcomes.

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