Are Alternative Birth Practices a Good Idea?

February 18, 2022 – Can I eat my placenta? Is a water birth safe for my baby? These are some of the questions more people have been asking Sarah Pachtman, MD, in recent years amid a boom in alternative birthing practices.

Pachtman, an obstetrician and gynecology physician and a maternal-fetal medicine specialist at Northwell Health in New York City, and the voice behind the @healthymamadoc Instagram account, says interest in these practices has been fueled — at least in part — by the pandemic .

“There is a lot of mistrust in the medical system and a lot of mistrust in the way doctors work now. And I think COVID and the pandemic have reinforced that a lot,” she says.

Recent interest in alternative practices has included water births, encapsulating and eating the placenta, and even vaginal seeding, or smearing a baby born by cesarean section with vaginal fluid with the aim of establishing a normal microbiome in the baby. Some have also expressed an interest in lotus births, in which parents leave the umbilical cord intact after birth until it detaches on its own, with the aim of providing the baby with extra blood and nutrients from the cord still attached.

For example, a recent search on the online marketplace Etsy yielded hundreds of hits for products involved in lotus births, including kits containing “lotus birth herb mixture, the lotus birth bag, seven disposable bag liners, and a roll of gauze wrapped around the umbilical cord to keep the baby warm while still attached.” ” New parents can even purchase a onesie for their newborn that reads “My Mom Ate My Placenta.”

But few of these practices have been studied. Scientists and doctors have no clear idea of ​​their benefits — if any — or the potential risks to parent and baby. Because they have no evidence of benefit, Pachtman and many of her colleagues do not recommend these practices.

Here’s what we know — and don’t know — about the safety and benefits of two much-discussed alternative birth practices: water births and eating the placenta.

Water Labor and Births

When talking about water births, it’s important to distinguish between working in water and giving birth underwater.

Working in water during the early stages of pregnancy has been associated with pain relief in people with healthy, uncomplicated, fully completed pregnancies.

“Certainly, in select patients, that’s a reasonable option,” says Alison Cahill, MD, a maternal-fetal medicine specialist at the Women’s Health Institute at UT Health Austin. Cahill also chairs the Clinical Consensus Committee in Obstetrics of the American College of Obstetricians and Gynecologists (ACOG).

Cahill says she’s more concerned about women giving birth underwater. Major medical associations, such as the ACOG, do not support this practice due to a lack of evidence that it does more good than harm. Cahill worries about drowning babies, while Pachtman stresses that any home birth can be risky if an emergency arises.

Infection, while rare, is still a realistic concern as there can be devastating consequences. In 2016, for example, two babies born through water delivery contracted Legionnaires’ Disease, a life-threatening bacterial infection. While both babies survived, one baby in 2014 was also diagnosed with Legionnaires after a water birth and died. And in 2017, a baby in Canada died of an infection with a herpes virus after having a water birth.

Ashton Gelzinis, a doula with Birth Naturally Brevard in Indian Harbor Beach, FL, gave birth to both of her children in the water at home.

“It doesn’t necessarily take everything away, but it just flips the dial to the intensity of labor,” she says. Gelzinis says she hasn’t had any problems with infections in her time as a doula, although she points out that it’s important to make sure the birthing team is qualified and can act quickly in emergencies. Midwives and their assistants should be trained in neonatal resuscitation and carry medications with them to stop bleeding, for example.

Eating the placenta

Pachtman says eating the placenta after delivery is one of the most popular practices people ask her about. Most dry out the placenta, grind it into a powder, and put it into pills — a process called encapsulation.

People who have done this report that they have more energy, are less concerned about their milk supply, and heal slightly faster.

“But again, just like with a water birth, there isn’t a lot of research and evidence to back it up [these reports]says Gelzinis, who consumed her placenta after delivery and offers encapsulation for her clients.

If you do become pregnant and are considering natural/alternative delivery, I highly recommend that you go ahead with it. i also recommend alternative birth center at ochsner baptist

— Princess Bubblegum (@debamichelle) January 13, 2021

“I’ve never had anyone have negative results with taking the placenta,” she says.

Still, the stories of this practice do not mean that there is scientific evidence that consuming the placenta is beneficial.

“We can’t say there’s any benefit,” Cahill says.

“It’s all anecdotal…and while I respect those stories, I also tell my patients that there’s a risk that your placenta has a virus,” such as hepatitis, HIV, Zika or COVID, Pachtman says.

The placenta acts like a filter, collecting toxins for 9 months, so there can be a risk of infection if you eat it, explains Pachtman. A report from Oregon in June 2017 found that a newborn developed group B strep associated with the placenta capsules consumed by the child’s mother after delivery.

To take decisions

For pregnant people and their partners with questions about alternative birth practices, Pachtman and Cahill recommend talking to their obstetrician about what they’re reading, hearing, and thinking.

“We want to respect patient autonomy, but of course we want to keep pregnant people and unborn babies safe,” Cahill says.

Gelzinis recommends that all expectant parents take a childbirth education course to learn their options, rather than going through the internet “rabbit dens” to make a choice.

“I am regularly shocked by the number of people on the internet who ask random people for medical advice. To make the best decision for you and your family, find a doctor or birth provider you trust. And if you want more information and they don’t have it, ask them to look it up” and help put the new information into context, Pachtman says. “Get the information from people who have read and studied and learned this for many, many years.”

WebMD health news


Sarah Pachtman, MD, maternal-fetal medicine specialist, Northwell Health, New York City.

Alison Cahill, MD, maternal-fetal medicine specialist, Women’s Health Institute, UT Health Austin.

Ashton Gelzinis, doula, Birth Natural Brevard, Indian Harbor Beach, FL.

CDC: “Comments from the Field: Late-Onset Infant Group B Streptococcus Infection Associated with Maternal Consumption of Capsules Containing Dehydrated Placenta – Oregon, 2016.”

American College of Obstetricians and Gynecologists: “Commission’s Opinion: Water Immersion During Labor and Delivery.”


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