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Why do you have to pay for your own placenta?

That's because the placenta – an organ that develops on the wall of the uterus and helps sustain the fetus during pregnancy through nutrient-rich blood – is considered to be medical waste, like most organs or tissue removed during medical procedures.

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Eating placenta after labor has received a lot of buzz from celebrities who say it has helped them fight postpartum depression and increased their milk production, but a recent case in Mississippi highlights that the practice can be complicated and expensive for some women. That's because the placenta – an organ that develops on the wall of the uterus and helps sustain the fetus during pregnancy through nutrient-rich blood – is considered to be medical waste, like most organs or tissue removed during medical procedures. But to women who want to engage in the controversial practice of ingesting the placenta after childbirth, the right to take it home represents an extension of their right to control their own bodies. The issue was most recently highlighted by a 25-year-old Mississippi woman, Jordan Thiering, who had to obtain a court order to take her placenta home after the hospital at which she is scheduled to give birth bristled at her request. The judge handling the case wanted to confirm that taking the placenta home wouldn't pose a public health threat. Thiering and her husband are expecting to have a son June 24, and a doula – or birthing coach – will be converting the placenta into capsules. Some women eat their placentas raw right after birth. Others mix it into smoothies. Thiering says she has friends who use it to make art and knows others plant it with a tree to commemorate their child's birth. While the benefits of eating the placenta are disputed, Thiering hopes it will help her relieve pain and increase energy. "Whether it's a placebo effect or it works, it's my body and my choice, and it doesn't affect anyone else's body," she said in an email interview. Though her attorney agreed to defend her case pro bono, Thiering paid $148 for the court filing fee in Rankin County, Mississippi. Her attorney, Jacqueline Hammack, who hasn't defended a case like this before and recently started the organization Birth Justice, said attorney's fees would typically total at least $750. "Most moms don't have the time or money for unnecessary court orders and for something that grew alongside your baby, it seems ridiculous to need one in the first place," Thiering said in an email. Hammack says it's likely that a similar court order would be required in Mississippi if someone wanted to take their appendix or tonsils home. But Thiering wouldn't necessarily have faced these barriers if she had lived in another state. Oregon, Hawaii and Texas each have a separate law that allows mothers to take the placenta home. Even in states that do not have these laws, some hospitals let women take the placenta home once they sign a liability waiver. "Ms. Thiering and I hope that the Mississippi Department of Health will amend their rules and regulations similarly, so that families do not have to obtain court orders to leave the hospital with their placentas," her attorney said in an email.

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Women who give birth at home are not subject to the restrictions imposed by hospitals, but when they give birth in a hospital they can face a patchwork of regulatory barriers because of hospitals' biosafety policies or because of city or state laws. The American Hospital Association does not have a policy on the practice and doesn't track which hospitals do not allow it. The rules governing the disposal of the placenta emerged from a larger set of laws guiding the proper disposal of biohazards during the 1980s, when the public was inundated with images of syringes and other medical waste washing up on beaches. In response, Congress passed the Medical Waste Tracking Act, which required the Environmental Protection Agency to create a medical waste demonstration program. After that, states, counties and cities passed regulations to handle medical waste. Some states require strict packaging, labeling and tracking or sterilization and incineration. Some biohazards are stored inside in refrigerators and others are stored outside in containers. States also define medical waste differently, according to data compiled by the Healthcare Environmental Resource Center. Dr. Rebecca Starck, chairwoman for regional obstetrics and gynecology at the Cleveland Clinic in Ohio, says patients at her facility are allowed to bring their placentas home. The patient and doctor must sign a specimen release form, and the placenta goes home in a biohazard bag. Patients also must leave the premises soon after they receive the organ. "My concern would be infection risk or preservation of human tissue and inherent risks of cross-contamination," Starck says. Following delivery complications, however, sometimes a placenta is sent to pathology, which is not a sterile environment. Women cannot take the placenta home in this case, and the placenta is converted to a liquid that cannot be handled by unauthorized personnel. At Massachusetts General Hospital in Boston, the placenta is sent to surgical pathology first and is then available to patients for pickup. The hospital requires consent forms from parents and packages the tissue for them, helping to prepare it for consumption. Sometimes city and states are more strict. Several pregnancy websites and message boards give women tips about how to sneak their placenta out of the hospital without medical staff noticing.

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