Placenta Services Contract

Placenta Encapsulation Description 
Placenta encapsulation is the process of preparing the mother's placenta after the birth of the baby. The ingestion of the placenta is known as "placentophagy."  The purpose of placentophagy is to reintroduce beneficial vitamins, minerals, hormones, and other nutrients to the mother's body following labor and birth to help restore a more balanced body function, increase breastmilk production, shorten healing time, increase maternal energy levels, and provide an overall feeling of wellness to aid in the transition between pregnancy and the early postpartum period.

Limitations and Disclaimer
I am not a physician, and I cannot diagnose, treat, or prescribe for any health condition. Services and fees are for the preparation and encapsulation of your placenta, not for the sale of the pills. The benefits of placentophagy are supported by ongoing research but have not been evaluated by the FDA. Benefits will vary from person to person, and no specific benefits or effects are promised. I can supply you with relevant research on placentophagy. It is your responsibility to determine whether using placenta preparations may be of benefit to you. Placenta services are not meant to be a replacement for medical advice or prescription medicines. If you are experiencing symptoms of postpartum depression, low milk supply, or other medical concerns, please speak to your midwife or doctor.

PLEASE INITIAL HERE TO INDICATE YOU HAVE READ AND UNDERSTOOD THESE LIMITATIONS* 

Client Responsibility
It is your responsibility to notify me as soon after birth to make arrangements for me to carry out the encapsulation. (I will give you further instructions on contacting me after I receive your information.) Failure to do so may result in delayed placenta preparation and may cause spoilage of the placenta, which could render it unusable for encapsulation. It is your responsibility to inform me of any known bloodborne illnesses or other health issues that may put me at risk of infection through contact with bodily fluids, such as HIV, Hepatitis, or STIs.
 

  • If birthing in the hospital: It is your responsibility to discuss your placenta's release from the hospital and ensure its storage in a cooler, refrigerator, or freezer within 3-4 hours following the birth. When I receive your information, I will send you further instructions based on which hospital you plan to birth in.

  • If birthing at home: Please ensure that your placenta is refrigerated within 3-4 hours following the birth. If it is more than 4 days before the placenta can be prepared, it should be frozen.


Your placenta must not be treated with alcohol, formalin, or any other preservative.

There may be circumstances under which your placenta cannot be used. Significant abnormalities of the placenta may necessitate your care provider sending your placenta to Pathology for further examination. Other conditions, such as signs of maternal infection during labor, may mean that consuming your placenta will not be beneficial to you. If in doubt, I will consult with you before proceeding. It is usually possible to claim your placenta after a cesarean birth.

INITIAL HERE TO INDICATE THAT YOU HAVE READ AND UNDERSTAND YOUR RESPONSIBILITIES*

Service Description
I will pick up your placenta from your birthing location (unless other arrangements are made), carry out the encapsulation process in my home, and deliver your capsules to you. I do not currently offer encapsulation in the client's home -- I have found that I can more carefully maintain a properly sanitized environment in the dedicated space in my home that I have set up for placenta encapsulation.

 

As a placenta service provider, I can formulate your placenta via the Raw or Traditional Chinese Medicine processes of encapsulation, yielding approximately 100-200 capsules taken throughout the postpartum period. Nutrients and hormones are restored, supporting the new mother as her energy returns, encouraging an abundant milk supply, and helping to ward off postpartum depression. 

 

Traditional Chinese Medicine – This traditional Chinese medicine method follows the preparation of lightly steaming the placenta with your choice of warming herbs (ginger, lemon, jalapeno pepper) before dehydration. When it is completely dry, I powder and encapsulate it.

 

Raw Placenta Encapsulation – The placenta is dehydrated raw and follows the principles of the raw food diet. It is said to retain more vitamins and helpful enzymes.


I maintain carefully sanitized equipment, and I have completed training in bloodborne pathogens. I carry out proper cleanliness and preparation precautions to ensure the highest quality of placenta encapsulation possible. When I deliver your placenta capsules, I will provide you with a detailed written explanation of the proper storing and handling of the finished placenta pills and suggestions for daily ingestion recommendations.

Service Area
My service area is limited to Dallas and surrounding areas within 30 miles of Rowlett. If you are outside this area, please contact me to refer you to an encapsulation specialist closer to you!

 

Fees
This service fee is $250, which includes the preparation and encapsulation of the placenta, a storage container for capsules, written instructions for storage and handling, and guidelines for taking your pills. An umbilical cord keepsake and placenta print are also provided where possible. If you would like a tincture as well, that is an additional $50. In all cases, I request a nonrefundable deposit of $100 upon signing this contract, with the balance payable upon receipt of your placenta. Payments may be made online via Venmo to @naturalbornmidwifery. If you need to pay in another form please let me know to make arrangements.

Refunds
In the event your placenta is unavailable to you (e.g., sent to Pathology and not released) or if you change your mind and choose to terminate this contract before releasing your placenta to me, you are not responsible for the final payment, but the deposit is nonrefundable. Once your placenta is in hand, payment will be due in full, even if you choose not to take the finished capsules.

 

Hold Harmless Agreement:

We will indemnify and hold Natural Born Midwifery harmless from and against any and all liabilities including personal injury, death, or property damage, any of which may incur as a result of any action or failure to act by Natural Born Midwifery or arising out of this Agreement or the subject matter thereof. Natural Born Midwifery shall only be liable to use for her gross negligence or intentional misconduct. We assume all other liabilities relating to or arising from this Agreement or the subject matter hereof, including and without limitation to any investigation or failure to investigate our doula and her qualifications and limited services provided.

 

In signing this contract, you acknowledge that you have read and understood, and agreed to this contract's terms and conditions.

PREFERRED ENCAPSULATIN CHOICE
If choosing TCM, please choose any additional ingredients you would like. If no options are selected, then I will assume you desire no additions.
Capsule preference
WOULD YOU LIKE TO ADD A TINCTURE TO YOUR ORDER FOR AN ADDITIONAL $50?