China’s regulations on sale of birth by-product in chaos

In a cramped, quiet room, several bloody placentas sit in a machine, drying. Some workers then ground them down and filled capsules with the viscera.

This gory scene is not from a horror movie but the day-to-day business of an underground placenta encapsulation workshop in China.

For unborn babies, placentas are a source of nutrition, blood and oxygen from their mothers. To hospitals, they are biological waste.

However, to some people, placentas are medicine.

For thousands of years, placentas, known in Chinese as ziheche, have been used in traditional Chinese medicine (TCM).

Although the Chinese health authorities have decided that medical institutions and businesses are banned to sell placentas, the sale of placentas by individuals and businesses offering placenta-related services falls into a gray area. As observers worry about the dangers of consuming placentas, authorities have found it difficult to regulate.

Underground trade

Zhang Hongbin (pseudonym), a 32-year-old father of a 3-month-old girl from Baoding, Hebei Province, still remembers the smell of blood in the workshop, located on the fourth floor of a residential building, where he had his wife's placenta encapsulated so she could take it as medicine.

Zhang told the Global Times that he paid around 200 yuan ($32) for the service and that he received a bottle of about 100 capsules.

An owner of a placenta encapsulation workshop from Anhui Province, surnamed Liang, told the Global Times that the quality of the product he produces can be trusted because a nearby hospital supplies him with placentas.

More than 60 percent of parents simply leave their placentas for the hospital to deal with, according to an obstetrician, surnamed Xu, who works in a hospital in Liuzhou, the Guangxi Zhuang Autonomous Region. "Hospitals should deal with placentas as a biohazard. But some of them just sell the birth by-product for profit," Xu told the Global Times.

Several placenta dealers reached by the Global Times claimed that the price of placentas has increased in recent years due to authorities' stricter supervision of hospitals.

A raw placenta could be bought or sold for between 150 and 500 yuan, according to these dealers.

"It is not legal but few of us have been captured by the authorities," Liang said.

Ensuring safety

Some books on TCM, such as the Compendium of Materia Medica written by Li Shizhen over 400 years ago, describe the placenta as being able to improve the immune system and slow aging.

Sun Xiaoxiao (pseudonym), a 27-year-old mother of a 6-month-old boy from Nanjing, Jiangsu Province, said that eating two placenta tablets each day gives her more energy. Although she has to wake up several times at night to feed her baby, she claimed that she never feels tired. "It's my first baby so I can't make comparisons. But it was a good experience."

Doctor Xu said that consuming placenta tablets could have some health benefits but the effectiveness depends on the quality of the placenta used and the pre-existing health condition of the consumer.

"If the mother has a disease such as hepatitis B, it is possible that the placenta contains the same virus. If people consume placentas bought on the underground market. It is very difficult to ensure the quality," Xu said.

China is not the only country where people choose to eat this by-product of mammalian birth. Eating placentas in the form of a capsule, or even drinking it in a meaty smoothies, has become a controversial trend in some Western countries, according a BBC report last May.

The Independent Placenta Encapsulation Network (IPEN), a British firm founded in 2010, provides placenta encapsulation services and helped mothers make placenta and fruit smoothies. According to their website, they have helped more than 4,000 mothers consume their placentas in the UK.

The European Food Safety Authority has classified placentas as a "novel food," which means that businesses that sell placentas and provide related services need to go through a rigorous inspection process, The Independent newspaper reported in June.

According to a survey conducted by medical anthropologists at the University of Nevada-Las Vegas in February 2013, 76 percent of the 189 women that consumed their placentas after childbirth surveyed reported health benefits, such as improved mood, energy and lactation volume.

However, research fellows noted that very little work has been carried out to assess the validity of this anecdotal evidence, the BBC said.

Administration void

According to a 2005 notice issued by the Ministry of Health, now the National Health and Family Planning Commission, a placenta belongs to the woman that discharged it and the trading of placentas by institutions or businesses is banned. It also says that hospitals must dispose of placentas in accordance with the Regulations on the Administration of Medical Waste if mothers do not take them home.

However, the lack of any laws regarding placentas and businesses that offer placenta related services, means it is hard to properly regulate this industry.

For example, police officers in Kaifeng, Henan Province, arrested two people suspected of selling placentas in 2010. Following this investigation, a local hospital was discovered to have been selling placentas to individuals and businesses for more than a decade.

However, the police found that they could not press charges against the two suspects as there was no evidence showing that they had caused any public health incidents, the People's Daily reported.

The placenta is listed in the Pharmacopoeia of the People's Republic of China as a TCM ingredient and there are more than 12 types of medicines that use placentas as an ingredient, according to the China Food and Drug Administration's website.

Zhuo Xiaoqin, a law professor at the Beijing University of Chinese Medicine, was quoted by the People's Daily as saying that the law did not stipulate how TCM manufacturers should legally acquire placentas for the production of these medicines, which causes another gray area for authorities who wish to supervise these businesses.

Staff working for the Harbin food and drug authorities told the Xinhua News Agency that there are no laws banning businesses offering placenta services so they have found it very difficult to shut down such businesses when they are suspected of misconduct.