WEBVTT 1 00:00:02.160 --> 00:00:04.960 This is parent data. I'm Emily Oster. 2 00:00:07.240 --> 00:00:07.960 Pop quiz. 3 00:00:08.920 --> 00:00:12.760 What is the only organ that you grow and then discard, 4 00:00:13.720 --> 00:00:17.480 that magically bosses around all of your hormones and your 5 00:00:17.680 --> 00:00:21.680 entire body, that changes your heart rate and is actually 6 00:00:21.920 --> 00:00:24.239 made up of someone else's cells. 7 00:00:24.280 --> 00:00:28.840 In addition to yours answer, it's the placenta. 8 00:00:30.280 --> 00:00:33.360 Less obvious to some of us is how completely awesome 9 00:00:33.560 --> 00:00:37.080 and amazing it is. A lot of us totally forget 10 00:00:37.200 --> 00:00:40.800 that we even had a placenta or delivered it, because 11 00:00:40.880 --> 00:00:43.880 when the placenta comes out, you're sitting with the little 12 00:00:43.920 --> 00:00:47.960 baby on your chest, and it's easy, relatively speaking, to 13 00:00:48.040 --> 00:00:52.720 push out the placenta. Also, it looks really gross, but 14 00:00:52.880 --> 00:00:57.240 that last little push when you're holding your baby says 15 00:00:57.280 --> 00:01:02.760 goodbye to a truly amazing organ, to a couch cushion, 16 00:01:03.040 --> 00:01:08.160 your baby's first bodyguard, it's waterbed, it's your baby's first friend. 17 00:01:09.080 --> 00:01:11.680 And today we're going to finally give. 18 00:01:11.520 --> 00:01:13.200 The placenta it's due. 19 00:01:13.520 --> 00:01:16.840 I invited doctor Gillian Goddard back for a mini episode 20 00:01:17.080 --> 00:01:19.720 to talk all about the placenta. 21 00:01:19.520 --> 00:01:21.600 And how amazing it is and how much we love it. 22 00:01:22.200 --> 00:01:25.240 We're going to follow its journey through conception to pregnancy 23 00:01:25.760 --> 00:01:27.640 and beyond, and we're going to ask the. 24 00:01:27.640 --> 00:01:30.400 Important questions like whether you should eat it. 25 00:01:31.800 --> 00:01:34.000 So the placenta, it's the best. 26 00:01:34.800 --> 00:01:40.560 Enjoy doctor Jillian Goddard, thank you for coming back to 27 00:01:40.600 --> 00:01:42.560 Parent Data to talk about science with us. 28 00:01:43.040 --> 00:01:46.000 Oh, I'm so excited. I always like to talk with you. 29 00:01:46.319 --> 00:01:48.120 I always like to talk with you too, And today 30 00:01:48.160 --> 00:01:52.120 we're talking about the world's greatest organ, the placenta, and 31 00:01:52.200 --> 00:01:54.559 we can discuss whether you think it's the greatest organ. 32 00:01:54.720 --> 00:01:56.360 But I'm not going to open with that question. 33 00:01:58.840 --> 00:02:02.960 Let's set the stage just explaining what is the placenta. 34 00:02:04.240 --> 00:02:09.280 The placenta is an organ. It does many different things, 35 00:02:09.320 --> 00:02:13.720 but I think at the most basic level allows communication 36 00:02:14.000 --> 00:02:18.480 between the fetus and the mother so that the fetus 37 00:02:18.560 --> 00:02:21.160 can get the things that it needs to grow and 38 00:02:21.200 --> 00:02:22.440 develop appropriately. 39 00:02:23.960 --> 00:02:27.960 So before you get pregnant, you do not have a 40 00:02:28.000 --> 00:02:33.080 placenta that is correct. Correct, So you get pregnant, and 41 00:02:33.160 --> 00:02:35.600 then let's just like talk about how the placenta arrives. 42 00:02:35.720 --> 00:02:39.480 So you get pregnant, and then there's a well, let's start. 43 00:02:39.560 --> 00:02:43.560 The sperm fertilizes the egg, it travels down the fallopian tube, 44 00:02:44.000 --> 00:02:48.960 it gets into the uterus, it implants and then say 45 00:02:49.000 --> 00:02:50.080 more right. 46 00:02:50.080 --> 00:02:52.680 So when it implants in the side of the. 47 00:02:52.680 --> 00:02:56.360 Uterus, there are multiple cells at this point in the embryo, 48 00:02:57.040 --> 00:03:03.040 and the very earliest things that happen are some differentiation 49 00:03:03.240 --> 00:03:06.960 of some different types or groups of cells in that 50 00:03:07.440 --> 00:03:11.560 little clump of cells that is a very very early pregnancy, 51 00:03:12.600 --> 00:03:19.440 and one set of those groups of cells actually grows 52 00:03:19.480 --> 00:03:23.639 into the placenta and it actually tells the uterine lining 53 00:03:23.919 --> 00:03:29.880 to change so that the uterine lining interfaces with the 54 00:03:29.919 --> 00:03:34.120 cells that grow into the placenta. So if you've ever 55 00:03:34.160 --> 00:03:36.960 had something called choreonic villas sampling, which is one of 56 00:03:36.960 --> 00:03:39.960 the tests that we do for genetic testing, they're actually 57 00:03:40.240 --> 00:03:45.240 testing the villi, which are the little pieces of baby 58 00:03:45.360 --> 00:03:50.360 DNA that are interfacing with the lining of the uterus 59 00:03:50.920 --> 00:03:52.840 to communicate. 60 00:03:52.240 --> 00:03:52.920 With one another. 61 00:03:53.040 --> 00:03:56.960 So in some ways, the placenta is the only organ that's. 62 00:03:56.880 --> 00:03:59.080 Kind of made up of two people together. 63 00:03:59.640 --> 00:04:02.240 I just love So it's made up of two people 64 00:04:02.320 --> 00:04:05.480 in the sense that like it's the baby's cells, but 65 00:04:05.640 --> 00:04:07.520 then it's interfacing with your. 66 00:04:07.400 --> 00:04:09.520 Cells to like create the plain exactly. 67 00:04:10.560 --> 00:04:12.840 So if you if you harvested the placenta and you 68 00:04:12.960 --> 00:04:15.160 tested it, it would be like some kind of mosaic 69 00:04:15.280 --> 00:04:17.680 between you and the baby kind of. 70 00:04:17.720 --> 00:04:20.800 I mean, there's specific structures that would be cells from 71 00:04:20.839 --> 00:04:23.880 the baby and then specific structures that would be sells 72 00:04:23.920 --> 00:04:26.039 from you. But if you didn't know, if you just 73 00:04:26.080 --> 00:04:29.200 took like a like a core through the placenta, you 74 00:04:29.240 --> 00:04:33.920 would pass through baby and mom in all the different 75 00:04:33.920 --> 00:04:34.960 cells that you collected. 76 00:04:35.520 --> 00:04:38.560 And the way the placental works is there's like it's 77 00:04:38.600 --> 00:04:40.600 like attached to the wall of the uterus, and then 78 00:04:40.680 --> 00:04:41.960 it like it's like it goes through. 79 00:04:42.000 --> 00:04:44.200 It's like between the wall of the uterus and the baby. 80 00:04:44.279 --> 00:04:47.560 It's it, yes, So it sits. It's almost like a 81 00:04:47.560 --> 00:04:49.400 little cushion that sits. 82 00:04:49.839 --> 00:04:51.840 You can't nobody's gonna be able to see me making 83 00:04:51.839 --> 00:04:52.640 all these hands just. 84 00:04:52.680 --> 00:04:53.880 A green bag care. 85 00:04:55.279 --> 00:04:56.880 It's like a couch cushion. 86 00:04:57.240 --> 00:05:00.520 It sits on one side of your uterus, between the 87 00:05:00.560 --> 00:05:03.320 wall of the uterus and the baby. But it's physically 88 00:05:03.360 --> 00:05:05.320 attached to the wall of the uterus. 89 00:05:05.880 --> 00:05:09.280 And why do we need the placenta. Why not just 90 00:05:09.320 --> 00:05:11.599 connect directly to the baby, which seems more efficient. 91 00:05:11.640 --> 00:05:15.599 So the placenta does more than connect mom and baby. 92 00:05:16.960 --> 00:05:21.159 It it is a barrier that can keep some things 93 00:05:21.240 --> 00:05:23.520 from mom away from baby. 94 00:05:23.760 --> 00:05:25.560 So some types of. 95 00:05:28.240 --> 00:05:32.039 Things that mom might experience, some types of illnesses and 96 00:05:32.080 --> 00:05:35.440 things can't cross the placenta, and so in that way 97 00:05:35.480 --> 00:05:39.559 it's protective for the baby. But the placenta does more 98 00:05:39.640 --> 00:05:43.919 than just interface with mom in a physical way. 99 00:05:44.040 --> 00:05:47.760 It is it's an endocrine organ It makes. 100 00:05:47.400 --> 00:05:53.760 All kinds of hormones that direct the mom's body to 101 00:05:53.920 --> 00:05:59.320 do things that support the growth of a healthy fetus. 102 00:06:00.160 --> 00:06:04.960 Like what so when we talk about pregnancy physiology, everything 103 00:06:05.080 --> 00:06:09.400 changes by forty percent. So the plus tells you to 104 00:06:09.440 --> 00:06:14.440 make forty percent more blood cells, It tells your kidneys 105 00:06:14.480 --> 00:06:19.000 to filter forty percent more. It tells your heart to 106 00:06:19.040 --> 00:06:22.800 push out forty percent more blood with every heartbeat. It 107 00:06:22.839 --> 00:06:25.920 tells your body to make forty percent more thyroide hormone, 108 00:06:25.920 --> 00:06:29.880 and forty percent more cortisol, and all of. 109 00:06:29.720 --> 00:06:33.320 These things actually allow. 110 00:06:33.400 --> 00:06:37.359 The nutrients that the baby needs to get to the 111 00:06:37.400 --> 00:06:42.120 baby because it changes things like circulation and how much 112 00:06:42.160 --> 00:06:44.960 blood you have and how much carrying capacity your blood has. 113 00:06:45.680 --> 00:06:51.040 It also changes how women's bodies process sugar. Babies need 114 00:06:51.120 --> 00:06:55.480 sugar to grow, so it creates a situation in which 115 00:06:56.120 --> 00:07:01.000 more sugar is available for baby to grow than would 116 00:07:01.040 --> 00:07:04.520 be just in the mom's usual bloodstream. 117 00:07:05.880 --> 00:07:09.040 So I am imagining this sort of like the baby 118 00:07:09.080 --> 00:07:12.880 has grown this extra organ which bosses mom's body to 119 00:07:12.960 --> 00:07:15.200 do things that the baby needs. Is it responsive in 120 00:07:15.240 --> 00:07:16.920 that sense? Like is there a sense in which if 121 00:07:16.920 --> 00:07:19.800 the baby needs more, it like uses the placenta to 122 00:07:19.960 --> 00:07:22.440 like get more from mom. 123 00:07:23.440 --> 00:07:29.600 It's less responsive than that. It's more that it sets 124 00:07:29.680 --> 00:07:37.240 up this entire ecosystem almost inside of mom's body that 125 00:07:37.520 --> 00:07:41.520 supports baby. But it tends to make more and more 126 00:07:41.560 --> 00:07:44.160 and more of things and not necessarily to turn things 127 00:07:44.240 --> 00:07:47.560 up and down. So at the beginning of pregnancy, the 128 00:07:47.600 --> 00:07:53.080 placenta is smaller, it's making fewer hormones, and over the 129 00:07:53.160 --> 00:07:56.840 course of pregnancy it makes more and more and more 130 00:07:56.920 --> 00:08:01.280 hormones as the baby gets bigger and needs more nutrients 131 00:08:01.320 --> 00:08:02.920 to continue to grow and develop. 132 00:08:03.440 --> 00:08:07.120 I have an evolutionary question, which is when did the 133 00:08:07.120 --> 00:08:09.160 placenta start? 134 00:08:09.680 --> 00:08:13.560 So the plus centa is present. 135 00:08:13.480 --> 00:08:20.120 In all mammals, and there are some pluscental like stretchers 136 00:08:20.160 --> 00:08:25.160 in the eggs of animals that do not have a placenta, 137 00:08:25.240 --> 00:08:29.960 but really the placenta developed with mammalion differentiations. 138 00:08:30.280 --> 00:08:33.240 We have any idea why like, why is this an 139 00:08:33.280 --> 00:08:35.120 efficient way to do this? 140 00:08:35.440 --> 00:08:39.440 I don't know that we know exactly why. I mean, 141 00:08:39.559 --> 00:08:40.600 some of this is that. 142 00:08:41.160 --> 00:08:44.200 Mammals are much more complex, and so they need more 143 00:08:44.720 --> 00:08:48.520 nutrients in order to grow and develop during pregnancy because 144 00:08:48.520 --> 00:08:53.000 you're developing a much more complex creature with a more 145 00:08:53.120 --> 00:08:58.320 complex brain and more complex types of physiology. 146 00:08:58.360 --> 00:09:01.040 Mammals are warm blooded. There's all kinds of. 147 00:09:01.240 --> 00:09:05.600 You know, maintaining body temperature that have to develop as 148 00:09:05.640 --> 00:09:09.280 part of being a healthy mammal to function in the world. 149 00:09:10.120 --> 00:09:12.760 And so this allows the system allows you to grow 150 00:09:12.800 --> 00:09:14.640 a more complex thing. 151 00:09:15.160 --> 00:09:18.200 Animals in person, yes, exactly any. 152 00:09:18.000 --> 00:09:18.720 Type of animal. 153 00:09:19.800 --> 00:09:24.080 Okay, So let's talk about what can go right or 154 00:09:24.080 --> 00:09:26.440 wrong with the placenta. And let me frame the question 155 00:09:26.600 --> 00:09:28.360 in a way that I think many people would ask, 156 00:09:28.400 --> 00:09:30.679 which is like, what can I do to. 157 00:09:30.679 --> 00:09:31.920 Get the best placenta? 158 00:09:32.320 --> 00:09:34.520 Like, what kind of things could I do to make 159 00:09:34.559 --> 00:09:38.160 my placenta really like a nice cushion, you know, with 160 00:09:38.280 --> 00:09:41.319 like a good quality upholstery stain resistant? 161 00:09:41.720 --> 00:09:42.920 What's it going to take? 162 00:09:44.000 --> 00:09:47.160 I mean, the biggest thing that you need to grow 163 00:09:47.320 --> 00:09:52.520 a placenta is a healthy embryo, which you only have 164 00:09:52.640 --> 00:09:58.520 so much control over and Remember, this isn't something like, 165 00:09:59.679 --> 00:10:01.320 you know, so I want to give my baby a 166 00:10:01.400 --> 00:10:08.360 super high IQ. We're talking about just creating quite frankly, 167 00:10:08.400 --> 00:10:12.560 a temporary organ. You need a healthy embryo, and you 168 00:10:12.640 --> 00:10:13.520 need lots. 169 00:10:13.200 --> 00:10:14.360 And lots of energy. 170 00:10:14.520 --> 00:10:19.560 And that is why the beginning of pregnancy can make 171 00:10:19.600 --> 00:10:23.360 people feel really, really tired, because it requires a lot 172 00:10:23.679 --> 00:10:29.680 from the mother's body to undergo this big physiologic change 173 00:10:30.120 --> 00:10:34.079 to support baby. And so the biggest thing you can 174 00:10:34.120 --> 00:10:37.520 do is listen to that and rest as much as 175 00:10:37.520 --> 00:10:38.240 you can rest. 176 00:10:38.280 --> 00:10:40.199 It's not easy, but it's not easy. 177 00:10:41.360 --> 00:10:44.000 So then let's talk a little more serious about sort 178 00:10:44.040 --> 00:10:47.920 of what can go wrong with the placenta, you know, 179 00:10:48.080 --> 00:10:49.680 and we're going to talk about the end of pregnancy, 180 00:10:49.679 --> 00:10:51.880 but sort of are there things that can go wrong 181 00:10:51.920 --> 00:10:54.720 with the organ in the middle of pregnancy that might 182 00:10:54.760 --> 00:10:55.880 be an issue. 183 00:10:56.080 --> 00:10:59.480 Yeah, I mean, the biggest things that can go wrong 184 00:10:59.800 --> 00:11:05.080 or in pregnancy with the plus centa are related to 185 00:11:05.080 --> 00:11:07.720 how the placenta is attached to the side of. 186 00:11:07.720 --> 00:11:08.480 The uterine wall. 187 00:11:09.160 --> 00:11:12.520 So if something happens to the placenta so that the 188 00:11:12.520 --> 00:11:18.640 plus centa is not adequately attached, that can cause problems. 189 00:11:18.679 --> 00:11:22.040 So one of the really common things that you see 190 00:11:22.400 --> 00:11:25.480 in early pregnancy is people will get something called a 191 00:11:25.559 --> 00:11:31.320 subcoreonic hemorrhage, which is like a little area where the 192 00:11:31.360 --> 00:11:34.800 plus centa and in a lot of cases it's really small. 193 00:11:35.880 --> 00:11:38.600 You get a little bit of a detachment between the 194 00:11:38.640 --> 00:11:41.120 placenta and the wall of the uterus, and it can 195 00:11:41.240 --> 00:11:45.679 get a little bit of blood in it from mom's circulation. 196 00:11:47.640 --> 00:11:51.760 If that became extreme then and you don't have enough 197 00:11:51.760 --> 00:11:55.319 of the placenta attached, then that can cause a problem. 198 00:11:55.360 --> 00:11:57.600 But attachment issues are sort of. 199 00:11:57.520 --> 00:12:00.480 The biggest issues in early pregnant, that's saying. 200 00:12:01.800 --> 00:12:03.720 And then as we get later in pregnancy, and people 201 00:12:03.800 --> 00:12:06.880 used to have the understanding that like the placenta was 202 00:12:06.920 --> 00:12:07.559 like a blocker. 203 00:12:08.720 --> 00:12:09.800 I mean, I think over the. 204 00:12:09.760 --> 00:12:12.400 Course of human history, there's been a variety of understanding. 205 00:12:12.520 --> 00:12:15.400 Some that the placenta let's everything through. Sometimes it is 206 00:12:15.440 --> 00:12:18.360 like a brick wall, but let's nothing through. Neither of 207 00:12:18.400 --> 00:12:21.120 those is is correct. It is neither a sieve nor 208 00:12:21.160 --> 00:12:22.200 a wa correct. 209 00:12:21.880 --> 00:12:23.680 Correct correct, It's something in between. 210 00:12:24.120 --> 00:12:24.360 Yeah. 211 00:12:24.400 --> 00:12:27.080 So some even when we talk about things like like 212 00:12:27.200 --> 00:12:29.679 medications or some kinds of medications that will that will 213 00:12:29.679 --> 00:12:31.800 pass through some kinds of illnesses that can pass through 214 00:12:31.840 --> 00:12:35.960 some kinds of illnesses and medications. Yes, okay, So during 215 00:12:36.000 --> 00:12:38.840 this sort of middle period of pregnancy, the placenta is 216 00:12:38.880 --> 00:12:42.920 basically put like telling mom what to do, filtering some 217 00:12:42.960 --> 00:12:45.640 things out and letting other things through, providing nutrients to 218 00:12:45.679 --> 00:12:48.200 the baby. Oh here's a question I have that people 219 00:12:48.520 --> 00:12:53.880 ask if I eat like kimchi. Yeah, does the placenta 220 00:12:54.000 --> 00:12:55.800 pass the taste to my baby? 221 00:12:55.920 --> 00:12:56.880 No? It does not. 222 00:12:57.200 --> 00:13:03.040 So basically, by the time baby sees what you're eating, 223 00:13:03.840 --> 00:13:07.400 the food that you're eating has been completely broken down 224 00:13:07.600 --> 00:13:14.960 and metabolized into its component parts of fat, carbohydrate, and protein, 225 00:13:15.840 --> 00:13:20.400 and so all baby is seeing as like individual glucose 226 00:13:20.480 --> 00:13:27.079 molecules and individual free fatty acids and individual protein peat 227 00:13:27.160 --> 00:13:31.079 like amino acids to build proteins. It's not like breastfeeding 228 00:13:31.120 --> 00:13:35.839 where they're getting some of the intact like aromatic comp 229 00:13:36.200 --> 00:13:40.600 like chemicals that I mean. I mean aromatic sort of 230 00:13:40.600 --> 00:13:43.120 in the chemical sense, but it also is in the 231 00:13:43.240 --> 00:13:48.600 actual sense that gives food its taste and smell. They're 232 00:13:48.640 --> 00:13:53.040 just getting the totally broken down products through your bloodstream 233 00:13:53.320 --> 00:13:57.320 and the macro yeah macro's not blue yeah, and vitamins. 234 00:13:58.040 --> 00:14:00.760 So sometimes people get told they have either an anterior 235 00:14:00.840 --> 00:14:02.199 or posterior placenta. 236 00:14:02.360 --> 00:14:05.679 What does that mean it. 237 00:14:05.160 --> 00:14:09.800 It literally just refers to the location on the wall 238 00:14:09.840 --> 00:14:13.280 of the uterus where the placenta has grown. So when 239 00:14:13.360 --> 00:14:17.480 that little embryo, that little clump of cells, comes floating 240 00:14:17.520 --> 00:14:23.520 into your uterus from the fallopian tube, it implants at 241 00:14:23.600 --> 00:14:26.000 some place on the wall. 242 00:14:25.800 --> 00:14:30.880 Of the uterus, ideally sort of near the top of 243 00:14:30.960 --> 00:14:31.800 the uterus, which. 244 00:14:31.720 --> 00:14:35.840 Is called the fundus, but it can be more to 245 00:14:35.880 --> 00:14:38.360 the front or more to the back, it can be 246 00:14:38.600 --> 00:14:39.600 a little lower down. 247 00:14:40.400 --> 00:14:41.280 It can really. 248 00:14:41.040 --> 00:14:47.400 Implant anywhere and wherever it implants, that is where the 249 00:14:47.400 --> 00:14:49.960 placenta is going to start to grow. 250 00:14:50.480 --> 00:14:54.840 Now, our uterus is about the size of a. 251 00:14:54.640 --> 00:14:58.160 Closed fist, and maybe even an even a little smaller, 252 00:14:59.280 --> 00:15:02.640 and so over the course of forty weeks, your uterus 253 00:15:02.720 --> 00:15:06.600 is gonna grow and change quite substantially to. 254 00:15:06.560 --> 00:15:09.000 Accommodate you know, a full term baby. 255 00:15:09.800 --> 00:15:15.320 And so over time your uterus will move around, not detaching, 256 00:15:15.320 --> 00:15:18.680 but just as the uterus grows, where it implanted will 257 00:15:19.080 --> 00:15:22.200 change its location a little bit on the wall of 258 00:15:22.200 --> 00:15:25.800 the uterus. But the reason I mean, I think the 259 00:15:25.800 --> 00:15:31.720 biggest reason that people even talk about this is because 260 00:15:32.160 --> 00:15:38.560 it does affect how mom experiences fetal movement. So if 261 00:15:38.640 --> 00:15:43.760 you have an anterior plasenta, it's that you think about. 262 00:15:43.840 --> 00:15:46.000 If you think about it as a couch cushion, right, 263 00:15:46.080 --> 00:15:51.720 then you have a couch cushion between your abdominal wall 264 00:15:51.800 --> 00:15:53.920 where you're sensing the fetal movement. 265 00:15:53.760 --> 00:15:54.520 And the baby. 266 00:15:54.840 --> 00:15:58.320 And so if a teeny tiny little fetus is, you know, 267 00:15:58.440 --> 00:16:04.000 moving around, that movement is going to be buffeted by 268 00:16:04.480 --> 00:16:06.600 by the placenta and you won't feel it as much 269 00:16:07.120 --> 00:16:10.320 as opposed to if your placentile it was on the 270 00:16:10.360 --> 00:16:13.280 back wall of the uterus. I think a lot of 271 00:16:13.320 --> 00:16:16.640 our perception of the of baby moving is how we 272 00:16:16.680 --> 00:16:18.880 feel it on our like abdominal wall. 273 00:16:19.160 --> 00:16:22.000 So, and the other thing to say about this positioning 274 00:16:22.400 --> 00:16:27.760 is people placenta previa is a reasonably common diagnosis and 275 00:16:27.800 --> 00:16:30.920 occurs when the placenta is basically low positions low in 276 00:16:30.960 --> 00:16:34.400 the uterus and is over the cervix. Yes, and that 277 00:16:34.440 --> 00:16:37.400 can be completely over partially over and and what you 278 00:16:37.440 --> 00:16:40.320 said about the growth of the uterus is important to 279 00:16:40.360 --> 00:16:44.040 that because that is often diagnosed early in pregnancy and 280 00:16:44.080 --> 00:16:47.280 then as the uterus grows, Basically a placenta moves, moves 281 00:16:47.280 --> 00:16:49.560 out of the way, and so actually a very large share, 282 00:16:50.000 --> 00:16:53.080 like ninety percent of diagnosed previas do result. 283 00:16:52.880 --> 00:16:55.840 Resolve on their own with no intervention whatsoever. 284 00:16:56.560 --> 00:16:58.640 So so I always find that I think that's a 285 00:16:58.720 --> 00:17:01.280 very reassuring thing for people because this is something we 286 00:17:01.320 --> 00:17:03.560 didn't used to look for very much. Now is very 287 00:17:03.600 --> 00:17:05.960 commonly look for early and pregnancy. Huge share of people 288 00:17:06.000 --> 00:17:07.440 are diagnosed, and you just want to be like, hey, 289 00:17:07.800 --> 00:17:10.080 like this is something to watch because of course, if 290 00:17:10.080 --> 00:17:12.479 it's still there at delivery, you don't want to have 291 00:17:12.520 --> 00:17:14.879 a vaginal birth because the placenta will be in the 292 00:17:14.920 --> 00:17:16.560 way and that puts you at risk for hemorrhage. 293 00:17:16.600 --> 00:17:18.640 But the chance that it resolves is really. 294 00:17:18.480 --> 00:17:19.840 Really really really high. 295 00:17:20.040 --> 00:17:24.440 Yes, absolutely, So I want to ask one question about 296 00:17:24.440 --> 00:17:29.520 the umbilical cord, which is if you only have two vessels, 297 00:17:29.560 --> 00:17:32.439 what does that mean? Why are there multiple vessels and 298 00:17:32.680 --> 00:17:33.359 does it matter? 299 00:17:33.720 --> 00:17:38.320 Yeah, So the umbilical cord, like the default is three vessels, 300 00:17:38.480 --> 00:17:41.320 it's one artery in two veins, and so sometimes people 301 00:17:41.359 --> 00:17:44.600 will The venous system in the human body, and I'm 302 00:17:44.640 --> 00:17:50.239 sure in other animals as well, is incredibly variable. So 303 00:17:51.200 --> 00:17:55.240 there are certain veins people will have, but they'll also there. 304 00:17:55.280 --> 00:17:59.320 Where exactly they are and how exactly they are structured 305 00:17:59.400 --> 00:18:02.760 will very widely from one person to the next. The 306 00:18:02.920 --> 00:18:06.160 arterial system, which is the system that delivers blood from 307 00:18:06.200 --> 00:18:10.280 the heart to various parts of the body, that system 308 00:18:10.800 --> 00:18:12.639 is like very very set. 309 00:18:12.920 --> 00:18:13.800 We don't see a lot. 310 00:18:13.640 --> 00:18:17.199 Of variability in arteries, including in the umbilical artery, but 311 00:18:17.440 --> 00:18:19.840 the venus system is very variable from one person to 312 00:18:19.840 --> 00:18:22.560 the next, and so some people will only have one 313 00:18:22.680 --> 00:18:25.679 vein and it doesn't have much in the way of 314 00:18:26.600 --> 00:18:30.320 impact on anything, which is why it's like blue eyes 315 00:18:30.320 --> 00:18:33.080 are brown, right, Okay. 316 00:18:33.240 --> 00:18:35.240 So then we fast forward to the end of pregnancy, 317 00:18:35.280 --> 00:18:36.840 and the end of pregnancy is when I think we 318 00:18:36.920 --> 00:18:39.520 have a lot of placental discussion. And the first thing 319 00:18:39.720 --> 00:18:43.320 that comes up often is the question of whether your 320 00:18:43.440 --> 00:18:49.760 placenta wears out effectively, like whether some of you know 321 00:18:49.800 --> 00:18:51.920 some of the push, for example, to not let people 322 00:18:52.080 --> 00:18:54.880 go past forty one or forty two weeks. So pregnancy 323 00:18:54.920 --> 00:18:57.080 is a feeling like this placenta is a temporary organ 324 00:18:57.400 --> 00:18:59.359 and it only has so much time, and if it 325 00:18:59.359 --> 00:19:02.399 wears out, that can be that can be dangerous. So 326 00:19:02.440 --> 00:19:04.840 how much do we know about that whether that happens 327 00:19:04.840 --> 00:19:06.120 that process, et cetera. 328 00:19:06.240 --> 00:19:11.520 We're really just starting to understand exactly what's going on 329 00:19:11.600 --> 00:19:16.440 in that process. There are some relatively simple hormones called 330 00:19:16.480 --> 00:19:22.680 peptide hormones that impact the way that the mother's vasculature 331 00:19:23.280 --> 00:19:28.040 is connected to the placenta, and we think that these. 332 00:19:27.880 --> 00:19:31.400 Hormones are important. 333 00:19:33.000 --> 00:19:35.679 And may play a role in some of the complications 334 00:19:35.680 --> 00:19:38.560 that can happen in the third trimester. And we and 335 00:19:38.640 --> 00:19:42.040 we're starting to think that maybe these hormones have an 336 00:19:42.040 --> 00:19:47.479 impact on triggering things like labor and on sort of 337 00:19:47.520 --> 00:19:51.159 what what we often talk about is like placental sufficiency 338 00:19:51.280 --> 00:19:56.520 or insufficiency, sort of how how much capacity the placenta 339 00:19:56.560 --> 00:19:58.959 has to do its job. And we actually think it's 340 00:19:59.480 --> 00:20:02.360 it may be related to some of these hormones that 341 00:20:02.680 --> 00:20:07.760 affect the blood flow on the mother's side to the placenta. 342 00:20:08.600 --> 00:20:11.080 If you looked at a placenta that was like thirty 343 00:20:11.119 --> 00:20:14.359 eight weeks versus forty two weeks at delivery, would it 344 00:20:14.400 --> 00:20:14.879 look different? 345 00:20:14.960 --> 00:20:15.400 No? 346 00:20:14.960 --> 00:20:19.560 No, no, okay, it's not like looking old and decrepity. 347 00:20:19.560 --> 00:20:21.800 No, it's not like it shrivels up and turns gray 348 00:20:22.040 --> 00:20:26.640 or anything, not like those of us not like the 349 00:20:26.680 --> 00:20:27.640 actual forties. 350 00:20:31.200 --> 00:20:34.159 Okay, So at the end of pregnancy do you go 351 00:20:34.200 --> 00:20:36.600 into labor. Let's imagine you have a. 352 00:20:36.560 --> 00:20:39.000 Vaginal bart, you deliver the baby, and then the. 353 00:20:38.920 --> 00:20:41.560 Third stage of labor is the delivery of the placenta, 354 00:20:42.080 --> 00:20:46.720 and some people find that surprising. It's typically like one 355 00:20:46.760 --> 00:20:50.480 contraction and the placenta sort of comes out, yes, ideally 356 00:20:50.520 --> 00:20:53.480 all in all, in one piece. So one thing that 357 00:20:53.520 --> 00:20:56.760 can happen is the placenta can get stuck, yes, and 358 00:20:56.840 --> 00:20:57.440 not come out. 359 00:20:57.680 --> 00:20:59.320 Why is that of concern. 360 00:20:59.520 --> 00:21:04.840 Because if there's pieces of the placenta stuck, or if 361 00:21:04.840 --> 00:21:11.040 the whole placenta is stuck, it doesn't allow the blood 362 00:21:11.160 --> 00:21:15.879 vessels on the mother's side to clamp down and stop 363 00:21:16.000 --> 00:21:21.000 delivering blood, and so it allows for really significant hemorrhage 364 00:21:21.160 --> 00:21:24.919 on the mother side, which can be of course, quite dangerous. 365 00:21:25.480 --> 00:21:28.359 All right, So, assuming that your placenta is delivered at 366 00:21:28.400 --> 00:21:30.120 the end of the third stage of labor, it's there, 367 00:21:30.280 --> 00:21:30.760 it's in it. 368 00:21:30.760 --> 00:21:33.240 They put it in like one of those you know, bedpands. 369 00:21:34.080 --> 00:21:36.959 And then we're going to get the most important question 370 00:21:37.080 --> 00:21:41.600 in this interview, which is should I eat it? 371 00:21:46.160 --> 00:21:49.399 I don't think that there are any proven benefits of 372 00:21:49.480 --> 00:21:50.720 eating your placenta. 373 00:21:51.840 --> 00:21:53.400 I just want to say stories give me just start 374 00:21:53.440 --> 00:21:56.360 by saying like, you shouldn't just eat it, Like I'm 375 00:21:56.400 --> 00:21:58.600 just gonna say you shouldn't just eat it wrong, like, 376 00:21:58.720 --> 00:22:02.119 don't just start eating it. Even though some animals, some 377 00:22:02.280 --> 00:22:04.320 animals do eat their placentas. 378 00:22:04.280 --> 00:22:06.880 Raw, yes, after birth, but yes, people should not. 379 00:22:06.840 --> 00:22:11.080 Do People should not do that. People should not do that. No, 380 00:22:11.680 --> 00:22:15.400 vaginas are not sterile, you, They're. 381 00:22:15.840 --> 00:22:17.119 All kinds of other stuff. 382 00:22:17.240 --> 00:22:20.160 Yeah, happen, Okay, there's happen. 383 00:22:21.280 --> 00:22:24.119 But sometimes people will take somebody, will give somebody your 384 00:22:24.160 --> 00:22:26.120 placenta and have them turn it into pills. 385 00:22:26.600 --> 00:22:28.000 So what's the evidence on those. 386 00:22:29.160 --> 00:22:32.840 There's no proven benefit to that whatsoever. I think some 387 00:22:32.880 --> 00:22:37.200 of the theories is that it might help with like 388 00:22:37.200 --> 00:22:42.000 like your recovery after pregnancy because there's a little bit 389 00:22:42.040 --> 00:22:43.040 of iron. 390 00:22:42.640 --> 00:22:43.440 In the placenta. 391 00:22:43.480 --> 00:22:46.240 But it's literally there's ninety milligrams of iron in your 392 00:22:46.240 --> 00:22:49.639 placenta at the end of pregnancy. That's like two days 393 00:22:49.640 --> 00:22:52.600 worth of iron supplements that are available over the counter. 394 00:22:52.640 --> 00:22:54.200 It's not Also, they sell. 395 00:22:54.040 --> 00:22:56.960 Iron supplements in Amazon. You can just get a whole 396 00:22:57.119 --> 00:22:57.760 bottle of them. 397 00:22:57.800 --> 00:23:02.120 It's like you don't exactly, so, like there's no actual 398 00:23:02.240 --> 00:23:08.800 proven benefits to aiding encapsulated placenta or. 399 00:23:09.359 --> 00:23:11.240 Consuming it in any other way. 400 00:23:11.359 --> 00:23:15.560 And to my knowledge, and I'm not an anthropologist, this 401 00:23:15.720 --> 00:23:19.640