Review Article

The Disposal of Placenta among Indigenous Groups Globally: An Integrative Literature Review

Table 1

Evaluation of publication using Whittemore and Knafl 3-point scale (high, low, and not reported).

Author(s), year,
country
Design and method population and samplePurposeQuality appraisal (scale: h = high; l = low; nr = not reported)

Adatara et al., 2019 [10], Northern GhanaA qualitative explorative design
Ten (10) out of a total of twenty-seven (27) practicing traditional birth attendants in the study area were purposefully selected from five (5) rural communities in the Bongo District of Ghana for the study. Data were collected through in-depth, unstructured, and individual interviews using a guide.
To explore and describe the role of traditional birth attendants in maternal health care in the rural areas in Ghana(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed

Aziato and Omenyo, 2018 [4], GhanaExploratory qualitative design
In the purposive sampling technique, both males and females were recruited. To be included in the study, TBAs should have practiced for two years
To gain an in-depth understanding of the initiation of TBAs and their traditional and spiritual practices employed during pregnancy and childbirth in Ghana.(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(h) Implications discussed

Benyshek et al., 2018 [11]Comparison study
Data come from the MANA Stats dataset, birth years 2016–2018
This dataset contains complete course of care information for birthing people who planned community births with midwives who participate in the MANA Stats data collection project
To characterize the practice of placentophagy and its attendant neonatal outcomes among a large sample of women in the United States.(l) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed

Bosco and Diaz, 2018 [12]Review articleTo scientifically document the healthcare team about the risks of placentophagy(l) Aims and objectives clearly stated
(nr) Study design adequately described
(nr) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(l) Implications discussed

Botelle and Willot, 2020 [13], United KingdomQualitative
1752 posts from 956 users across 85 threads from the parenting forums Mumsnet and Netmums were included. A thematic discourse analysis was performed using NVivo.
To explore the discourse produced on two UK Internet forums regarding the practice of placentophagia and how opinions are expressed, discussed, debated, and created through forum participation.(l) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed

Burns, 2014 [5], AustraliaQuantitative explorative
58 Australian home-birthing women, doulas, and independent midwives recruited via web-based forums
43 participants who had recently birthed at home with an independent midwife or were pregnant at the time of the interview and were planning a home birth with an independent midwife
To analyse an alternative childbirth discourse rooted in spirituality, ritual, and sacralisation of space(h) Aims and objectives clearly stated
(l) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(l) Implications discussed

Chikato and Joseph, 2017 [14], BeninCommentary articleTo draw attention to or present critique on previously published articles(nr)Aims and objectives clearly stated
(nr) Study design adequately described
(nr) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(nr) Implications discussed

Cohen, 2020 [15]Analytic articleTo provide a comprehensive legal analysis of the various uses and modes of consumption of placentas today(h) Aims and objectives clearly stated
(nr) Study design adequately described
(l) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(h) Implications discussed

Corbett et al., 2017 [16], VietnamQualitative study
A convenience sample of 8 Hmong women who had recently given birth were interviewed regarding the perinatal experience.
The purpose of this study is to gain an understanding of the meaning of childbirth among Hmong women living in Vietnam(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed

Fadare et al., 2021 [7], NigeriaQualitative, descriptive, and exploratory research
Semistructured interviews working in the two facilities
22 postpartum mothers and 3 midwives
Purposive sampling technique
To assess the perceptions of midwives and mothers on postpartum placenta rituals at selected health centers in Ado-Ekiti, Ekiti State(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(h) Explicit theoretical framework
(nr) Limitations presented.
(h) Implications discussed

Farr et al., 2017 [15]Review paper(nr)Aims and objectives clearly stated
(nr) Study design adequately described
(nr) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(h) Implications discussed

Johnson et al., 2018 [1]Review paperTo evaluate the ingestion of processed placenta as a puerperal remedy, the potential risks (trace elements, microorganisms) and possible benefit (hormones in the placental tissue) of such a practice(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(h) Implications discussed

Knapp van Bogaert and Ogunbanjo, 2013 [18], South AfricaEthical and legal reviewTo discuss legal and ethical considerations regarding postbirth rituals and their relevance to the South African Human Tissue Act(nr) Aims and objectives clearly stated
(nr) Study design adequately described
(nr) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed

Mainah et al., 2021 [19], SomaliaExplorative, qualitative study
2 married men, 3 TBAs, 2 pregnant mothers, and 2 safe mothers/community midwives.
Purposive sampling
To establish the religion-cultural drivers behind placenta disposal; how and where they dispose the placenta and its significance, the manner in which placenta is disposed for the mother, baby, and community at large(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(h) Implications discussed

Mota-Rojas et al., 2020 [20]Review articleThe paper is aimed at describing the causes and effects of placentophagia, the endocrine aspects involved, nutritional or analgesic benefits, and the adverse effects that have been published in humans and nonhuman mammals.(h) Aims and objectives clearly stated
(nr) Study design adequately described
(nr) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(l) Implications discussed

Ohaja and Anyim, 2021 [6], Cameroon, Ghana, Kenya, Madagascar, and MaliThis paper is drawing on empirical literature and relevant commentariesThe aim of this paper is to discuss selected rituals and embodied practices surrounding the start of life (pregnancy, birth, and early motherhood).(h) Aims and objectives clearly stated
(nr) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(h) Implications discussed

Oyama, 2016 [21], South AfricaQualitative study
Zulu, Black South Africans who were 18 years of age or older from Masxha, KZN
Semistructured interviews
Purposeful sampling
To gain an understanding of the changes in attitudes towards practicing Zulu rituals during a woman’s pregnancy, labor, birth, and postpartum period(l) Aims and objectives clearly stated
(nr) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(l) Limitations presented
(h) Implications discussed

Reed et al., 2019 [2], AustraliaA qualitative interpretive approach that was underpinned by a feminist framework
11 women who had expectant management, eight who had active management, and one who was unsure. Semistructured in-depth interviews
Purposive sampling
To explore women’s experiences of birthing their placenta and, therefore, makes an important contribution to the body of knowledge(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(h) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed

Rono et al., 2018 [3], KenyaA descriptive cross-sectional design of qualitative and quantitative methods
186 mothers, selected using multistage cluster sampling, were interviewed: mothers below 20 years of age, another with mothers above 45 years of age, and the third one with married men
Purposive sampling
To obtain in part the sociocultural factors that influence the choice of women’s birthing site among the Marakwet community of Kenya(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(nr) Limitations presented
(l) Implications discussed

Selander et al., 2013 [8], USAQuantitative study
Internet-based survey on 189 women with an average age of 31 years
To identify a demographic profile of women who have engaged in placentophagia and to evaluate their self-reported motivations for and experiences with the practice(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed

Sharma et al., 2016 [22], NepalA qualitative study
Five in-depth face-to-face interviews and 14 focus group discussions with mainly women, but also men and health service providers
Purposive sampling
To explore social and cultural practices that have health implications in the childbirth and postnatal periods of rural Nepali women(h) Aims and objectives clearly stated
(h) Study design adequately described
(h) Research methods appropriate
(nr) Explicit theoretical framework
(h) Limitations presented
(h) Implications discussed