Placenta Services Intake/Service Request Form

    Client Responsibility & Placenta Care Instructions

    ​It is the client’s responsibility to notify Robin Maza LAc.  as labor begins, or as soon after the birth as possible (preferably the same day as the birth itself) to request pick-up of the placenta(s) by Robin,  at the location previously agreed upon by both parties. Failure to do so may result in delayed placenta preparation and encapsulation or possible spoilage of the placenta(s) which would render it unusable for encapsulation, if not properly stored in this time.
     
    It is advised that the client discusses the release of the mother’s placenta(s) with her physician or midwife prior to labor, and to be acquainted with the hospital’s or birthing center’s policy, in addition to the hospital or birth center where she will deliver to ensure the release and  proper storage of her placenta(s). The placenta(s) should be stored in a refrigerator or cooler with the placenta(s) placed on ice immediately after the birth, until it can be picked up or delivered to Robin Maza for preparation and encapsulation. If no refrigeration is possible, be prepared with ice and a cooler, and continue to refresh the ice to maintain a cold temperature in the cooler. Additionally, come to the birth place prepared with two (2) gallon sized zip-lock bags in case they are needed for placenta storage inside the cooler.
     
    If the placenta is to be tested in the hospital for any reason, request that a part of the placenta be cut off and sent to pathology, as opposed to the entire placenta, as once the placenta is sent to pathology, it will no longer be suitable for encapsulation & consumption. It is advised that the placenta stays in your possession or the possession of someone you know and trust. Please be sure that they place an identification sticker on the container or bag that the placenta is placed in.
     
    The placenta will be picked up as close to the birth as possible, and pills returned usually within 72 hours of the pickup. If for any reason there will be a delay in the pickup of the placenta more than 3 days after the birth, the placenta should be placed in the freezer until pick up is available. Pick up of the placenta typically take place during typical business hours, within 48 hours of the birth. 

    If for any reason Robin Maza is unavailable at the time of the birth, her backup will be prepared to do the pickup and encapsulation, and all arrangements will be handled for your convenience.
                                                                                                                           
    It is the client’s responsibility to inform Robin Maza LAc. of any known blood-borne illness(es) or other health issues that the mother has, as Robin will be in contact with blood and bodily fluids throughout the preparation of the placenta.
     
    All preparation is done within Robin Maza’s designated preparation space (or in the back-up preparer’s space), and with stainless steel and single use equipment. All equipment is sanitized both before and after each encapsulation. Robin Maza and back-ups follow strict OSHA guidelines in the encapsulation process.
     
    Payment is collected prior to placenta pick up. If for any reason the client no longer wants the pills and the placenta has already been picked up, full payment is collected. 
                                                              
    The American Food and Drug Administration has not evaluated the efficacy of the use of dried placenta. Clinical indications for the usage of dried placenta are based on Traditional Chinese Medicine and years of results have influenced the claims of Robin Maza Acupuncture and Qi of Life Birth Services to be an effective post partum supplement. Families who choose to utilize the service take full responsibility for their own health and capsule usage.