If you have consumed your placenta through encapsulation, raw, or other methods please feel free to print the survery, answer it, and fax it to me. It does not have to be services through me, this is to anyone who has ever done it. Also if you're a birth professional please feel free to print out this survery for your own use with your clients.
My fax number is 507-776-2578
If you don't have access to a fax machine, or can't get it to fax then feel free to copy and paste it to an email and email it to me.
This survey should be taken any time after 6 months postpartum
What form of placental consumption did you use?
Dried Encapsulated___ Raw Encapsulated___ Raw___ Food/Smothie___ Other___
Where did you give birth?
Hospital___ Home___ Birth Center___ Other___
If you gave birth in a hospital was it easy or hard to obtain your placenta?
Easy___ Hard___ Other___
Who prepared your placenta?
Myself___ Doula___ Midwife___ Encapsulation Professional___ Other___
How many days after birth did you start taking your placenta? ______
How many capsules did you take for each "dose"? _____
How did you take them?
With food___ With wine___ After a meal___ Before a meal___ Other___
How long did you take the capsules?_____
Did you use all the capsules or did you save some?
Used all___ Saved some___
What day after birth did your milk come in? _____
Did you have an supply problems? _____
If yes to the above, please explain. _____________
_________________________________________
Did you experience any Postpartum Depression or baby blues?
Yes___ No___
If yes to the above, how long did it last? _____
For these next questions please circle the one that best describes your answer.
My mood has been
Depressed Lower than I expected What I've expected Better than expected
My energy has been
Low So-so Good Excellent
Overall the experience of placental consumption has been
Less than what I expected What I thought it'd be Better than I expected
Would you consume your placenta in the future?
Yes___ No___
Would you recommend placental consumption to others?
Yes___ No___