A Buddhist Meditation Teacher on Why She Paints Placentas

On birthing + loving imperfection.

Hello readers,

This is a guest post from my dear friend Jess Mack, a meditation teacher, death and transition doula, and narrative coach who writes about all the stuff of life through a Buddhist lens over on her Substack Birdseed. She is a brilliant mind and a beautiful writer, and I asked her if I could publish a piece of hers about the placenta: The organ’s power and its peril, and how hers inspired a post-birth creative practice.

Her piece is below, with an original introduction situating her work in the context of reproductive health, feminism, and the power of the body. Please enjoy, subscribe to her Substack, and check out her gorgeous placenta paintings.

xx Jill

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Preeclampsia Haunts Women Worldwide. Why Don’t We Hear More About it?

You’ve likely heard of preeclampsia, a dangerous pregnancy and postpartum complication related to very high blood pressure. It’s what sweet Sybill died from during Season 3 of Downton Abbey (sorry for the spoiler). It’s a leading cause of maternal mortality worldwide, affecting 2-7% pregnancies in the US and 5-14% globally.

Maternal mortality rates in the US are still double, triple, or more than those in countries of similar economic standing, with the highest burden of risk consistently placed on Black women, who also experience preeclampsia at a 60% higher rate than White women.

Despite its clear and present danger, relatively little is known about the disease – in fact, its causes remain unclear – except a long, general list of possible contributors ranging from family history to chronic conditions to age to the unpredictable health of the placenta (the organ your body magically grows to sustain a pregnancy). And while often not formally listed, racism, misogyny, and the continued abysmal state of women’s health care are also surely leading contributors.

Preeclampsia is a difficult disease to diagnose because, as my doctor told me when I was marshmallow-ankled with rising blood pressure at 35 weeks, by the time most women hit the threshold of symptoms it’s “too late.” High blood pressure is dangerous because it can shift suddenly, spiking in a matter of hours and triggering stroke or seizure.

It’s overwhelming, then, to consider how to realistically avoid or protect against this disease. A new blood test approved by the FDA last year can be administered in the first trimester and will offer the first predictor of preeclampsia before 34 weeks. Assuming this can become readily available to everyone during prenatal appointments this test will absolutely save lives.

We know that providers make assumptions about our healthcare risks, needs, and behaviors based on how we look. That obviously must change, but that’s their limitation and doesn’t have to be ours. We can continue to educate ourselves and each other, sharing stories and mindfully consuming research, while asking more questions and advocating for testing even if a provider brushes us off. Remember, you’re the only one inside your body.

The placenta’s potential role in triggering the disease remains unclear, much like the mysterious organ itself. “Poor blood flow” or just being “insufficient” are often placental attributes blamed for the disease. Amidst a series of care systems that restrict reproductive rights and discount women’s pain, it’s difficult for these diagnoses not to become one more way that women are “bad” or “not enough.”

I wrote about my experience being diagnosed with severe preeclampsia at 36 weeks and how it opened up a new avenue of reproductive advocacy for me: a creative one. I paint custom abstract placenta watercolors – for anyone, not just those who’ve had preeclampsia – as a way to support and affirm the magical, arduous, and very good work our bodies do despite what society reflects back to us.

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After I gave birth, I began painting watercolors. I had spent the better part of a year preparing to give birth and yet, in the end, everything was entirely unexpected.

In particular, I found myself painting placentas: the ephemeral, endogenous, and magical organ that fed my son and nearly poisoned me to death.

The disease of preeclampsia is fascinating; it’s elusive, and can be fatal. Basically, your placenta — this critical life-giving organ that grows you a baby — hits a wall and turns on you.

Isn’t that life? What was once the best thing can suddenly become the worst thing. Winds change, circumstances shift.

I gave birth the same day I was diagnosed.

Blood pressure rises and the body swells; the kidneys and liver become burdened as the placenta stops functioning well. All of a sudden the placenta is a time bomb that must be dismantled before it detonates. There’s no sure way to predict or prevent preeclampsia, and the only cure is birth.

Left: “My liver, made it.” Watercolor; Right: “My kidney (right? left?)” Watercolor

The first placenta I painted was a still life of my own, from a photo taken by my midwife. Then I found I couldn’t stop. Each one thereafter became more imaginary and abstract, though still very much a member of a murky sisterhood.

Painting placentas became ritualistic for me: a cathartic fascination; a peacemaking exploration; a meaning-making mission; and OK maybe a little obsessive.

Painting them became a prostration to the majestic organ itself— the only one that can be grown, discarded, then grown again like some omnipotent starfish arm.

Painting placentas became a devotion, in my vulnerable state, to what might have been and what was. An elegy to the thing that tried to kill me but didn’t, and now lay dead.

As I painted each one, I meditated on its magical and gory lobes. I reflected on its miraculous existence, complicated composition, and eventual demise. My son’s first and other mother, before I met him, responsible for his breath and his growth. Filtering toxins and managing immunity and blood flow: the bouncer of my womb.

“Thank you + good job girl” August 20, 2023. Watercolor + breastmilk.

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The placenta begins to form almost immediately upon an egg’s fertilization, as the lucky blastocyst, that powerful little ball of cells, begins to embed into the uterus wall. Some of those cells become parts of the developing fetus, while others are destined for the bright lights of placenta life.

By about 10-12 weeks into a pregnancy, the placenta is formed enough to “take over” as lead gardener, tending to the pregnancy with the right hormones and nourishment. The placenta accompanies the pregnancy, growing alongside it until it is time to land on earth.

My own placenta was hard-fought and well-won. This pregnancy had come years after I first set out for it, and had required several surgeries, months of near-daily blood draws, dozens of doctors appointments, hundreds of hormone shots, and an excruciating extended stay in the unknown.

While some have the kind of pregnancies that take them by surprise, I had the kind I didn’t fully believe in until at last my son was in my arms.

At eleven weeks pregnant, when my placenta should have “taken over,” I was still administering daily progesterone shots into my ass. It’s not that the doctors didn’t trust my placenta, but I guess they didn’t really trust my placenta. So I suppose I didn’t either, an accomplice in mistrust. The shots were an added safeguard to help this fragile victory stay a while; bumpers in the gutter although you can bowl a turkey.

While I was filling up another sharps container, I wondered what my placenta was doing. Waiting in the wings, biding its time. Maybe feeling insulted. It could take over, but would it?

The exact cause of preeclampsia is unknown, but it’s thought to originate in the placenta. At some point the placenta begins to lose its magical vascularity, with blood supply to the fetus dwindling and pressure rising in the rest of the body. Asset becomes liability. Most likely, it’s that — for some reason — the placenta never developed properly at all. She was a bad egg from the start.

Before I got preeclampsia, I had been planning to welcome my placenta into the world at home, with ritual, just like my baby. I envisioned birthing my son then birthing my placenta. Him slippery and tethered to it, his grim but vital twin.

I’d envisioned the luxury of time spent with my placenta, taking it in with marvel, in all its beautiful bloodiness. I would gaze upon it in the flesh, for the first and last time, and maybe touch it. I would honor it and most of all thank it. Good work, girl. You did it; we did it.

My husband and I had mulled over what to do with it: bury it or something else? Across more than 4,000 species of land mammal, most eat their placenta after delivering it. In part, because it’s so nutrient rich; in part, to hide the evidence of fresh vulnerability from potential predators.

When my health took a turn at 36 weeks pregnant, it turned out my placenta was the predator.

My planned spontaneous home birth quickly gave way to an urgent cesarean section a month early. Instead of laboring it lovingly into my own home, my placenta — like my son — was sliced out of my body with celerity. Then it was quickly severed from him. A near-instantaneous family fracture on day one.

My son was laid on my chest as my placenta was bagged. My midwife stood just outside the operating room, cooler in hand, and whisked it away.

At home a week later, my midwife brought it back to me in a small jar of clear capsules filled with rusty-looking dust. She also shared with me a precious photo of my placenta she’d taken before processing it. This was the first time I laid eyes on it; I felt love, pain, and some disbelief. A final photo of an estranged loved one, now deceased.

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In the early days’ haze of postpartum, I began painting almost mindlessly. Well, mindfully, but not cerebrally. I began painting intuitively, as I lay on my couch healing, swirling, spinning. My body was still swollen, a reminder of my no-good placenta.

In seismology, aftershocks occur as the earth’s displaced crust resettles after an earthquake. They’re distinguished from the main event by their diminishing magnitude and dispersed location. In other cases, a single earthquake can occur in two or more ruptures that have similar magnitude and originate from the same location — the same shifting chasm. These twin ruptures might occur ten minutes apart, or many years. This is called a doublet.

I was home from the hospital just two days, with an eight-day old newborn and a fresh wound, when the doublet hit. Postpartum preeclampsia, god damn. The disease seemed etched into my body like, “placenta was here.” In the ER, they struggled to coax my blood pressure back down from the 170s. I spent the next few days hooked up once again to a magnesium drip to prevent stroke or seizure while my body tried desperately to normalize.

From inside of the experience, I thought what in actual hell is going on here?

Finally home, again, I struggled to make sense or meaning. The more I researched preeclampsia, the more I searched for peace in my paintings. The peril of my condition, as it had continued to manifest, was alarming.

I tried on the narrative reflected back to me by the literature on the disease: my placenta was malformed; not vascular or healthy enough; not strong enough to allow me to carry my son to term; simply not enough.

The idea that my placenta was to blame curdled in my belly. It echoed from a dark place I’d visited many times before in my life. When you’re trying to get pregnant and not, or when you’re getting pregnant and losing it…things get heavy.

At best, your body feels insufficient and impotent; at worst, it is your enemy — a vicious traitor. The through line between that unfortunate pendulum swing is a profound, corporeal lacking.

I had trudged through blizzard after blizzard of not enough to get to where I was. At last I was bone-tired of hurting myself by believing it.

Laying on my chest, wheezing beautifully, was a thriving little human who survived both despite my placenta and because of it; a creature who could not have existed without it. Thanks to my placenta, his head was warm and soft against my face and I could smell heaven.

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It wasn’t until I began inching toward a prolific number of painted placentas (more than one is already prolific, one might argue) that I realized what this time was gifting me: the goodbye I’d been robbed of.

I didn’t have the luxurious meeting with my placenta that I’d imagined and my son didn’t have a proper goodbye. Instead, we had — the three of us — experienced a sudden doublet; a rending followed by a forever loss.

Painting was allowing me to pay my respects. But paying respects — as you know if you’ve lost someone, and we all have — is as much flowers and elegies as it is a bewildered or angry, “what the fuck?!”

So painting became a truth and reconciliation space to hold it all. Through brushstrokes I asked and answered, “What do I make of you, who was both not enough and exactly enough?” and “How do I love you, who tried to quit on me and my child?” and “What more do you need of me now?”

How do you eulogize a loved one who was so deeply imperfect? Who was violent and dangerous, but also gave so much and loved their absolute hardest? How do you, in death, protect the posterity of the both / and?

Here I am, trying.

The most radical concept in Buddhism is bodhicitta, or the notion that every sentient being — even every thing — contains the awakened heart and mind of the Buddha. Chogyam Trungpa Rinpoche called this our basic goodness — a foundational, inherent, self-arising truth that at our core we are loving, open, and good. It’s not conditional on anything at all, it just is.

You don’t have to be anything other than what you already are. You just have to find a way to see all that you are and all that you contain. Then you will see that all of you is so, so good.

Sometimes this insight doesn’t come until the very end of our lives, or in the experience of death.

Sitting here in the postpartum, which is also the postmortem, I see how my placenta loved my son to life, enough to bring him to me. I paint its bodhicitta— watery, vivid, dark, dreamy, mysterious. Mine and not mine at all. Basically good and certainly enough.