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Placenta Encapsulation Registration Form for Oklahoma City and Surrounding.


Whether you're currently pregnant or in the midst of labor, it's not too late to encapsulate your placenta. Feel free to call our number 405-397-7810 with any questions you may have.


This will take a few minutes to complete. We require a $150 upfront payment to schedule our services. In the event your placenta is unavailable to you or if you choose to terminate services, you will be entitled to a refund minus a $75 scheduling fee.


A scheduling confirmation email with detailed information regarding your placenta and day of delivery will be sent to you once you complete this form and your payment of $150 is successfully made (takes about one hour to 24 hours for your form to be reviewed).

Our Capsules - ($330): At Peace of Mommy Encapsulation, we specialize in placenta encapsulation using The Steamed method of preparation. This method is designed to eliminate any potential bacteria, including group B strep. The process involves seasoning the placenta with lemon juice, cayenne pepper, and ginger. The placenta is then steamed by subjecting the placenta to temperatures higher than 140 degrees F. Once Steamed the placenta is cut into pieces and dehydrated for 24 hours, we then grind the placenta into fine powder and place it into unflavored vegan gelatine capsules. Our vegan capsules are free from preservatives, artificial coloring and flavoring. We stopped serving flavored capsules because we no longer want to be affiliated with artificial coloring or flavoring. Depending on the size and density of the placenta, our service typically yields 110-200 capsules, ensuring that new mothers have a substantial supply of placenta pills to support their postpartum recovery.


Umbilical Cord Keepsake - (free): At no extra cost, we dehydrate the umbilical cord into a heart shape with color of your preference.


Placenta Tincture - ($30): Comes in a 2 oz dropper glass bottle. The tincture is made by soaking a small piece of fresh placenta in strong alcohol; the benefit to having a tincture made is that it can be used in addition to and long after the capsules are gone. By tincturing a small piece of the placenta in a high grade alcohol, the length and benefits of your placenta for is increased. Some clients also give the tincture to their children in times of illness or transition. The tincture can be used in any time of trauma, hormonal imbalance, emotional distress and for mother later in life during menopause.


Placenta Balm - ($30): Comes in a 5.1 oz tin jar. Placenta salve can be used to heal C-Section incisions, lessen scarring, itching and discomfort. It can also be used for hemorrhoids, perineal tearing, burns, baby diaper rash, eczema, stretch marks and skin irritation.

Ingredients: Coconut oil, almond oil, Shea butter, comfrey leaf, calendula petals, beeswax, plantain leaf, placenta powder.


Placenta print - ($25): The placenta print is the print of your placenta using food grade water colors. This is printed in a 11" x 15" watercolor paper.

Please check all the boxes that apply. Boxes that are left unchecked will not be added to your order. Once we review your form, we'll send you an invoice with remaining balance.
Umbilical Cord keepsake Color (if applicable):
What is your estimated due date?
When dropping off your placenta products, would you like us to hand them to you personally, or would you like us to leave them outside your door and then receiving a drop off confirmation text? We always make sure you’re home from the hospital before deli
Drop off
Hand them to me
I understand that THE ONLY reason my placenta is unsafe to encapsulate is if I have AIDS/HIV Positive
I understand

CLIENT RESPONSIBILITY: It is your responsibility to discuss the release of your placenta the day of your delivery with your primary health care provider as well as the facility you will be birthing in the day of your delivery. Your placenta may be kept at room temperature for 3­-4 hours following your birth. After 4 hours it needs to be in a sealed container or ziplock bag, and it needs to be chilled at 30-40 degrees (hospitals will provide their own containers and ice for your placenta).


How to go about asking to keep your placenta: Some women like to let their health providers know ahead of time but it's not necessary. The day you deliver your baby, before you go into labor simply let your nurses know that you'll be keeping your placenta and that you've made arrangements for someone to come pick it up after your delivery. You do not have to ask for permission to keep your placenta. IT IS YOUR ORGAN!


Some hospitals will keep your placenta in a fridge until we pick it up, if that is the case make sure the hospital labels the container with a note that says "DO NOT TAKE-PATIENT IS TAKING HOME." We recommend bringing your own cooler with you so your placenta does not leave your room to reduce chances of your placenta being misplaced or being taken away.


It is your responsibility to notify me when you are in labor and again as soon as possible after birth to make arrangements for transfer of your placenta to me. Improperly handled placentas are susceptible to spoilage.


It is important to note that there may be circumstances under which your placenta can not be used. Significant abnormalities of the placenta may necessitate your doctor or midwife sending your placenta to Pathology for further examination. Please call us as we can consult with you before proceeding with any decision they make regarding your placenta.


Our placenta pick up hours are Monday-Sunday from 9 am to 9 pm. UNLESS your hospital has a specific time frame in which the placenta needs to be picked up. If they schedule you for induction or C-Section please let us know the date and time. If possible, let us know when you’re about to go into labor and once again when your placenta is ready for pick up. Text/Dm or Call us when your placenta is ready for pick up (4053977810) We will give you an estimated time in which your placenta will be picked up.


LIMITATIONS AND DISCLAIMER: We are not licensed medical professionals and We are not able to diagnose, treat or prescribe for any health condition. Services and fees are for the preparation and encapsulation of your placenta, not for the sale of the pills. No specific benefits or effects are promised. Benefits will vary from person to person. Many of the benefits are well supported by evidence based research; but none have been evaluated or approved by the FDA (all holistic medicine is usually not FDA approved, such as dietary supplements, herbal supplements, and natural remedies).


REFUNDS: In the event your placenta is unavailable to you (ex. sent to Pathology and not released), if you choose to terminate services, or if your placenta has been contaminated with a bacterial infection, you will be entitled to a refund minus a $75 scheduling fee.

Please note that there will be no refund and remaining balance will be due once preparation of placenta has begun, even if you choose not to take delivery of the finished capsules.



By signing below, my permission is granted for your specialist to transport your placenta for preparation and delivery of completed capsules. Your placenta will be handled and encapsulated according to OSHA bloodborne pathogens universal precautions and Food Safety and Handling standards. Your placenta will be cleaned, steamed, dehydrated and put into capsule form in the sanitary and disinfected work space indicated above. I understand that upon receiving the pills, my placenta specialist is no longer liable, including but not limited to any other person(s) ingesting my own placenta capsules. Peace of Mommy Encapsulation does not determine whether my placenta should be consumed and makes no guarantee of my personal results from the capsules. The capsules should not be taken during times of illness, such as the common cold, flu, or mastitis. I understand that taking the capsules in any manner other than as labelled can have undesirable results. We keep this document on file as a record of our agreement. No copies will be released to any third parties.


Registration deposit payment
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489 E 15th St, Edmond, OK 73013

405-397-7810

Placenta Capsules do not replace medical care and should not be used to treat severe anemia, inadequate milk supply, and severe ppd.



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