Kalehua and Kihapai Krug had no trouble collecting the placenta after the births of their first two children, Kamalei and Kaula.

As do a growing number of Native Hawaiian couples, the Krugs conduct rituals to honor the placenta that enveloped their babies while in utero.

So they were stunned last fall when told by an O'ahu hospital that they could not take possession of the placenta, or 'iewe, after the birth of their third child, Leleapaoo.

The Krugs are now among several Native Hawaiian families who want state lawmakers to reverse a Health Department policy that bars them from taking home the placenta after childbirth. They argue that the state is stifling their religious and spiritual beliefs.

Bills that would change state policy were approved by health committees in both houses of the Legislature this week, but must move past several other legislative hurdles before becoming law.

But state Health Director Chiyome Fukino said new legislation is not necessary, because new Health Department policy is being drafted that would establish a process allowing families to take home placentas as long as the mothers have been found clear of infectious diseases.

Several Native Hawaiian doctors at a news conference yesterday said placentas have long been released into the care of families seeking them for cultural or religious reasons.

But last summer, when a doctor at Kaiser Permanente Moanalua Medical Center sought advice after a request by a family, Fukino said, state health officials learned about the cultural practice and rules that appear to block release of placenta.

Those rules, instituted in the early 1990s, as awareness of the AIDS epidemic heightened, address disposal of "byproducts of surgery and the process of delivery."

Fukino said that after reviewing requirements pertaining to the disposal and management of infectious waste, her staff sent a memo in July to hospitals and other healthcare providers advising them to ban release of placenta.

Since then the Health Department has been working to establish a proposal for a waiver, which must be approved by the governor before undergoing a public hearing process. Fukino said that a lawsuit filed by the Native Hawaiian Legal Corp. on behalf of two of the families contributed to a delay in pursuing the waiver proposal by tying up the attorney assigned to the issue.

"It is not the intent of the Department of Health to not let it happen," she said. "We support cultural practices, but we couldn't find any way to release it."

Meanwhile, the Women's Legislative Caucus, the Hawai'i Women's Coalition and a number of Native Hawaiian doctors and cultural practitioners have lined up in support of the bills moving through the Legislature.

Kalehua Krug, a specialist at the University of Hawai'i's College of Education, said his family conducts a spiritual cleansing ritual for the placenta before "returning it to the earth."

The ritual is based in part on family tradition, he said, and what he and his wife have learned through research and discussions with elders in the Hawaiian community.

Kihei Nahale-a and Nohea Stibbard of Hilo also were denied possession of a placenta, following the birth of their daughter in July.

As part of the culture, he has learned, "the placenta needs to be returned back to the earth, to the honua, to keep the baby firmly rooted in the land, so that the baby knows, and we all know, who she is and where she comes from," said Nahale-a, a lecturer at the University of Hawai'i-Hilo and Hawai'i Community College.

Reach Gordon Y.K. Pang at gpang@honoluluadvertiser.com.