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Confinement Care
Know your traditional confinement care practices
Whatever the race, the aim of confinement care is to nurse the new mum’s body back to health. The Chinese refer to this period of rest as zhuo yue, literally “sitting still for a month”. Some women hire a confinement nanny, called a pei yue (“companion for a month”), who stays over to take round-the-clock care of the new mum’s meals, baths, household chores, as well as her baby.
Among most new Malay mothers, the dalam pantang is a common practice, in which the mother or mother-in-law lives in to supervise the mum’s confinement. Indian women, like their Malay counterparts, also usually stay with their mothers or mothers-in-law during this period as well.
A woman’s confinement coincides with the phase known as puerperium, or the period from birth to six weeks in which the woman’s body, which had undergone massive changes during her pregnancy, recovers gradually and returns to the non-pregnant state.
Mother & Baby expert Dr Christopher Chong, a consultant obstetrician, gynaecologist and urogynaecologist at Gleneagles Medical Centre, explains, “Everything swells in pregnancy, and it’ll take about six weeks after delivery for your organs to go back to normal.”
In those six weeks, the uterus gradually shrinks from about 900g back to its pre-pregnancy size and weight of less than 100g, while the site where the placenta was attached repairs itself. The volume of blood in the body, which had expanded by one-and-a-half times during pregnancy, also returns to normal. Hormonal changes occur as well, besides preparing the breasts for breastfeeding, it sometimes gives rise to postpartum blues and hair loss.
During this crucial period following childbirth, new Chinese, Malay and Indian mothers eat nutritious dishes that feature rejuvenating herbs and tonics as well as get massages and wraps, especially for Malays and Indians. This special care is to enable wounds to heal properly, shrink the uterus, strengthen joints and muscles, as well as help them regain their pre-pregnancy figures.
THE WIND CHILL FACTOR
“From the TCM perspective, the whole pregnancy and labour process is completely ‘exhausts’ the mother’s health,” says Jin Jinhua, a Raffles Chinese Medicine acupuncturist. “After childbirth, the mother is usually weaker and more susceptible to the invasion of ‘wind’, ‘dampness’ and ‘cold’. As such, TCM places great emphasis on good confinement practices in order to prevent future ailments.”
She explains that after giving birth, the Chinese believe that women are considered to be extremely “deficient” from the loss of blood and energy. As such, there is a strong emphasis on keeping the body warm, as well as on avoiding exposure to “wind” and cold elements. This forms the basis of the well-known and peculiar custom that postnatal mums refrain from bathing and washing their hair. Hardcore followers even avoid washing their hands.
During her confinement month, Joyce Tian, 28, an accounts executive and mum to 14-month-old Jonas, used a herbal concoction daily to wipe herself clean and a special shampoo formula to dry clean her hair. She even wore plastic gloves when she visited the toilet to dodge washing her hands.
Since the new mum’s immunity is low, which makes her susceptible to germs, she is advised from leaving home during her confinement. Also, as her pores are open and her joints loose, going out may cause “wind” to enter her body, weakening it further and causing joint problems later, Jin points out. She should not expose herself to cold water and low temperatures, avoid direct “wind” from the fan or air-conditioning. Some women even close their windows and wear wearing socks, long pants and long-sleeved tops. The rationale: You will have backache, arthritis, rheumatism and incontinence
when you are old if you ignore such customs.
HOMEWARD BOUND
Similarly, Malays believe that the pores on a woman’s body are open during labour, so care should be taken to keep the body warm, as well as to prevent “wind” from entering it. “During confinement, we can move around in the house but we don't do housework, and we must always wear socks and bedroom slippers to prevent ‘wind’ from coming in through the feet ? believed to be the most notorious place for ‘wind’ to enter,” Haslinda elaborates.
Farlinzah Mahmood, 36, an editorial administrator, and mum to Farah Adriana, 4, and Muhammad Farihin, 8, was not allowed out of her home for 40 days. “My mum told me that the body is at its most fragile state, and I shouldn’t expose myself to the air outside. This would help prevent headaches and white blood cells from going up to the head, which can result in blindness,” she recalls. “I was also not allowed to bathe in the evenings, that was the hardest part for me, since I normally shower twice a day.”
Indian postnatal mums are discouraged from taking normal showers, taking instead, herbal baths that use different types of leaves. These are thought to warm the body, dispel “wind”, improve blood circulation and reduce fatigue. They are also advised against using the air-conditioner or fan, as well as to close their windows.
Indian customs also frown at postpartum mums who go out during their 40-day confinement. “As the woman’s immunity is low, she should avoid being in contact with a lot of people, so as not to catch any illnesses,” explains mum-of-two Nehal Kamdar, a Raffles Hospital dietitian.
KNEADS AND WANTS
Most women can’t wait to return to their pre-pregnancy shape. Many Malay women get a helping hand in this area by engaging a postnatal massage expert to trim her newly slack tummy. These days, this traditional Malay practice is finding favour among Chinese, Indian and Caucasian mums. At Traditional Wellness spa, some 80 per cent of its customers are non-Malays.
“You can start three days after a natural delivery, or for those who’ve had a C-section, about one to two weeks later, upon your gynae’s consent,” Haslinda notes. The number and frequency of massages depend on your finances or personal preference. Her postnatal massage, which uses plant-based oil, helps to regulate blood flow, release “wind”, reduce water retention, tone abdominal muscles, as well as heal the womb.
“Done in the right way, a postnatal massage strengthens the uterus by stimulating cell-renewal and healing, allowing the womb to go back to its prenatal size and position. This is the most important benefit of traditional Malay massage,” she says. “When the womb is not properly aligned in its rightful place, a woman may face some discomfort, such as incontinence or bad stomach cramps, and in some cases, she may experience difficulty in conceiving.”
Some masseuses even wrap the new mum’s stomach to restore its shape and help the uterus return to its original position. This stomach-binding practice, called bengkung, is a hallmark of traditional Malay massage.
Haslinda explains, “Worn throughout the confinement period, the bengkung prevents the sagging skin from pulling the stomach downwards and firms it up after the massage. Binding also stabilises the womb so you can move freely without worrying about your delicate womb.”
A herbal paste called pilis, another traditional Malay treatment, is also applied on the forehead to prevent headaches, stomach pain and blurring of eyesight. Women with long hair must always tie their hair in a neat bun or ponytail, away from the face, to prevent headaches, she adds.
Similarly, Indian mothers get a daily massage using spiced mustard oil to warm the body. Nehal notes, “A massage lady comes to your home to give you, as well as your baby, a massage every day during the entire confinement period, and it’s just beautiful! We also use a spice-based paste on the tummy area, as well as herbal wraps to shrink the uterus and help the woman regain her figure.”
Unlike the soothing massage, the wrap was hot and extremely uncomfortable, she recalls. As the Indians believe that using olive oil for the massage will improve baby’s colour and skin texture, the masseuse also provides baby massage as part of her postnatal services.
GOOD SENSE
From the Chinese belief in avoiding water, to the Malay practice of taking herbs and the Indians’ use of spices, Asian confinement care is rooted in tradition. While science does not provide adequate answers for such customs, the view that most medical professionals have towards these practices is “do no harm”.
Dr Chong asserts, “I do not agree with confinement practices of cooking or drinking alcohol if a woman is breastfeeding, as alcohol goes into the breastmilk and the baby’s liver is not ready to break down alcohol. I also don’t approve of the practice of not bathing or washing your hair for the simple reason that you need to be clean to care for and nurse your very vulnerable baby.”
Other than that, he’s got no beef if his patients abide by traditional cultural practices. He says, “My philosophy is that if it does not cause actual harm and discomfort, nor affect the patient psychologically, then go ahead, but only if you’re happy to follow it.”
So, make an informed decision for yourself on what is best and do what’s comfortable for you. The first few weeks after delivery are bound to be a physically challenging and hormonally unsettling time, particularly if it’s your first baby. Add to this the countless confinement practices that confound you, and you can become confused, miserable and stressed. Indeed, many new mums in our Asian society can relate to the distress of having to listen to advice from well-meaning elders and friends.
Ultimately, what is most important is the health and wellbeing of the mother and child, Dr Chong reckons. “If you’re unhappy and feel forced to follow certain practices, it can lead to postnatal blues. Use logic, science and common sense to guide your decisions, and always stay active, clean and healthy.”
If you have any comments or practical suggestions, write to us at editor@family.sg
- Mother & Baby
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