What is Traditional Postnatal Confinement?

“Do I have to follow tradition or is there a modern confinement practice?” This is a very interesting question that the majority of pregnant women ask when preparing for the birth of their baby.

In Malaysia, tradition still reigns to some extent, whereby pregnancy and post natal practices and taboos are still adhered to by the Malays, Indians and Chinese regardless of their educational background. Most of the so called ‘taboos’ may sound ridiculous and nobody is able to give us a good explanation why this or that is done, but if you look at it closely, there is a very sound logical reason behind each taboo which somehow have been lost over the years.   

Confinement – Chinese style

In the old days, the month immediately after delivery is considered a time of great danger, of illness and potential death to both mother and baby. This is because during the post partum period the mother's physiological classification changes to a period of strongest Yin when her body is at the weakest and traditional Chinese women must follow a program that consists of 15 well-defined cultural practices designed to reduce this danger.

According to ancient Chinese text, women who follow the traditions during this period are said to be ‘doing the month’ when the new mother and her baby are practically confined to their room. It is probably from here that the word “confinement” is coined.   Officially, the confinement period is 30 days culminating with a big feast called “full moon” banquet when visitors come bearing gifts for the baby.

The fifteen cultural practices/taboos that she must strictly adhere to are:

• Eat chicken everyday.     
  


• Eat ‘heaty’ food.
  


• Not to eat raw or cold foods.
  


• Not to wash her hair or body.   
  


• Not to go outside the home
  


• Not to sit in a draft or in the wind
  


• Not to move about the house needlessly but stay in the room
  


• Not to visit another’s home
  


• Abstain from sexual intercourse for 100 days
  


• Practice positive behaviour to avoid becoming ill
  


• Do not read or cry
  


• Do not eat with other family members
  


• Not to offend the gods by burning incense
  


• Avoid any potentially disease causing object
  


• Avoid contaminating family members with any fetal blood residue

Can you figure out the reasons for the above practices?

The first 3 are fairly easy to understand. In the old days, the order at mealtimes are that the men eat first, followed by the children and lastly the women. This means that most women do not get to eat a well balanced diet and the only time they get to correct this imbalance is during the confinement period. The aim of traditional Chinese confinement diet is to prevent ailments arising during old age, therefore all the recommended foods to be consumed are more of a preventive measure rather than treatment. As the Chinese believe that the body is very Yin or cold after childbirth, it is important to try and warm it up by eating ‘heaty’ food. If you look at all the so called ‘heaty’ food most of them contain nutrients that are needed to improve milk production, help tissue repair and improve the general well being of the mother. Traditional Chinese confinement food consists mainly of old ginger, rice wine, sesame oil, black vinegar, herbs, some warming alcohol, lots of meat especially kampong chicken (30 birds) and lean pork, white fish such as white pomfret and some non-cooling vegetables.

The recommendation is that you should consume about 12 bottles of rice wine during the confinement month. This is not difficult to achieve because almost every dish will have the wine in it. Rice wine is fermented pulut rice, which is rice in iron, low in fat and free of cholesterol with high dietary fibre to reduce risk of heart attack and diabetes. The commercial name is Shaoxing wine. If you plan to go with the traditional Chinese confinement diet, it is best to get some of the dry ingredients about two to three weeks before your due date, just in case baby decides to come early.

The practice of not bathing and washing hair in the old days are understandable because in ancient China everyone has very long hair and it takes a long time to dry the hair after washing. In addition, most of the old houses are draughty so it is easy to catch a chill whether during confinement or not. Our mothers and grandmothers swear that if you bath during the confinement month you will develop joint pains in your old age. The good news is that the period for not bathing has been reduced to 2 weeks. Who decreed this, nobody knows! However, the bath water must be boiled and infused with water from boiled herbs. Somewhere over the years someone introduced the tradition of bathing with a whole concoction of herbs in the water such as serai, limau perut, daun kunyit etc. This is probably from being exposed to local Malay customs. 

Another tradition which is not listed in the 15 practices is that a newly delivered mother is not allowed to touch water during the confinement month. This is actually ridiculous because: 

1. You must practice good hand washing and personal hygiene to protect your baby.
   


2. After the delivery you will bleed for a few days and if you don't wash, the blood will dry up and become a fantastic dinner place for germs which could lead to infection.
   


3. If you have been in labour for several hours and had a vaginal delivery, you will be sweaty and if you add on more days of sweat from eating 'heaty' food, nobody will be able to sit next to you.  

The reason for being confined to the room and house is probably to prevent women from starting to do housework and maybe even going out to the fields. If the newly delivered mother uses up all her energy with strenuous work and is over tired, she will not be able to produce sufficient milk for her baby. Remember, in the old days all babies are exclusively breast fed. Also it takes about 6 – 8 weeks for the body to return to its pre-pregnant state therefore the confinement is to ensure that the mother properly recovers from the stress of childbirth.

What about abstaining from sex for 100 days? This is probably because in those days there are no contraceptive devices and if a woman becomes pregnant again within the 100 days she will not have a chance to recover from the stress of the present pregnancy and childbirth. Following delivery, there is a raw area in the woman’s womb where the placenta was attached. There is a high risk for this area to become infected during sexual intercourse. In fact, the modern recommendation is abstinence for 6 weeks following a vaginal delivery and 8 weeks after a caesarean section.

I believe that it is important for the newly delivered mother to practice positive behaviour and avoid being ill. The mother is the primary care taker of the baby and if she is ill she will not be able to take care of her baby. In addition, the baby is very sensitive to the mother’s emotions therefore will react accordingly. If any negative behaviour is prolonged it will eventually have a negative effect on the baby’s character and behaviour. If you want a baby who is happy and easy to look after you have to be positive and happy starting from pregnancy.

The last 4 practices in my opinion are out of context these days especially when some of us are from different religious faiths and there is no substantial evidence to show the outcome of observing these last practices. 

Having worked with women from Western countries and Malaysia I must say that our elderly ladies have less gynaecological and arthritic problems. Could this be due to our confinement practices or genetic makeup? I honestly cannot answer this question. 

For those of you who are still unsure about the value of traditional practices my advice is that sometimes it may be easier to comply with the elders’ advice for the sake of peace even though you may feel very uncomfortable for a few days. Then there will always be this doubt about what will happen if we do not comply. Later, if we complain of aches and pains we will definitely hear this phrase “I told you so”.