Traditional Chinese Medicine (TCM) is becoming increasingly popular in Australia. Many people are turning to organic or traditional practices and medicines as an alternative to pharmacy based healing and there are some very good reasons why! One of Australia’s leading nutritionists and BellyBelly’s own TCM expert, Nicole Chien, can guide you through the ancient concepts, traditional beliefs and modern realities of the postpartum confinement period.

What is postpartum confinement or care?

The philosophy and practice of postpartum confinement, (also known as ‘sitting the month’, ‘doing the month’, or ‘home care’) is a traditional practice in many cultures, especially in Asian countries. For many mums and their partners in Australia, it can be a difficult concept to grasp, let alone embrace. Typically, the period of postpartum or postnatal confinement starts from the birth of your baby and lasts between 30 and 100 days, depending on your cultural beliefs and customs.

The idea that a new mother should have a special diet, eat only certain foods and spend her time resting and bonding with her newborn seems like an impractical dream in many Western cultures. Instead, most mums give birth one day, are discharged the next and start overnight feeds almost immediately. There little understanding about a mother’s recovery needs.

For many new mothers from Asian cultures or backgrounds, however, postpartum care is embraced wholeheartedly. It is believed that a lot of Qi (energy and blood) is lost during childbirth, so it is necessary to replenish it and re-balance the body after childbirth, through rest, recuperation, care and nutrition. Traditional postpartum care is deeply rooted in Chinese culture and practices across many Asian cultures and some countries in the Middle East.

Is postpartum care necessary?

The keys to ‘remember the mother’. Increasingly, in western countries, the idea that the mother be given as much nurture and care as her newborn is gaining significant traction. Studies show there is a lower incidence of postpartum depression when the mother is prioritised as much as her child.

We are beginning to see a shift in focus, where the period after giving birth is referred to as the fourth trimester and, like the first three, involves the wellbeing of both mother and baby. In Australia and around the world, there is also the growing trend of employing a ‘confinement nanny’ or ‘postpartum doula’. They provide postpartum support for mothers of newly born babies when care from partners and family is not available; it’s a natural extension of doulas’ support during birth.

Across Asia, they are referred to as ‘confinement nannies’ or ‘confinement ladies’ rather than postpartum doulas. There is a difference between confinement nannies and doulas; confinement nannies combine traditional confinement practices with meals that include Chinese herbs, herbal medicines and they follow postpartum confinement concepts that have been used successfully for thousands of years.

Postpartum doulas also help mothers learn how to feed, settle and care for their babies. Some doulas might also help with household chores and meal preparation.

What are the benefits of postpartum confinement practices?

The benefits of postpartum confinement practices for mothers are manifold. Not least is the opportunity for mothers to bond with their own mothers or other family members, if they are lucky enough to have them live nearby. The emotional support, knowledge and experience they offer can be invaluable. The support provided by professionals should not be discounted either; doulas and Chinese postpartum confinement specialists can also contribute a great deal to the wellbeing of mother and child.

1. Healing after pregnancy and birth

Postpartum confinement helps new mothers recover from the physical and mental fatigue of pregnancy and childbirth. It supports the re-balancing of hormones after delivery, uterine contractions and wound healing, which also reduces the chance of postpartum depression. The physical recovery and emotional healing process for a mother is very important.

2. Replenishment of Qi and blood

In traditional postpartum practices (based on Chinese medicine), a 3-stage progressive recovery plan assists the mother with a diet focused on replenishing Qi and blood lost during birth. A good diet after childbirth is vital for a mother’s postpartum recovery. Each stage of nutrition should be designed to supplement the body, in accordance with traditional practices, resulting in gradual progression and improvement.

3. Better breastfeeding and a new way of life

Postpartum practices are physically and emotionally advantageous to new mothers. The foods they eat are designed to promote faster and better recovery, according to Traditional Chinese Medicine. The practices ensure sufficient breast milk production and better breastfeeding results and will help a new mother feel at her peak.

A calmer, more assured and supported mother is naturally able to bond better with her new baby without any background anxiety creating a barrier.

4. Enhanced immunity

During child delivery (natural or assisted), a mother’s body will experience wounds, coupled with the weakening of the body’s resistance. Without sufficient rest and recovery, she might have longer healing times, health complications or infections. During the first few weeks of a new mother’s recovery, therefore, it’s necessary for her to rest, enhance her immune system and restore her metabolism to normal levels.

5. Significant reduction in postnatal depression

After childbirth, about 80% of mothers experience ‘baby blues’ – feelings of sadness, irritability, depression, fatigue and moodiness. These are caused by rapid hormonal changes in the body during the first 48 hours after delivery.

Many low and middle income countries in South and East Asia, the Middle East, Latin America, and Africa follow local traditions for postpartum period care or some sort of confinement practices after childbirth. Research, as shown in studies and scientific literature, clearly shows that support provided during this time of confinement – adequate rest, proper nutritional foods, tonics and family and professional support – helps relieve postpartum depression.

Is postpartum nutrition important?

From a Traditional Chinese Medicine perspective, it is imperative that new mothers make sure their postpartum nutrition is a high priority. It is recommended that they follow what is called the 3-stage recovery plan after giving birth.

This consists of:

Metabolism. Eating, at this stage, helps replenish the body with the nutrients lost during childbirth
Restoration. The diet supports the recovery of physical body strength
Nourishment. Eating quality protein, suitable for postnatal mothers, is designed to boost immunity and restore energy.

What are some of the benefits of postpartum meals?

The magic of postpartum meals is that they fuel the body’s incredible healing process, provide a boost for energy and immune levels, and lay a foundation for healthy breastfeeding.
Let’s look at how nourishing yourself nourishes your entire postpartum journey.

Restores uterine function. A good diet of confinement meals and tonics is needed to restore the liver and clear the meridians, to help the uterus pass out all the lochia (postpartum vaginal discharge) for uterine recovery.

Restores Qi and metabolism. Women experience a deficiency of Qi and blood, and poor physical health during childbirth. Avoiding cold foods will help to clear and unblock the flow of blood and Qi in the body.

Prevents back pain and joint problems. Back aches are common during pregnancy. Mothers should make sure they eat well to keep their energy levels high, have quality rest, and refrain from standing too long or lifting heavy objects.

Preventing postpartum depression. Adequate rest and proper food consumption can help women avoid postpartum depression. It’s essential to have good physical and mental health.

Restores body shape. Well balanced postnatal meals provide for all nutrients – protein, fibre, vitamins and minerals – that mothers need to help reshape the body.

What to do when postpartum confinement ends?

Postpartum confinement practices are generally required for at least 30-60 days, as it takes 6-8 weeks (the postpartum period), for the uterus and the body to recover after childbirth. By the time postpartum confinement ends, most mothers are accustomed to caring for their babies and are taking steps to ease the transition and support the recovery of their body.

Eating a nutritional and balanced diet is still important, though, and this should continue while mum is breastfeeding. During this time, mothers are encouraged to remain physically active and do gentle exercise, such as yoga or walking. Partners play an important role during this transition period, by providing a supportive environment. They might help with household work, encourage breaks for mum and help with her emotional needs, to make sure the transition from confinement feels manageable and comfortable.