Postpartum Practices from Chinese Medicine Experts
Postpartum is an important time in many East Asian cultures when those who have just given birth are stepping into a new role in life as a parent, creating new routines in the home while also physically healing and recovering from birth. In Mandarin, zuo yue zi, (坐月子) or ‘sitting the month’, is the practice in which rest and recovery is prioritized in the first postpartum month. This is a critical time for healing as well as promoting future health and longevity for the birther and newborn.
Dr. Paige Yang
Zuo yue zi practices vary among cultures, regions and family traditions but some of the most commonly known practices are: refraining from showers, protecting the body from cold exposure, limiting social contact, avoiding cold foods, heavy lifting, exercise or heavy exertion, while also prioritizing rest, keeping the body warm and eating herbal soups, nourishing foods and having family take care of the birther and newborn. I asked some of my colleagues in East Asian Medicine to share first hand experience on zuo yue zi practices and their expertise on it.
Dr. Paige Yang, a doctor of Chinese Medicine in Kailua, Hawai’i, fondly recalls her mother’s home cooked ham hock jook (congee) seasoned with soy sauce, sesame oil and green onions as one of her favorite postpartum foods. Additionally, Dr. Paige’s mother-in-law was able to spend 30 days with her, preparing three meals everyday. “She followed all the family recipes of soups to clean out uterus, promote lactation, keep the uterus suspended to avoid prolapse, build qi and blood,” she recalls. “She made me 5-8 courses every single meal which always included a soup.”
Ivy Lee, an acupuncturist and herbalist in Oakland, California, says, “In Chinese Medicine we understand that nourishment postpartum is essential. It's a lot for the body to go through the demands of pregnancy, birth, postpartum recovery, feeding and caring for baby.” She emphasized on “eating warm, easy-to-digest, Qi and Blood building foods.” Some of her favorites were “bone broth, congee, oatmeal, sweet potatoes, soups and stews with ginger.” She also adds, “I really enjoyed a sweet porridge of amaranth with coconut milk, black sesame seeds, and honey.”
Joie Jacala
Joie Jacala, mother of three, who practices acupuncture and herbal medicine in Fayetteville, Georgia is a lover of congee. Joie says that a big part of her recovery postpartum was having her mother present for at least 30 days, all three times she gave birth, to nourish her “back to health by cooking Chinese and Filipino foods like silkie chicken congee with black rice, pig feet congee, lotus root with snow pea stir-fry with duck, boiled peanut tea, lots of blood building and warming herbs and foods.”
Dr. Paige shares some of her other zuo yue zi practices that included, “primarily bed rest though making sure I got up throughout the day to keep my uterus from prolapsing, I would do sitz baths and then sponge baths.” She refrained from taking a full shower, but instead washed her hair every 3-4 days in the tub. She also adds, “My husband spoon fed me and gave me a straw to drink. I took Chinese herbs, got abdominal massage at the house from my midwife to help shrink the uterus back down. I also did some herbal wraps and my husband walked me to the bathroom to make sure I wouldn't faint and if I needed support sitting during recovery. I ate and drank about 4,000 calories a day which helped ensure a very good breastmilk supply. Baby and I never went outside for the 30 days.”
Ivy shares more about her zuo yue zi saying, “I had a homebirth with my daughter and stayed home for more than a month after. The practice of laying in bed, resting, having others tend to the cooking, cleaning and chores, was so beneficial in enabling me to recover postpartum and focus on bonding with baby. Also, birth and postpartum was an incredible portal that opened up so much energetically, so being at home without external distractions and a lot of people around was really supportive in creating a energetic container for me and baby. The peace and sanctuary of being at home held me as I navigated the life initiation into parenthood.”
Ivy Lee
Joie emphasizes that having her mother present with her each time, “to help with belly binding; allowed me to get necessary sleep for recovery and taught me how to care for my very first newborn (swaddle, nurse, burp, etc).” She believes that just having the space for zuo yue zi was significant to her postpartum experience and highly recommends it to those who can do it. She was able to take rest after each birth for a little over a month. She also refrained from fully showering for 1 week. Joie also says that “Self-kindness and self-forgiveness are big things I've learned as a mom.”
Bathing and hair washing after giving birth is a topic that comes up a lot for those who are familiar with zuo yue zi practices while living in the US. There is always an emphasis to stay warm and not catch cold in many Asian cultures. It is also important to factor the climate and time of year you’re giving birth in. Dr. Paige, who gave birth in Hawai’i in September, when it’s hot, felt that being less clothed to focus on skin to skin contact was beneficial. Though she did refrain from fully bathing for a period of time, she also says that “I truly feel being mostly naked with baby helped build his wei qi/immune system, ensured smooth breastfeeding and also allowed us to regulate our rhythm together.”
Dr. Paige said no to visitors, outside of her parents and mother-in-law for the first two weeks. She recalls “This was essential to recovery. After the first two weeks, I only had very few people come to visit and they always brought food and I told them they could only visit for 30 minutes.” Dr. Paige also mentions that this gave time for her newborn “to build his natural immune system before seeing people. Since he was born at home, that ironically was the ‘cleanest’ environment because he never had to leave his place of birth, interact with people outside of those at his birth and be away from his place of birth. I wanted to keep that nice ‘holy bubble’ for two solid weeks to help strengthen him up before having outside influences in the mix.”
Ivy shares that boundaries, postpartum were also important to her. She says, “Something I tell my patients is, ‘You grew and birthed baby, so it's your postpartum.’” She encourages pregnant people to, “take the time to think about what you want your precious postpartum time to be like. What is important to you, what would be supportive for you, what do you want to receive. For example, this could be having a limit to how long visitors stay for, or communicating that you will be the one holding baby and people can help by washing dishes. Know that postpartum is the time for you to ask for help and receive abundantly, for your needs and baby's needs to be prioritized, and for your physical and emotional wellbeing to be cared for.”
Ivy Lee
Joie adds that zuo yue zi can feel like a “lost practice that is so essential but unfortunately impractical for modern living. Most families don't live together any more, and most people don't tend toward traditional practices and opt for modern services/conveniences.”
It is not always accessible for all families to have the time and resources to be able to practice zuo yue zi, especially when paid maternity leave in the United States is not a standard. For those of us born and raised in western cultures, such practices can appear to be a luxury or pampering but they really are preventative practices to ensure long term health. After giving birth your state of health can be in a precarious place and how you spend the next 30 days can either damage or strengthen your body. In the US, it is more culturally acceptable for a person who has just given birth to hurry up and get back to work or get back in the gym, which can actually harm a body that is trying to recover from 9 months of pregnancy and then the physicality of giving birth. There is a lack of emphasis on postpartum care in the US and it is important to keep this in mind for those who are planning to have families. This can be an opportunity to invest some time and money into building a postpartum plan that allows for rest and recovery for the body that has given birth as well as protecting the health of the newborn while they adjust to life outside the womb.
Though there are now some meal delivery services and retreat centers that specialize in postpartum care, there are still only a handful of these type of small businesses. Many people have a limit as to how long they can take leave from work as well as financial resources to afford these services. Others have found a way to reconcile this by planning ahead and organizing meal trains or having friends and family who are available to help with household chores.
Contributors
Dr. Paige Yang (she/her)
paigeyangacupuncture.janeapp.com
Kailua, HI
Ivy Lee (she/her)
Oakland, CA
Joie Jacala (she/her
Fayetteville, GA
Postpartum services
Boram is a postpartum retreat stay (NYC) boramcare.com
Jing Mommy meal prep and delivery (California) postpartummeal.com
Chen Mommy meal prep and delivery (New York) chenmommykitchen.com
Written by Dr. Emily Siy on 12/11/23 with contributions from Dr. Paige Yang, Ivy Lee and Joie Jacala
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