Postpartum traditions to admire

The First 40 Days for a new mother

As I approach the birth of my second baby, part of my preparation this time is stretching to the all-important postnatal period and how I can practice doing what I'm terrible at - asking for help. My thinking has led me to discover how they approach this time in other cultures all around the world. It seems there are postpartum care traditions that honour the first 40 days (or thereabouts) after a mother gives birth in many many countries, putting us somewhat to shame in the UK for the lack of attention and TLC that we give our new mothers.

It is approached as a time for her to heal, to replenish and restore her energy and transition to the role of mother, whether it's for the first, second time or more. Of course this resonates with me, because as a second time mother, I've really noticed the reduction in interest in this pregnancy compared to the attention my first pregnancy received. I'm not saying this because I particularly wanted or needed attention, just that it has given me an element of understanding as to how 2nd, 3rd or more pregnancies can result in an even more lonely and unsupported postpartum than the first...but that's another post for another time...

In my research, the postnatal time around the world is a time for taking away the new mother's responsibilities so she can be still, feed her baby, sleep, be peaceful, be fed! It's neighbours, aunties, friends and relatives, showing up with soup and a listening ear and a desire to serve the woman who has just given birth. It's cocooning her up as we know to cocoon up the baby - because she too is in need of protection and nurturing during this important, overwhelming time.

These traditions are passed down from mother - daughter, grandmother to granddaughter, midwife to client. Some traditions are more 'tough love' than others but the common thread is that there is wisdom surround over-exertion after childbirth and the serious consequences that her and her baby can face if this happens.

As it stands in the UK

In the UK we seem to have lost or be lacking the sorts of social structures that hold onto these traditions and rituals. We don't live with, or often anywhere near our elders and unless we are part of a church or specific community group we don't have that network of people to rally round us in the same way as other cultures do. Postnatal Doulas are in high demand as a result - women who mother the mother and do everything they can to be a helping hand doing anything that needs doing in order to keep the motherbaby dyad together, feeding, resting and bonding. Making lunch, tidying, helping with older siblings, making the mother lunch, signposting her to specialised support and assisting her breastfeeding journey,

For us, within days our new mothers are walking the streets gathering groceries and seeming 'back to normal' in the busyness of life but to the detriment of her health, bonding with new baby and long-term mental and physical well-being. After 1-2 weeks the fathers return to work and we are thrown into solo parenting, home alone, leaking, healing, overwhelmed. It's just too soon.  

The Golden Hour or ideally hours, weeks or even month(s) are so so precious to you and your baby. It isn't indulgent to have a week in bed, a week on the sofa and a few more weeks in your pjs between the two. Snuggling, feeding, eating, feeding, pottering, feeding, bathing, feeding and being well and truly worshipped in the process!

So here are some examples of how other countries and cultures approach the time after a mother gives birth:

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China - Zuo Yuezi - 'The Sitting Month'.

One of the more 'tough love' approaches to postnatal care and comes with a bit of a no-nonsense attitude. According to traditional Chinese medicine, blood carries chi, your “life force,” which fuels all the functions of the body. When you lose blood, you lose chi, and this causes your body to go into a state of yin (cold). When yin (cold) and yang (hot) are out of balance, your body will suffer physical disorders. Sponge baths are given, instead of showers. Books and reading isn't allowed to avoid straining the eyes. No watching of films in case some scenes upset the mother and disrupt her state of chi. Homemade chicken soup and goji berry tea.

Korea - 'Samchilil' - which literally means 21 days.

Miyeokguk (a traditional seaweed soup with various ingredients added such as different veggies, beef, chicken or fish) is served several times a day to boost circulation, restore lost nutrients and boost milk supply.
The baby isn't introduced to the wider family after 100 days.

India

Ayurveda, the sister-science to yoga in India, teaches the principle, "42 days for 42 years". This means that the way a mother is nourished for the first 6 weeks after birth can determine how successfully she gives her light to the world for the next 4 decades. Isn't that incredible?! The new mother returns to her parents home for up to 3 months of focused, round-the-clock maternal care from many different pairs of hands. Soft and nurturing foods are fed to her, including ghee, protein-rich foods, special spices (all easy to digest) and herbal tonics for lactation, immunity and energy. Warm oil massages are given to her and she is shown how to massage her newborn.

Latin America - La Cuarentena "The Quarantine"

La Cuarentena is also a play off the Spanish word for 'forty' - cuarenta. It's a 40-day period where all female relatives come and take over all the household duties for the new mother so she can rest. They safeguard her from future exhaustion-related illness. Homemade traditional chicken soup is made and fed to her. Her abdomen is bound with a Faja (cloth) to keep her belly warm and help close her bones/support her pelvis and core muscles.

Native America - the 'lying in period'

Ceremony is key. Ritualistic bathing. A baby-naming ceremony is organised and held. Hopi people in the South West US practice a 20-day seclusion for mother and baby, where the mother is fed traditional corn bread, a ceremonial food for rites of passage such as becoming a mother. Various grooming, binding, washing and steaming treatments and ceremonies are performed for the mother. Most tribes require that the father participate in the postpartum traditions or enter into traditions of his own - one of which might be making his own cradling board (a traditional Native American baby carrier. Women of the tribes are revered and regarded with respect and dignity, seen as the life-giving citizens. 

Indonesia

A bright light burns in the new mother's home for 40 days after birth to honour the new life that has arrived. Midwife will visit DAILY to massage the mother, bathe her and feed her Jamu, a nourishing soup made of egg yolks, tamarind, sugar and healing herbs.
Belly binding is also done to help her womb to heal. Her placenta is kept near her for 40 days before being buried because it is believed to hold spiritual power that protects her from illness and infection.

Malaysia - 'Pantang'.

The word ‘pantang‘ comes from the phrase ‘pantang larang‘ which means ‘taboo’ - this in itself highlightss the restrictions placed on the mother after she has given birth. The mother secludes herself (or rather, her mother or mother-in-law confines her!) for 44-days and receives hot stone massages, full body exfoliation, herbal baths and hot compresses to care for her womb. 

Both mother and baby are expected to stay put at home and again, food plays a huge part of the ritual. For example, foods like the haruan fish (Channa striatus) is served because it’s supposed to help promote healing of wounds and stitches.

Thailand

From what I could find about Thai traditions, there is real significance around the four elements; earth, air, fire and water. According to traditional Thai medicine, childbirth unbalances the body, mind–heart, and energy (Salguero, 2003). Excessive loss of blood, embryonic fluid, sweat, and urine decreases the Water element. A perineal wound damages the Earth element. During labour, pushing changes the Air element, and a woman’s physical effort depletes her Fire element. It is believed that these bodily instabilities can quickly have a negative effect on the woman’s mind so it seems special care is taken to reduce her likelihood of developing postnatal depression.
Thai massage is given to the new mother for her energetic rebalance.

There also seems to be a lot of tradition surrounding helping the new mother to regain her 'heat.' Hot drinks, sitting by fires, herbal healing baths, avoiding wind, keeping wrapped up and restricting certain cold foods.

Zambia - the mother is strictly banned from any work around the house until the umbilical cord falls off at least.

Vietnam - rules are that the new baby is not introduced to strangers until after the first 6 weeks, to protect them from envy, or too much attention/stimulation.

Japan - new mothers go home to their mothers' home for at least 1-2 months for focused care and TLC.

And there are so many more countries to look into that I just haven't had time to do for this post! i.e

Jordan, Lebanon, Egypt, Palestine, the list goes on. 
 

But why is the time after birth so important?

There are so often consequences for the mother and therefore the baby and the rest of the family, if proper nourishment and nurturing is not given to the new mother. Adrenaline-fuelled euphoria after birthing your baby gives way eventually to fatigue then exhaustion and anxiety. We may lose a connection to our intuition, we begin to doubt everything about ourselves and our choices and of course that may then continue to more sever anxiety, isolation and postnatal depression.

Every single one of these countries detailed above, share the knowledge that childbearing does not end when the baby is born. Wow UK, we have a lot to learn. 

You may also like to read: 

My Postnatal Herbal Bath recipe

Shining Light on the Golden Hours

Bouncing back or stepping forward after childbirth

 

Shining light on the Golden Hours

Your baby is born and you meet for the very first time. Her lungs are expanding and she begins taking her first breaths. Blood is still pumping from the placenta into her body, rich with oxygen and nutrients that can be wasted if cut too soon. As you and your baby gaze into each other’s eyes, smell each other and explore around each other’s amazing bodies, maybe the first feed happens. Her mouth meets your breast and the love hormone oxytocin is surging through you both. These magical, raw and beautiful first few minutes make up The Golden Hours.

There is an overwhelming body of evidence to prove that undisturbed skin-to-skin after birth has positive effects for both mother and baby, but sadly a lot of what we do during birth and immediately after does get in the way of the oxytocin-rich environment post-birth. It’s probably obvious to most of us that drugs and instruments and surgical procedures hinder the baby’s natural instincts to latch on for that first feed, but what about the routine procedures, even after a non-medicated birth? Things like:

  • Early cord clamping
  • Separating mother and baby after birth for whatever reason
  • Cleaning and swaddling the baby before presenting to the mother in arms rather than chest
  • Weighing the baby, dressing the baby with nappy, sleep suit and hat (!)
  • Bright lights, staff entering and leaving, photos, beeping machines, phone calls
  • Mother being washed too soon / baby being washed too soon. As mammals we imprint on each other via smell and pheromones- vital for safe and close attachment
  • Mother and baby not kept warm, safe, private, unobserved.

 

What are the benefits of an undisturbed first few hours?

Your baby entering the world, leaving your body after 10 months of closely guarded protection, is a big emotional and physical shift to say the least and instinctively, most women (although not all) will want to scoop their babies up and keep them close. Feeling that skin on skin contact keeps the surges of oxytocin, flooding your every cell. When this happens, just like in childbirth, your uterus contracts and then the placenta can follow more quickly and easily, reducing the risk of postpartum haemorrhage. Meanwhile the Motherbaby dyad are closely connected, already learning a thousand things about each other, smells, sights, sounds. The mother will already begin to recognise the early cues that her baby is giving her to feed – communicating earthside for the first time.

One of the things a Doula can do is to support you to have the optimal experience in your Golden Hours. I’ve spoken to many mothers who say that once their baby was born it was a bit of a blur and they don’t know what happened with the placenta, cord cutting or why baby was taken to be weighed at that particular moment, how a hat got on her head etc etc etc.  A Doula can help to keep Motherbaby together, as a Dyad, preferably, skin-to-skin, uninterrupted and undisturbed for as long as possible. Because we know the benefits, the evidence and we will know that the baby will weigh the same an hour or two after birth as they do the second they emerge, there really is no rush to weigh them!

It’s also common for caregivers to help the mother and baby with the first latch, but in most cases, this is unnecessary. When babies who have not been exposed to medication, are placed skin to skin with their mothers and left undisturbed, they will instinctually crawl to their mother’s breast and attach themselves to the nipple. This is now known as the ‘breast crawl’ and was first observed by Swedish researchers in the 1980s. There are lots of lovely You Tube videos on this if you search 'newborn breast crawl.' Here is one for example

Lots of skin-to-skin with the mother can also help babies born after a medicated birth or a c-section to find their way to the nipple.

 

Visitors

When it comes to feeding, as Doulas we will encourage uninterrupted skin-to-skin with mother until the first feed is completed at least, and then as much as possible for the first week, or even two or three weeks! It’s called the Golden Hours (plural) for a very good reason! I know of a Postnatal Doula who is on the firm-side with her clients. She tucks the mother and baby up together during her postnatal visits and arranges for the second Saturday after the birth to be an Open House for visitors. They are permitted to come if, and only if they bring food for the new mother and father, the baby stays in the mothers arms the entire time and they are gone within two hours! I just love her for this. Now, I’m not sure I will enforce these rules in my postnatal doula support just yet, BUT I respect why she does this and between you and me I sort of wish I had her after my own first birth!

 *It’s important to mention, that Doulas just want you to know your options and of course, this includes being presented with a nice clean baby in a pretty blanket for your first cuddle if that is what you want. It also includes Dad having the first cuddle if that's your choice, or visitors filling your house on day 2 postpartum. It’s my job to give you all the information, all the reading and evidence, all your options, then support your decision whatever that is.

My Top 3 Golden Hours Signposts

 1)    http://www.cochrane.org/CD003519/PREG_early-skin-skin-contact-mothers-and-their-healthy-newborn-infants

 (Some evidence from studies on skin-to-skin.)

Also here's something I wrote on the subject.

  

2)    http://www.kangaroomothercare.com/

Dr Bergman developed and implemented Kangaroo Mothercare (KMC) for premature infants from birth.

 

3) http://www.homebirth.org.uk/ (scroll down to Third Stage)

 

LL x