Postpartum Recovery and Traditional Forms of Medicine
Traditional Chinese medicine is an ancient system of medicine that has been practiced, studied, and documented in Chinese classical literature. The Traditional Chinese Medicine system is based upon the principle of human beings being deeply connected to their natural environment and to the earth, and that any imbalance in this relationship and environment eventually leads to disease. Traditional Chinese Medicine takes into account the theory of opposites balancing each other. These opposites are known as the Yin and the Yang; the feminine and the masculine; the moon and the sun; the dark and the light. They are complementary yet opposing forces that exist everywhere in the universe.
In this article I want to look at postpartum healing and nutrition from the viewpoint of Traditional Chinese Medicine (TCM). Through weaving ancient forms of medicine with the science and knowledge of our modern world we find a wholesome approach to postpartum healing and recovery, including the best of both worlds.
THE FOURTH TRIMESTER
Giving birth can be a beautiful, scary, intense, ecstatic, and transformative experience. From the viewpoint of Traditional Chinese Medicine, giving birth is the only naturally occurring event in a woman’s life where she loses such high amounts of Qi*, blood, and energy; and especially yang energy. Therefore, in the time after birth, she needs to replenish this energy in order to fully recover her strength and vitality. The process of giving birth is a ‘yang’ dominated experience; there is usually a lot of expression, noise, emotion, and energy as we give birth to our children. According to TCM, the opening that happens during birth allows a rush of coldness to enter into the body, which caused the mother to be deficient in her yin energy. Therefore, after this extreme yang, there is a period of time in which yin needs to flow into the woman’s body in order to maintain balance. This period is traditionally the first forty days after birth, sometimes longer, and can be referred to as the fourth trimester.
According to both TCM and Ayurveda, the fourth trimester is a period where rest, seclusion, and proper nourishment is highly advised in order to replenish the mother’s Qi. Traditional medicine teaches that this time has a sacredness to it, as it holds the key to the woman’s health and wellbeing moving forward, and also because it is when she truly gets to connect with her baby. The emphasis in TCM during this time is very much on the mother’s recovery, unlike in the west where attention is mostly on the newborn.
REPLENISHING THE YIN ENERGIES
Traditionally, the time after birth has been encouraged to be spent at home, where the mum should avoid anything that fuels the yang energy in her body, such as too much movement, any and all exercise, cold food, cold weather, cold showers, and exposure to wind or draft, to name a few. This time is partial to protect the new baby, and give him or her a gentle transition into the world. However, it is just as much considered an essential time for the mother to heal; a time for the new mother to be ”mothered”. We believe that if the mother is cared for well for in the time after birth, it will ensure her good health for the future. In Ayurvedic medicine, it is taught to take forty days off to rest, to ensure good health for the next forty years. On the other side, inadequate time to rest and heal after birth can lead to new health problems in the future.
When replenishing the yin energy in the mother, we must remember that this energy must come in a high-quality form; not too cold, not too isolated, not too empty. Even in the yin- rebalancing period, there is a need for a balance of yin and yang. The first organ that needs attention during the postpartum period of recovery is the spleen and stomach. In TCM, it is this system, the digestion, that is in charge of transforming food into Qi. A well functioning digestive system helps ensure that the body benefits from the nutrition in the food we consume. However, if the digestive system is out of balance and isn't working optimally, our bodies won’t be able to soak up the nutrients in our food, leading to potential nutritional deficiencies, or manifesting in symptoms such as low energy, tiredness, light-headedness, brain fog or nausea. On the other side, if the digestion is working well, and the spleen and stomach Qi is strong, we feel energetic and clear-headed, have more robust immune systems, better stamina, and are less prone to disease.
ZUO YUEZI OR ‘DOING THE MONTH’ OR ‘THE FOURTH TRIMESTER’
Traditional Chinese Medicine teaches the value of zuo yue zi (坐⽉月⼦子), translated as ‘sitting the month’. This time is actually the forty-day period of deep rest and recovery time mentioned earlier. Traced back to as early as the year 960, zuo yue zi is a set of diet and lifestyle recommendations practiced after birth to restore a woman’s postpartum body. Across China and in many Asian countries, this is still a common practice. There are regional deviations, but the essence remains very much the same; after giving birth, mom stays at home with her newborn; resting for at least forty days. Traditionally, the mother’s mum, her mother in law, or another female relative would take care of her and her baby by bringing food and paying daily visits. Parents living further away or overseas often fly in and live with the mother for at least a month, and often longer. The mother is fed meals especially prepared for her, whilst remaining in bed resting and allowing her body the time it needs to heal.
Unfortunately, the approach to postpartum in the west has strayed far from our original tradition and traditional medicine. There is little honoring of the enormous amount of energy it takes to create and birth a baby, not to mention the energy it takes to feed and care for the little one after he or she has been born. Instead, we praise women who ‘bounce back’ to their pre-pregnancy lifestyle and body as quickly as possible. We expect women to «recover» and function as she did before birth within a few weeks, with very little acknowledgment of how this might impact their physical and emotional health and wellbeing in the longer run. This is now showing up in the west with increased rates of postpartum depression, postpartum depletion, postpartum mood disorders, decreased rates of mothers choosing to breastfeed, and in many other ways we may not yet understand is linked to pregnancy and postpartum.
«Oh, how far we’ve strayed from that old wisdom! Somehow, a pervasive idea has spread in modern times that the mom who is out and about soonest with her baby is somehow the strongest, like an episode of ‘Survivor’. For some type-A parents, it’s almost like a badge of honor to say you made it to yoga after two weeks, snuck of the office for a meeting, or flew with your infant across time zones. But that’s all upside down- in a healthy postpartum period, it’s she who stays still that wins the prize.» - Heng Ou
When it comes to food and diet, there are a few basic principles mum should follow in order to replenish her yin energy. Warm, cooked and soft foods are recommended, and anything cold, frozen, refrigerated or raw is generally avoided. Warmth in all its forms are encouraged, not just through food and diet, but through love, laughter, happiness, companionship and connection. Many traditions around the world encourages warmth and heat during pregnancy and postpartum, and have rituals where the mother is gently steamed, rubbed, massaged and brought into balance.
Food to include after giving birth are typical yang foods;
• foods that are high in fat, protein, calories, and sodium.
• root vegetables and mushrooms
• warm spices, such as cinnamon, nutmeg, and ginger.
• eggs, glutinous rice, sesame oil
• Soups, broths, stews, kitchari and gongee, and hearty dishes
• Herbal teas, hot milks, chai etc. Warm and milky drinks are especially calming and soothing for the nervous system, and liquids are important to keep mums body healthy, hydrated and nourishes mum’s breast milk.
*Traditional Chinese Medicine is a system in which the practitioners use herbal medicines and mind-body practices, such as acupuncture and Tai Chi, both to treat health ailments and enhance wellbeing. In TCM, we are introduced to Meridians as channels that direct the flow of Qi. Qi (also known as Chi, Ki, Prana, or Life Force) is directly translated as ‘air breath’, and is the subtle yet very powerful energy that informs nature. It is the pulsation of the yin and the yang, the meeting of the feminine and the masculine energies, and the ebb and flow of the universe. The state of our Qi directly impacts our physical and mental health.
The meridians are an interconnected network of channels that comes together as a complete energetic circuit. Each of the meridians is associated with a different internal organ, and the health of each organ is affected by the way Qi flows through in that specific area. Like the ways our physical and emotional health are interconnected, the health of our organs has a direct impact on our mental and emotional health.