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A “good birth” goes beyond having a healthy baby

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A “good birth” goes beyond having a healthy baby

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WHO

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A "good birth" goes beyond having a healthy baby

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Today, there is a massive discrepancy in the support provided to women around childbirth. At one end of the spectrum, they are offered too many medical interventions too soon. At the other, they get too little support too late - or none at all.

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How Other Cultures Prevent Postpartum Depression. 

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How Other Cultures Prevent Postpartum Depression. 

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Take it step by step © 2018 DoulaD Here comes another day, I'll take it as it comes © 2018 DoulaD

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Mental health and wellbeing in the postnatal period

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Mental health and wellbeing in the postnatal period

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A community of like minded dads and expectant fathers who are passionate about being the best possible dads for their kids.

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Is ours not a strange culture that focuses so much attention on childbirth-virtually all of it based on anxiety and fear-and so little on the crucial time after birth, when patterns are established that will affect the individual and the family for decades? - Suzanne Arms.

As citizens of an industrialized nation, we often act as if we have nothing to learn from low-income, developing countries. Yet many of these cultures are doing something extraordinarily right-especially in how they care for new mothers. In their classic paper, Stern and Kruckman ( 1983) present an anthropological critique of the literature. They found that in the cultures they studied, postpartum disorders, including the "baby blues," were virtually nonexistent. By contrast, 50% to 85% of new mothers in industrialized nations experience the "baby blues," and 15% to 25% (or more) experience postpartum depression.

Ken Tackett

What makes the difference?
Stern and Kruckman noted that cultures who had a low incidence of postpartum mood disorders all had rituals that provided support and care for new mothers. These cultures, although quite different from each other, all shared

5 protective social structures

Ken Tackett

1. A distinct postpartum period. In these other cultures, the postpartum period is recognized as a time that is distinct from normal life. It is a time when the mother is supposed to recuperate. Her activities are limited and her female relatives take care of her. This type of care was also common in colonial America, when postpartum was referred to as the "lying-in" period. This period functioned as a time of "apprenticeship," when more experienced mothers mentored the new mother.

2. Protective measures reflecting the new mother's vulnerability. During the postpartum period, new mothers are recognized as being especially vulnerable. Ritual bathing, washing of hair, massage, binding of the abdomen, and other types of personal care are prominent in the postpartum rituals of rural Guatemala, Mayan women in the Yucatan, Latina women both in the United States and Mexico. These rituals also mark the postpartum period as distinct from other times in women's lives.

3. Social seclusion and mandated rest. Postpartum is a time for the mother to rest, regain strength, and care for the baby. Related to the concept of vulnerability is the widespread practice of social seclusion for new mothers. For example, in the Punjab, women and their babies are secluded from everyone but female relatives and their midwives for five days. Seclusion is said to promote breastfeeding and it limits a woman's normal activities. In contrast, many American mothers are expected to entertain others-even during their hospital stay. Once they get home, this practice continues as they are often expected to entertain family and friends who come to see the baby.

4. Functional assistance. In order for seclusion and mandated rest to occur, mothers must be relieved of their normal workload. In these cultures, women are provided with someone to take care of older children and perform their household duties. As in the colonial period in the United States, women often return to the homes of their family of origin to ensure that this type of assistance is available.

5. Social recognition of her new role and status. In the cultures Stern and Kruckman studied, there was a great deal of personal attention given to the mother. In China and Nepal, very little attention is paid to the pregnancy; much more attention is focused on the mother after the baby is born. This has been described as "mothering the mother." For example, the status of the new mother is recognized through social rituals and gifts. In Punjabi culture, there is the "stepping-out ceremony," which includes ritual bathing and hair washing performed by the midwife, and a ceremonial meal prepared by a Brahmin. When the mother returns to her husband's family, she returns with many gifts she has been given for herself and the baby. The following is a description of a postpartum ritual performed by the Chagga of Uganda. It differs quite a bit from what mothers in industrialized countries may experience. ￼

Three months after the birth of her child, the Chagga woman's head is shaved and crowned with a bead tiara, she is robed in an ancient skin garment worked with beads, a staff such as the elders carry is put in her hand, and she emerges from her hut for her first public appearance with her baby. Proceeding slowly towards the market, they are greeted with songs such as are sung to warriors returning from battle. She and her baby have survived the weeks of danger. The child is no longer vulnerable, but a baby who has learned what love means, has smiled its first smiles, and is now ready to learn about the bright, loud world outside (Dunham, 1992; p. 148).

What American mothers experience

Ken Tackett

By contrast, American mothers often find that people are more concerned about them before the birth. While a woman is pregnant, people may offer to help her carry things or to open doors or to ask how she is feeling. Friends will give her a baby shower, where she will receive emotional support and gifts for her baby. There are prenatal classes and prenatal checkups, and many people wanting to know about the details of her daily experience.

After she has her baby, however, mother-focused support rapidly declines. Typically, a woman is discharged from the hospital within 24 to 48 hours after a vaginal birth, or 2 to 4 days after a cesarean section. She may or may not have anyone to help her at home-chances are no one at the hospital has even asked. Her mate will probably return to work within the week, and she is left alone to make sure she has enough to eat, to teach herself to breastfeed, and to recuperate from birth. The people who provided attention during her pregnancy are no longer there, and the people who do come around are often more interested in the baby. There is the tacit-and sometimes explicit-understanding that she is not to "bother" her medical caregivers unless there is a medical reason, and she must wait to talk to her physician until her six-week postpartum checkup. There probably are resources in her community that may help, but she has no idea where they are, and feels too overwhelmed to seek them out for herself. So she must fend for herself as best she can.

Ken Tackett

Is it any wonder that many women find the postpartum period to be extremely stressful? One popular book written for new mothers (Eisenberg, et al., 1989) describes this transition as "the reverse Cinderella-the pregnant princess has become the postpartum peasant" with a "wave of the obstetrician's wand" (p. 546).

Here are some comments mothers have shared with me.
I felt like I didn't matter. I felt like they weren't interested in me after I had my baby. My husband said, "Of course they are not interested. You've had your baby." After the birth, I had several people tell me that the most important thing was that I had a healthy baby. Yes, that is important. But what about me? No one pays attention to the fact that you've had major surgery. They would have paid more attention if I'd had had my appendix out.
As a culture, we have woefully neglected the needs of new mothers. But this was not always so. Historically, we recognized the importance of a community of women helping women, who provided this much needed practical and emotional assistance. In so doing, they provided a chance for postpartum women to recuperate and assimilate the major change that had taken place in their lives. Chances are it will be many years before there are organized efforts aimed at providing care for new mothers. The good news is that a grassroots movement has begun that seeks to meet the needs of postpartum women.

In store

The word " doula"-from the Greek word for servant-is becoming part of our vocabulary. A postpartum doula is someone who takes care of postpartum women by providing practical and emotional assistance (Lim, 1995; Webber, 1992). Friends, family or a woman's partner can be doulas. Or women in some communities might be able to hire a professional doula. In either case, the doula movement is in response to the lack of postpartum care available from traditional care providers.

In the following account, doula Salle Webber describes her care for new mothers and the types of support and assistance that they need.
In my work as a doula, my focus is on the mother. I want to provide whatever it is that she needs to feel comfortable, nourished, relaxed, and appreciated: to facilitate a harmonious transition for both mother and child in those profound first days and weeks after birth.
A mother needs someone who cares about how many times the baby woke to nurse in the night, how many diapers were changed, how her breasts are feeling. She may need her back massaged or her sheets changed, or she may need someone to provide an abundant supply of water or tea, salads ready-made in the refrigerator, a bowl of cut-up fruit. She needs to be able to complain about how little her mate understands what she's going through, and perhaps, some gentle reminders of all the contributions he has made. She needs someone to hold the baby so she can take a shower or even go to the bathroom; someone to answer the phone when she's napping; someone to water her plants or garden, to clean the kitchen and bathroom, to keep up on the family's laundry. She may have many questions and concerns that only an experienced mother can understand. She needs patience and kind words and a clean and calm environment (Webber, 1992, p. 17).

While our culture continues to lack supportive postpartum rituals, the work of individual women can make a significant difference. Many are surprised that this decidedly "low-tech" intervention can work. Yet this is perhaps the most important lesson we can learn from the cultures that Stern and Kruckman described.

We must begin to change the way we think about providing care for new mothers. This care should not stop once the baby is born, but should continue throughout the postpartum period.

In conclusion, we have learned that women can make a comfortable and peaceful transition into motherhood. Postpartum mental illness is not inevitable and in many cases can be prevented. It is time that we recognize and meet the needs of postpartum women. The health of our families depends on it.￼￼￼￼￼￼￼￼￼￼

References

Eisenberg, A., Murkoff, H.E., & Hathaway, S.E. (1989). What to Expect the First Year. New York: Workman.

Lim, R. ( 1995). After the Baby's Birth: A woman's way to wellness. Berkeley, CA: Celestial Arts. New edition: ( 2004). After the Baby's Birth: A Complete Guide for Postpartum Women.

Stern, G. & Kruckman, L. ( 1983). Multidisciplinary perspectives on postpartum depression: An anthropological critique. Social Science and Medicine, 17, 1027-1041.

Webber, S. (1992). Supporting the postpartum family. The Doula, 23, 16-17.

Kathleen Kendall-Tackett, PhD, IBCLC, FAPA

Dr. Kendall-Tackett is a health psychologist and International Board Certified Lactation Consultant, and the owner and Editor-in-Chief of Praeclarus Press, a small press specializing in women's health. She is Editor-in-Chief of two peer-reviewed journals: Clinical Lactation and Psychological Trauma. She is Fellow of the American Psychological Association in Health and Trauma Psychology, Past President of the APA Division of Trauma Psychology, and a member of the Board for the Advancement of Psychology in the Public Interest. Dr. Kendall-Tackett specializes in women's-health research including breastfeeding, depression, trauma, and health psychology, and has won many awards for her work including the 2016 Outstanding Service to the Field of Trauma Psychology from the American Psychological Association's Division 56.

Dr. Kendall-Tackett has authored more than 400 articles or chapters, and is currently completing her 35th book, The Phantom of the Opera: A Social History of the World's Most Popular Musical. Her most recent books include: Depression in New Mothers, 3 rd Edition (2016, Routledge UK, in press), Women's Mental Health Across the Lifespan (2016, Routledge US, in press, with Lesia Ruglass), Psychology of Trauma 101 (2015, Springer, with Lesia Ruglass) and The Science of Mother-Infant Sleep (2014, Praeclarus, with Wendy Middlemiss). Her websites are:

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Why Does Our Culture Focus So Much on Childbirth and So Little on The Time After?

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Save Is ours not a strange culture that focuses so much attention on childbirth-virtually all of it based on anxiety and fear-and so little on the crucial time after birth, when patterns are established that will affect the individual and the family for decades?

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What are confinement practices?

Confinement practices are traditional postnatal practices aimed at helping a new mum recover from the rigours of pregnancy, labour and birth. Mum and baby are said to be in confinement because they are effectively "quarantined" at home. Traditionally, they do not receive visitors apart from close family members until the confinement period is over.

In Malaysia, our ethnic Chinese, Malay and Indian communities all have their respective confinement practices. The common thread amongst the practices of the different communities is to support the new mum and help her recover from childbirth as well as regain her physical and emotional strength.

How long is the confinement period?

For a Malaysian-Chinese mum, the confinement period lasts for a whole month from baby's birth. Malay women usually observe a pantang period of 42 to 44 days. For a Malaysian-Indian mum, the confinement period varies between 30 and 40 days.

Some mothers choose to extend their confinement period in certain situations to receive more help and care. For example, you might not have family living close by, or you are taking longer than expected to recover from a caesarean section.

In every community, the confinement period is a time for the new mum to rest and avoid any physical work. During this time, sex is not allowed as the mum is not considered fully healed.

Who will help me during my confinement?

Traditionally, your mother or mother-in-law will take care of you during the confinement period.

Many Chinese mothers who can afford it also hire a confinement nanny or confinement lady, also known as a (Cantonese for "companion for a month"), who will see to your needs as well as your baby's. Read our BabyCenter mum's account of her confinement with a pui yuet.

Similarly, new mums in the Malay and Indian communities can also hire a special helper.

Mums in bigger cities and urban centres may also have the option to check into a confinement centre. These centres usually provide lodgings, confinement meals and have confinement ladies on hand to help. However, fathers are not allowed at some centres. Malay mums may also find it difficult to find a centre serving halal food.

Do I have to observe all confinement taboos and restrictions?

Some mums consider confinement to be old-fashioned and opt to not follow the more restrictive practices. Yet, many do still observe confinement as they welcome the enforced rest built into this tradition. Whatever your options, do what is comfortable and makes sense to you.

Chinese confinement restrictions include:

No washing your hair for the entire confinement period. Some mothers get around this rule by using dry shampoo.

Avoiding exposure to "cool" elements such as cold water. Low temperatures from an air-conditioner or fan must be avoided too.

Bathing only with specially prepared warm water that is infused with herbs.

These prohibitions are said to help ensure that your body retain as much heat as possible. It is believed this will help you avoid health problems such as rheumatism, arthritis, headaches and body pains later in life.
Some Malay practices:

Hiring a traditional masseuse (bidan) to massage the abdomen and bind the tummy with a special postnatal corset (bengkung).

Using hot stones on the abdomen to 'cleanse' the womb (menaikkan rahim).

Read more about Malay pantang.
Indian women may:

Bathe only with a herbal infusion.

Have a daily massage with special oil blends, such as mustard seed oil.

Read more about traditional Indian confinement.

Will I have to go on a special confinement diet?

If yours is a more traditional-minded family, family elders may expect you to observe a special diet during the confinement period. The aim of the diet is to boost your immune system and strength.

Chinese confinement diet
You will be required to eat a variety of dishes that will "warm" the body up. These include ginger and a traditional tonic brewed with herbs. They are believed to promote better blood circulation and strengthen the joints. The Chinese also believe that fish soups can help boost low milk supply. Read more about traditional confinement foods.

It is believed that "cooling" foods such as cold drinks, cucumber, cabbage and pineapple should be avoided. Also, "windy" foods such as onions and jackfruit are off limits as they are believed to cause colic in your baby. Read more about what not to eat during confinement, according to traditional Chinese medicine.

To take the hassle out of cooking these confinement dishes, which can be laborious to prepare, some companies now offer catering services for Chinese confinement foods.

Malay confinement diet
You will be encouraged to eat fresh fish, avoiding dried and salted fishes. It is believed fresh fish, such as snakehead fish ( ikan haruan) will promote healing internally. Certain fishes, such as mackerel ( ikan kembong) and shellfish, prawns and cockles must be avoided as they are believed to cause allergies and itchiness.

Similar to the Chinese, the Malays believe "cooling" elements found in foods such as cucumber, young coconut, water spinach ( kangkung) and sugarcane should be avoided. "Cooling" foods are said to cause rheumatism, arthritis and weak joints in a mother's body.

Indian confinement diet
Certain gourd vegetables such as lauki and tori are believed to increase milk supply. Betel leaves are supposed to help with lactation as well. Here are some recipes for traditional Indian confinement dishes.

To find out more, read these confinement confessions and DIY confinement practices.

Did other mums observe confinement practices? Ask them! Find mums in the same stage as you in our Pregnancy forum today!

Last reviewed: February 2014

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Confinement practices are traditional postnatal practices aimed at helping a new mum recover from the rigours of pregnancy, labour and birth. Mum and baby are said to be in confinement because they are effectively "quarantined" at home. Traditionally, they do not receive visitors apart from close family members until the confinement period is over.

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Every Mom Deserves 40 Days of Rest After Having a Baby - Baby Tips & Advice | mom.me

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Every Mom Deserves 40 Days of Rest After Having a Baby - Baby Tips & Advice | mom.me

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Currently, there are 9,327 books about pregnancy and childbirth on Amazon. That's nearly 10,000 possible resources to guide the expecting woman through the process of growing a baby and bringing that baby out into the world. Whether she's hoping for a home birth or has planned a scheduled cesarean she won't be without information and community.

But what support does a mother have once her baby arrives?

That's the period of time that gets me most excited. For the past six years I've been obsessed with the new mother's experience. I've had three of my own postpartum periods-all different, all illuminating-and have been helping new mothers across Los Angeles by delivering homemade, nutrient-dense foods and drinks right to their doorstep. The soups, stews, and smoothies are inspired by the tenets of Chinese Medicine, each designed to support brand new mothers during this exhausting, draining (exciting! exhilarating!) time.

RELATED: 10 Things No One Tells You About Postpartum Recovery

Often I would leave the food on the mother's doorstep, slipping away quietly so as not to disturb the few moments of slumber she may have found while her little one was napping. But sometimes she would hear my delivery and invite me in. I'd follow her into the kitchen, her arms full of baby, her t-shirt crusted with milk stains, her eyes sunken and dark. I'd warm her a bowl of soup and then offer to rock her baby for a few moments while she ate. Relief would roll through her-for the first time since the baby arrived she was the one being fed - and then she'd tell me what I'd go on to hear from pretty much every new mother I would meet: "I didn't know it would be this hard."

...and then she'd tell me what I'd go on to hear from pretty much every new mother I would meet: "I didn't know it would be this hard."

I understood just how hard it could be. After the births of my two younger children, India and Jude, I barreled my way through postpartum, working non-stop to keep my business going, taking care of my other kids, and running a household. I made no time to integrate the physical and emotional changes that a woman is hit with after birth. I couldn't find a way to slow down and give my focus to recovering from birth and connecting with this brand new member of my family. I ended up run down and depressed.

These challenging postpartum experiences were in stark contrast to how I felt after the birth of my first daughter, Khefri. Soon after she was born, my septuagenarian Auntie Ou took the bus from Oakland and arrived at my Los Angeles home armed with the supplies of zuo yuezi, which means "sitting the month" or "confinement." As she popped a warm hat on my head, unpacked her satchel of unusual ingredients (think: chicken feet and goji berries) and directed me back to bed with my infant, she explained that the month-long regimen of healing foods, focused rest, and seclusion was essential for ensuring an easy recovery from childbirth, abundant breast milk for the baby, and my ongoing reproductive health.

RELATED: I Ate My Placenta and So Should You

Smiling, she pointed to her still-black hair and nearly wrinkle-free face and bragged that the zou yuezi she experienced after she had my cousin Wendy also contributed to her unwavering youthful looks. Who was I to argue? I turned my cell phone to silent, and dedicated my days and nights to sipping my auntie's soups, resting, and feeding tiny Khefri. A few weeks later I felt rejuvenated and strong. I had a good handle on this breastfeeding thing and was ready to venture out into the world as a mother.

Of course, taking 40 days of dedicated rest and recovery is a luxury not every new mother will have. But it is possible to integrate the overarching philosophy of zou yuezi into your postpartum experience. Even if you do nothing more than arrange a system of help for those early weeks with baby, getting a few people to help you do laundry, take your older children to school, or cook a few simple meals (tip: ask for help before baby arrives, when you are still semi-coherent) or if you simply take the time to acknowledge the significance of pregnancy and birth, by sharing your birth story with a trusted friend or asking someone to watch the baby so you can take a soothing hot shower, you are giving yourself a more easeful, gentle, supported transition into motherhood - and every mother deserves that.
Heng Ou is co-author of The First Forty Days: The Essential Art of Nourishing the New Mother (Abrams) available atAmazon. Share this on Facebook?

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Every Mom Deserves 40 Days of Rest After Having a Baby

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Currently, there are 9,327 books about pregnancy and childbirth on Amazon. That's nearly 10,000 possible resources to guide the expecting woman through the process of growing a baby and bringing that baby out into the world. Whether she's hoping for a home birth or has planned a scheduled cesarean she won't be without information and community.

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Postnatal care traditions from around the world

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Postnatal care traditions from around the world

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There's no doubt about it-from maternity leave (or lack thereof) to postpartum care traditions for mother and baby, the United States is seriously lacking. Which is why we've found the book The First Forty Days: The Essential Art of Nourishing the New Mother so inspiring. Rooted in Chinese practices and giving a nod to rich postpartum rituals around the world, this thoughtful tome is filled with healing recipes and guidance on how women can take care of themselves after birth (or recruit others to take care of them). One of our favorite sections of the book is a rundown of other global postpartum care traditions that are thoroughly engrained in culture. Read some of them, excerpted from the book, below. Who knows, maybe some of these time-tested cultural traditions will inspire your own postpartum plans.

China: In its purest form, traditional Chinese zuo yuezi advises a tough-love approach of sponge baths instead of showers (to reduce the chance of catching a chill), no books in case reading strains the eyes, and no movies in case sad scenes upset you and disrupt your flow of chi-while others take over all your household duties, of course. Zuo yuezi is often referred to as "the Gateway," as it is a threshold between one way of being (your life before baby) and an entirely new existence (life with baby). The reward for spending dedicated time in this revitalizing in-between space? The mother can emerge more beautiful and rejuvenated than before. Traditional Chinese medicine (TCM) doctors say that if the woman shirks this recovery, she may experience a yin deficiency, resulting in insomnia, excessive night sweats, hair loss, anxiety, or headaches. Chinese-American families frequently do a bit of zuo yuezi without even realizing it. Many a relative has shown up to visit mom and newborn at the hospital with traditional chicken soup, appalled at the idea of her picking at a limp tuna sandwich from the canteen cooler. (A customary gift of dried longan fruit might come with the soup.) That small warming gesture in itself is tradition in action.

Zambia: In Zambia, the mom is strictly banned from any work around the house until the umbilical cord falls off. (A whopping week to ten days usually-and then it may be back to doing the dishes as normal).

Latin America: In many parts of Latin America, a forty-day period known as la cuarentena -it literally means "quarantine" yet also plays off the Spanish word for "forty," cuarenta-has female relatives take on all domestic duties to ensure the new mother rests at home, in order to safeguard against future exhaustion-related illnesses or ailments. Her midwife may visit frequently over the first two weeks to check on baby and mother's well-being, and homemade chicken soup simmers on the stove (overly spicy or heavy dishes are nixed). The new mother's abdomen is wrapped in a faja or cloth to help keep her belly warm.

Japan: Japanese mothers return to their mothers' houses for a month or two of focused care and traditional food.

Native Americans: In many Native American tribes, ceremony is key: The customary "lying in" period after birth culminates in ritualistic bathing, a baby-naming ceremony, and going to a sweat lodge to boost circulation and help mom's body eliminate any toxins. The Hopi people in the southwestern United States recall practices of twenty-day seclusion periods for mother and babe, during which the mother might be served blue corn piki bread, a ceremonial food. Prepared in an hours-long process by a wise elder woman of the community, the flaky, thin-as-air bread was served to honor rites of passage.

India: In India, the new mother often returns to her parents' home with her newborn for up to three months of focused care. There, many pairs of hands are on call throughout the day. The women of the family cook soft and nurturing foods, boil fresh milk three times in a row to break down its proteins, and stir in melted ghee (clarified butter) and special spices, so it becomes easy to digest and restores the mother's depleted state. These loving hands also hold the baby whenever mom needs a break. If members of the new mother's family are versed in Ayurveda-the five-thousand-year-old healing art of India-she may drink herbal tonics for energy, immunity, and lactation and receive daily, warm-oil massages from a specially trained technician to soothe her nerves by calming the excess vata or "wind" in her system after birth. She even gets taught how to gently massage her little one's body as well-a relaxing and bonding experience for both parties.

The Middle East: Forty-day rest periods for the new mother are traditional in Jordan, Lebanon, Egypt, and Palestine.

Korea: Korea's postpartum tradition of samchilil decrees a period of at least twenty-one days, and ideally thirty days, of specialized maternal care dedicated to keeping mom warm, snug, and well fed. Miyeokguk, a traditional seaweed soup with beef, chicken, or anchovies, is served several times a day, every day, to boost circulation, restore lost nutrients, and enrich breast milk. Gums are tender so icy foods are banned to avoid dental problems later. At one hundred days, the baby is introduced to the wider family for the first time with a baek-il ceremony-a kind of fourth-trimester graduation party! This also ends the close-up focus on mom care-she's ready to graduate, too.

Vietnam: Vietnamese parents don't introduce strangers to their babies for six weeks, to protect them from envy or, simply, too much attention.

Ivory Coast: Female relatives descend on the new mother's home in the Ivory Coast right after birth. The mother is bathed and massaged in shea butter by her own mother-a pampering rite that saturates skin with healing oils-while her grandmother and grandaunts gently bathe and dress the baby. Younger cousins and aunts cook a delicious meal, and after eating all together, the circle lets the new mother nap, with baby safe in their sights.

Indonesia: In Indonesia, a bright light burns in the new mother's home for forty days after birth to honor the new life that has arrived. The midwife visits daily to massage mom; bathe her in therapeutic baths; feed her jamu, a special nourishing concoction of egg yolks, palm sugar, tamarind, and healing herbs; and wrap her belly to support her uterine healing while also checking in on baby. For forty days, the placenta is preserved and kept near the mother before being ceremonially buried. It is believed that the placenta still holds protective spiritual power that can safeguard the new mother from infection or illness.

Moldova: The Eastern European country of Moldova has a special chicken soup to encourage breast milk production.

Malaysia: In Malaysia's pantang protocol, the mother secludes herself for forty-four days and receives hot stone massages, full-body exfoliation, herbal baths, and hot compresses to care for the life force that is sourced in her womb. Her mother or mother-in-law may oversee this, or an experienced live-in helper might guide her through this process. And it doesn't stop there. Ask women of different ethnicities and backgrounds about their maternal customs and the stories keep coming. What does it take to help the expanded winter melon-sized uterus return to its normal pear-like size? The dramatic changes in the body of a new mother have to be nurtured slowly back to its prenatal form. If the new mother does not take care during this time, the roots of various ailments will establish themselves and lie dormant in her body, surfacing in her middle age. Thus, a new mother should not be annoyed when her mother-in-law keeps advising her to eat more digestive food, drink more nutritional tonics and soups, and keep away from specific foods. Proper postnatal care, rest, and diet will rebuild a
more mature, yet beautiful, body for the new mother.

Shanghai & Hong Kong: At the far other end of the scale, in Shanghai and Hong Kong, high-luxury "confinement hotels" offer upwardly mobile women a red-carpet way to experience zuo yuezi-call it five-star confinement-and conveniently lets them sidestep the drama of having mother-in-law take up camp in their home for a month. Sumptuously bathrobed in her plush hotel room, the new mom is served medicinal soups from gourmet chefs and can visit an on-site spa as often as she likes, while uniformed nannies handle baby's every need, taking him out for sun baths daily and dipping him in warm pools to tone his muscles. It may be the antithesis of attachment parenting-and it certainly is a status symbol for the parents-but it hits the spot for busy women of means: Every moment of the month is devoted to optimal health for the newborn, and optimal rest and pampering for mom.

Europe and North America: In the past, special pui-yuet or confinement companions might have been hired by Chinese households to help run the month of care. Modern-day variations of this are emerging, putting traditional programs of postpartum care in reach of women wanting to experience the old ways: In Europe and North America, an emerging field of practitioners known as Ayurdoulas, postpartum doulas trained in Ayurvedic care, can be hired to visit the home over several weeks, bringing food, giving massages, and helping mom learn about baby care. In Canadian cities like Toronto and Vancouver, zuo yuezi -trained doulas do a bustling trade visiting homes in Chinese communities, and highly traditional cooking services can bring breast milk-enriching fish and papaya soup to your door. In New York and other U.S. cities, there are even humble Mandarin- or Cantonese-speaking guesthouses where first-generation immigrants who have no relatives nearby can "sit the month" in the old ways with a clutch of other mothers.

Reprinted with permission of the authors of The First Forty Days: The Essential Art of Nourishing the New Mother.
Related Article: An Arugument For Taking The First 40 Days Slow Postpartum.

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There's no doubt about it-from maternity leave (or lack thereof) to postpartum care traditions for mother and baby, the United States is seriously lacking. Which is why we've found the book The First Forty Days: The Essential Art of Nourishing the New Mother so inspiring.