Asian women have long practiced the traditional confinement method after childbirth. The confinement practice, depending on your heritage, may vary. Being a Malay woman in multi-cultural Malaysia, I managed to try out the different customs when I had my three children. The gist of it is somewhat similar. For 40 days moms will stay at home, eat healthy foods- soups mostly, spa-like sessions daily, and will be given a pass on daily duties of cooking, cleaning, and laundry.

Sounds magical, doesn’t it? But why is this tradition being practiced less and less with every generation? More women are forgoing it, where studies have shown a decline in the practice since the early 2000s. There are also allegations that postpartum depression is tied to the practice of confinement.  What was traditionally practiced without question, seems to be losing its appeal amongst urbanites in Malaysia.

Confined Moms

Perhaps, when you break it down and have a closer look at the rituals, it seems rather restrictive to a modern woman. Well, the term confinement sounds barbaric as it is and reminds you of being in prison!

The idea of being confined at home for 40 days can be daunting, a lot of people had trouble being home during the covid lockdown for two weeks! The so-called healthy foods, not only are they unappetising (salt content are reduced during the period) but come with all sorts of rules and restrictions. And don’t get me started with the herbal drinks and paste!

The concept of hot and cold, where cold is to be avoided like the plague- this goes for food as well as temperature for your surroundings. So, no ice creams or cold water, and moms have to be snuggled up in socks and sweatshirts. One can only imagine what discomfort that can be when you’re living in the sweltering heat of Malaysia.

During the confinement period, it is customary for a female relative to come and stay with you and help out with the household chores. The female relative may be your mother or mother-in-law. This comes with its own sets of challenges as it is. Too many cooks in the kitchen, the conflict will inevitably follow.

The loss of privacy and feeling undermined seems to be the theme that mums struggled with. Having your elder hovering over everything you do during this period can be stressful. Even though you know that they have good intentions but during this period, mums just need the space and please, spare us the lectures! Women have reported experiencing emotional disturbance and depression from being in such a situation during this period.

With all the do’s and don’ts constantly being thrown in your face and your hormones going wild, It’s enough to get a new mum’s head spinning!

Burden of tradition

So why do some women still participate in these practices? It seems that in order to partake in this, one must abide by ALL the rules. It is all or nothing.

Some may agree to perform the confinement only to appease their elders rather than believing in the methods. Going against the elders can be seen as a level of disrespect in the Asian culture. And not to mention with the lack of support from their husbands, going against the in-laws can be an isolated and lonely road.

Refusing to practice the tradition would also mean that they would forfeit the support and help that comes with it. Forgo having someone to help out around the house,  to help you figure out how to look after your newborn which leads to forgoing the opportunity to catch up on some much-needed sleep and recover!

Now, all is not lost. Two words, confinement lady! Around-the-clock help with the baby that will also cook your meals and look after the mother with none of the guilt and headaches that come with having your family member looking after you!

However, it comes at a price. The going rate per month ranges between RM 7,000 to RM 8,000 and that doesn’t include your postnatal massages package (which is around RM 3,000). With the average income in Malaysia, as of 2019 being RM 3,200 per month, unfortunately, a confinement lady is a luxury not everyone can afford in Malaysia.

Abandon ship?

Based on all this, I guess it makes sense to get rid of the tradition completely! However, looking at it from another angle, there is some sense to this ‘madness’.

Let’s first look at what a woman would go through post-birth. Depending on the level of birth difficulty, safe to say that either way you go it always involves being in pain for a number of hours. And in the case of cesarean birth, you’re basically been cut open to have the child taken out of you!

Women will then experience lochia; bleeding from their vagina that will continue on for the next 4-6 weeks. And as the uterus contracts to its original size, women may also experience after-birth pains. This pain can be similar to the contractions they experience when in labor, and occurs while mums are breastfeeding as well. A tear in the perineum and vaginal wall area during birth may also occur. The perineum may be swollen or in some cases was stitched up from the tear. Movements will be slow or restricted in this case and daily salt baths are required to ensure the area is not infected.

On top of the physical challenges, studies have shown that 80 percent of women experienced post baby blues in the first 2 weeks. This is brought on by the sudden change in hormones after delivery, combined with stress, fatigue, and a sense of isolation. Being tearful, emotionally fragile, and feeling overwhelmed is the common theme for post baby blues. Extra care needs to be taken to ensure it doesn’t develop into postpartum depression.

Compared to a western postpartum period where the focus is on infant care, the fundamental concept of a traditional confinement practice first and foremost is the wellbeing of the mother. Female elders or relatives rally around the new mother to provide support and care in order to restore her health. Having adequate rest, support and nutrition are definitely what a new mother desperately needs!

Birth can take the wind out of any woman and studies have shown that the first few weeks of rest is crucial for mums to regain their strength and recover. Nobody can argue the beneficial aspect of not having to worry about household chores or looking after other children in the family during this time.

For first-time mothers, not knowing what to do with their newborn can be daunting! Having someone around to show you how to care for your newborn can definitely help alleviate your anxiety and not to mention it’s probably safer for the baby. Having an overtired, sleep-deprived new mum looking after a newborn may not be wise.

Studies have also shown that consuming nutritious and clean food is important for a woman’s recovery (no matter how unpalatable it may be). The herbs that are used across all customs such as turmeric, ginger, red dates, and galangal, despite being snubbed as old wives’ tale by some before, now has scientific backing showing its therapeutic benefits.

So, where does this leave us? Some say that the pros outweigh the cons, so families who can’t afford a confinement lady, will just have to take what they can get and deal with the consequences later on.

In need of help

I guess it’s time to realise what postpartum care should be about and not which custom is best to practice. It should first and foremost be about looking after the mother’s mental health. The carer of a postpartum woman will need to understand this in order to facilitate the recovery. It is not about carrying on tradition or family practices from one generation to another. A mother has enough burden to bear as it is.

Unfortunately, mums are rarely the center of attention once the baby arrives. The psychological state of the woman is often overlooked. When was the last time you remember asking a new mum, how are you doing? How are you coping? Mostly the question centers around the baby. Is the baby sleeping well? Is the baby feeding well? Is the baby pooping well?!

The root of the problem is not the content of the practice but the psychological angle of it. Elders that are acting as a support system, unfortunately, with the wrong approach and attitude can be the catalyst on why a mother suffers during the postpartum period.

 

Women who had very little to no faith in the tradition will struggle indefinitely. And while going through the baby blues period, being put in a position against your will, no matter what the practice is, can only make things go from bad to worse in no time!

On the other hand, a new mum that is left to her own accord, without help to manage the first few weeks post birth will also suffer. Sleep deprived, alone, and anxious- It seems like it’s either “sink or swim” for them. Damn if you do (confinement practice) damn if you don’t!

Moving forward

To answer the question of whether traditional confinement practice does more harm than good to postpartum women, I would say that it is not the practice that can impose harm but rather the support network that is unaware of its responsibility and role. Looking at the fundamentals of the practice, clearly, it was carved with the woman’s best interest at heart.

What should be normalised in society now is for women to have a postpartum care plan. Managing their expectations by mentally preparing them on what to expect during the postpartum period will allow them to feel in control and give them confidence.

So what can be said to expecting mothers when they asked if they should go for it or not?

Looking at the big picture, traditional confinement practice definitely has its benefits. Tailoring it to your own comfort zone will do wonders for you, where you can pick and choose what works for you within the practice. You just need to find the courage and stand your ground!

Trusting your instincts will be my first advice. If your instinct tells you it’s not for you then I would listen. From my personal experience, my postpartum depression stems from guilt and disappointment in myself for not setting boundaries and saying no to people when I should have. However, if I were to do it all over again I would still opt for the confinement practice. Tailoring it to my preference and style, of course.

But whichever way you choose, one thing that I would insist on is that postpartum care for mum is vital. What our body goes through during childbirth, recovery should be taken seriously to ensure our physical and mental health is looked after.

If you are lucky enough to find female elders to offer you the support you need without driving you mad and adding further stress to you, then traditional confinement may do wonders for you. If not, then look to your partner. they should definitely be your source of support at this time. This moment should be a joyous occasion for every mother, not a struggle for survival! Empathy goes a long way fellas, and if it’s either ‘sink or swim’ for the postpartum women then maybe for the partner is either help out or start saving up for a confinement lady!