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Postpartum practices in China – reflections for global health studies

Holly D Mitchell6 March 2019

Written by Georgine Leung, PhD candidate (part-time), Institute for Global Health

Whilst childbirth is a biological event, the experiences of the women throughout pregnancy to the postpartum period are heavily shaped by social and cultural factors. Pregnancy, birthing and postpartum customs are commonly observed in Asia and Africa (and the overseas diaspora) where many women avoid transgressions of these customs for their own health and to promote social harmony. In particular, mothers follow postpartum practices to protect the health of the mother and the newborn baby, and to prevent future ailments.

The postpartum period usually refers to the window of up to six weeks following childbirth. The various practices during this time are a way to demonstrate the women’s transition into motherhood, a process which is imbued with cultural meanings sustained by their immediate social sphere including family elders. Having sufficient empathy towards these considerations are of paramount importance to allow for the management of major health problems including postpartum depression, and facilitates better uptake of maternal health services.

Chinese postpartum rituals, collectively termed as Zuo yuezi (“doing” or “sitting” the month), refer to a set of instructions and proscriptions on women’s food intake, movement and daily hygiene practices for around 30 days following childbirth. These are dated back to ancient China, and were first recorded in medical texts from the Han dynasty (206BC to 220AD). Customs include consuming special tonic foods and drinks, refraining from going outdoors and limiting contact with water during this time. Zuo yuezi is considered to be a set of traditions congruent to the principles of traditional medicine and theory to protect women and prevent them from future ailments.

Accordingly, pregnancy depletes the mother’s internal ‘heat’ and energy through blood loss during childbirth and places the woman in a cold state. The opening of her joints and tendons following pregnancy renders her susceptible to external forces, such as wind and humidity, which may cause ill-health. As a result, dietary and behavioural rules are used to guide the restoration of her body’s harmony. Importantly, this means women are sanctioned to rest whilst childcare and domestic chores are assumed by other members of the family. However, commercialised postpartum care (such as the hiring of postpartum nannies or nurses and staying in postpartum centres) has become increasingly popular. Although this remain largely for the rich and privileged, their implications have not been well studied in the rapidly changing society of Mainland China.

The exact practices of postpartum rituals differ across the regions in China, and the nature of the dietary rules reflect the therapeutic aspects of Chinese food culture. For example in southern China, water infused with roasted rice replaces plain water are drunk for its warming properties, whilst dishes such as pork knuckles cooked in rice vinegar and ginger are consumed for replenishing the women’s energy levels, and fish soup is considered an aid for lactation. These intricate ideas between food and health have been firmly imprinted in Chinese foodways and play an important role to guide women on their recovery throughout the postpartum period.

In the past few years, Chinese postpartum practices have gained media attention around the globe. Often referred to as ‘confinement’, these practices are usually written in a prejudiced way and are depicted as superstitious and disempowering. What these reports fail to cover is the cultural significance of the practices, their place in birthing customs and the ways knowledge in health and nutrition are transmitted across generations. The limited available literature on Zuo yuezi tend to focus on the negative biomedical and health associations of the practice, but do not offer meaningful understandings on the complexities of inter-relational dynamics, especially within the family, and how the practice of Zuo yuezi may be negotiated between the domestic, public and commercial spheres.

My research study situates within the Institute for Global Health and the Thomas Coram Research Unit at UCL. Through qualitative approaches using interviews and ethnography, I will examine the practice of, and discourses in, Zuo yuezi, the construction of authority and knowledge in health and parenting practices, and the possible influences from social media outlets in Mainland China. This project aims to understand how postpartum practices are dynamically fashioned, in order to add value to the scholarship on women’s health in Chinese contemporary society and contribute to global health studies.

Georgine Leung is a UK-based nutritionist who writes about food and health and runs community workshops and food practicals, with a focus on women, families and children. She grew up in Hong Kong and has recently completed an MA in the Anthropology of Food at SOAS, University of London. Read more on her website: www.georgineleung.com or follow Georgine on twitter: @GEORGINECHIKCHI