In Chinese culture, postpartum confinement is a critical period for women after childbirth. It is observed by new mothers for a period of one month following the delivery of a baby in which certain diets and healthcare practices are followed. According to TCM principles, childbirth takes a huge toll on a woman’s vital energy (known as qi) and blood, putting her body in an imbalanced state. Deficiency of both qi and blood disrupt the body’s circulation due to a lack of ‘driving force’ in the vessels, resulting in blood stagnation or stasis. Injuries caused by childbirth (either through c-section, episiotomy or perineal tears during vaginal delivery) also lead to damage to the arteries, resulting in poorer blood circulation. The condition of a postpartum woman is, thus, described as being in the state of ‘multiple deficiencies and stasis’ which is the cause of most postpartum health issues, including fatigue, constipation, poor breast milk production, insomnia, depression, abdominal pain, prolapse, prolonged lochia and headaches.
The purpose of the postpartum confinement practice is to allow the new mother to enjoy sufficient rest and to supply her body with nutritions that restore qi, yin (body fluid) and blood as well as to strengthen various organ functions. At the same time, measures are taken to prevent or protect her body against environmental stressors from wind, cold and dampness, which can aggravate imbalances and lead to further health complications. Drinking warm soup and water, taking a herbal warm bath, wearing comfortable clothing that keeps the body warm and preventing direct fan exposure are some of the measures that can keep environmental stressors at bay while nurturing the body back to balance. In addition to restoring the mother’s body constitution and vitality, postpartum recovery also aims to restore her muscle tone and figure through food, herbs, physical exercise and external therapy. TCM considers 100 days to be the period required to achieve full recovery following birth, termed the ‘big full moon’. Although the confinement period may last only for a month (‘small full moon’), special care and attention should still be paid to the new mother until her body recovers completely.
TCM methods for postpartum recovery
Food therapy and medicinal herbs
In TCM, food is more than just sustenance. Choosing the correct diet not only nourishes the body but can also prevent illnesses or stops diseases from worsening. Food can be classified into five nature – hot, warm, neutral, cool and cold based on the effects it has on a person’s body after consumption. Herbal medicines, in contrast, have stronger effects. They are often used when a desired therapeutic effect cannot be achieved through food alone. Food consumed during the confinement period typically aims at boosting qi and nourishing the yin and blood while promoting the well-being of several organ functions, especially the kidney, liver and spleen. Food that is classified as ‘cold’, such as raw vegetables and certain fruits like pears, watermelon and banana, are to be avoided. Meat that is warm and nourishing, such as chicken, lamb, pig trotter, pig kidney and stomach, are highly recommended. Food that has medicinal values commonly used during confinement are codonopsis root, red dates, ginger, goji berry, ginseng, angelica and rehmannia root. Herbal formulations comprising combinations of herbs are prescribed for treating specific postpartum conditions.
External therapy
In addition to food and herbal medicine, external techniques, such as acupuncture, tuina (massage), moxibustion, guasha and herbal compresses, can help speed up postpartum recovery and assist with pain management. These methods work on the principle that qi is carried throughout our bodies through a network of channels known as meridians. By acting on certain spots along the meridians, known as acupoints, the vital energy system can be controlled to achieve health maintenance and manage a disease.
Different types of external methods provide different kinds and degrees of stimulation. For example, acupuncture uses fine needles to penetrate the top layer of the skin, providing strong and instantaneous stimulation, whereas tuina uses the fingers to press the acupoints, which is much gentler.
In contrast, moxibustion (also known as mother warming) involves burning the leaves of mugwort closely above the acupoint to warm it, providing a moderate but continuous stimulation through heat. The mugwort plant expels the cold, removes dampness and promotes blood circulation which further enhances the therapeutic effects.
Guasha employs a smooth-edged tool that is either made of stone, animal horn, metal or wood to create millet-sized rashes in the skin at the acupoints and along the surface meridians by press-stroking. The aim is to remove the stasis of qi and blood and to promote circulation.
Herbal compresses are applied by pressing a cloth bag filled with steamed or roasted herbs to the skin at selected acupoints. By applying herbs to the external body, their active components can penetrate the skin and be carried to the interior part of the body through the meridian channels to activate healing.
Warm herbal baths are taken during the postpartum confinement period for the purpose of cleansing the body, dispelling wind and promoting blood circulation. Herbal baths are prepared by first boiling herbs in water and then allowing them to cool to room temperature. Following that, the herbs are removed and the herbal water is transferred into a basin containing warm bath water. A confinement nanny or a family member is usually engaged to carry out this task as it involves heavy lifting.
Depending on preferences and accessibility, new mothers can use a combination of internal and external methods to achieve optimal results during postpartum recovery.
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