Asian Post-natal Practice of the Confinement Month

What is the Confinement Month?

The confinement month is an Asian practice whereby new Mums are confined to the home for a period of one month after the delivery of their babies. This period is for the new mother to recover from the ordeal of childbirth and to help her restore her body after 9 months of nourishing her infant in her womb. She is cared for by a confinement lady (also called a "pui-yuet") who will cook, clean and help her look after the baby.

The Logic Behind the Confinement Practice

There is a Chinese belief that everything in life requires balance between the Yin and the Yang in order for harmony to exist. If an imbalance occurs, then ill will befall the individual. Illnesses are also considered to be the result of an imbalance of the Yin and Yang within the body. Although pregnancy is not an illness, it is believed to create an imbalance within the body that must be corrected post-natally or the mother will suffer the consequences in her later life.

The following is an explanation of Chinese concept of Yin and Yang, from "Asian Mothers Western Birth 2ed: Pregnancy, Childbirth and Childrearing : the Asian Experience in... By Pranee Liamputtong Rice"

According to the theory, health is the outcome of humoral equilibrium; illness due to an imbalance of either hot of cold humours in the body, and to a lesser degree, to imbalances of "wet" and "dry" humours and to "wind" or air. The diagnosis of an illness identifies the imbalance of hot or cold and treatment involves steps to correct this - hence a hot illness (such as measles) is treated with foods that are regarded as cold (including many fruits and vegetables), whilst a cold illness (respiratory infections are frequently so classified) is treated with hot foods and drinks, which are often high in energy and/or fats or sugars (depending on the area, these may include chicken, ginger, black pepper and coffee). Medication may also be classified as hot or cold, as determined by the imputed effect of the food or medicine on the body.

Physiological events such as pregnancy and parturition also disrupt humoural balance, and require careful dietary and other behavioural precautions to maintain good health during that period and to prevent later illness. The body is said to be "hot" in pregnancy, although in some cases the first trimester is regarded as "cold" (Manderson and Mathews, 1985), and the humoral balances change as the pregnancy progresses.

Although the body is hot during pregnancy, the subsequent delivery of the baby causes the body to lose its heat, therefore a post-natal mother needs to be protected from the cold in her confinement month. She is given "hot" foods, like ginger and wine, to replace the body's heat. Practices such as wearing socks and house slippers, longs and not bathing are all attempts to prevent the body from losing extra heat. The irony, I discovered, was that I was always sweating after my delivery so I couldn't understand how anyone could fear that I might get cold.

Another article about confinement practices on Urban Baby called "'Doing the month': Ancient tradition meets modern motherhood - by Anne Williams" provides some great insight behind some of the reasons for certain confinement practices. Here is an excerpt:

Where did confinement come from, and how do mothers safely honour a tradition whose basis was formed long before modern medicine?

Zuo Yuezi

The Chinese tradition of Zuo Yuezi (Cho Yuet in Cantonese) dictates that for 40 days from the birth of their children, mothers must stay inside and avoid bathing, washing their hair or brushing their teeth. They must cover their heads to prevent chills, keep the windows closed, and remain in bed for as long as possible.

Zuo Yuezi - which loosely translates into doing the month - also requires mothers to avoid all forms of stress, including crying, shouting and talking for an entire cycle of the moon. While ‘doing the month,' mothers can't eat ‘cold' foods such as cool drinks, ice cream, fruits or vegetables. Instead, they must load up on ‘hot' foods like boiled eggs and chicken and fish soup. Along with the tradition is a famous Chinese postpartum ‘decoction' known as Shenghua Tang - an herbal cleansing and purifying remedy.

Origins in Chinese Medicine Medical writings about Zuo Yuezi can be traced to the Qing Dynasty (1644 - 1911). According to Yi-Li Wu, associate professor of history at Albion College in Michigan, early Chinese medical writings described conditions such as eclampsia, maternal tetanus and other postpartum diseases that are still deadly today if left untreated.

Essentially, ‘doing the month' was a primitive form of quarantine to prevent postpartum complications. If you analyze Zuo Yuezi in an early medical context, many of the practices made sense. The avoidance of bathing and teeth-brushing was a way to prevent water-borne illness; staying indoors helped women and babies avoid exposure to communicable diseases, and covering the head protected new mothers from catching a ‘chill'.

Food-wise, the proteins and iron found in eggs, meat and fish provided mothers with strength and muscle repair. Rest and heavy consumption of hot soup helped prevent dehydration, kept moms warm and was believed to promote the production of breast milk. Most importantly, the legendary herbal decoction of Shenghua Tang was thought to purify the female body and help slow vaginal bleeding.

The Power of Superstition

‘Doing the month' wasn't only a product of Chinese medicine. Without scientific explanations for the phenomena of the times, many ancient cultures developed devout beliefs in the supernatural.

For example, some of the fear of leaving home in the first month after birth had to do with evil spirits seeking to steal babies. More common was the belief that spirits and pregnant women were out to steal breast milk. Out of these superstitions came the avoidance of expectant mothers and strangers during Zuo Yuezi.

Baby snatchers were the reason that the Chinese did not give first-born children their official names until ‘doing the month' was over. Instead, a newborn was given a little name or nickname to trick the evil spirits. Many parents continued to use the nickname throughout their children's lives.

Zuo Yuezi Today

Whether or not you believe in Chinese medicine or superstitions surrounding ‘doing the month,' there is no doubt that belief plays a significant role in one's feeling of health and well-being.

Clearly a lot of these reasons behind the confinement are now obsolete since we don't have to fear contaminated water supplies, nor would we be concerned about catching a "chill", especially if you live in a tropical country. Although I think that the fallacy that you can catch a "chill" from cold weather should be acknowledged.

In this current day, the advantage of having a confinement lady is the R&R afforded to the new mother since the confinement lady is responsible for taking care of the household matters. Instead of worrying about cooking, cleaning and looking after the baby, she can put her feet up and be pampered while her stitches heal.

The Confinement Pratice

After pregnancy, the mother's uterus has expanded from the size of a pear to the size of a large winter melon. The main function of the confinement period, therefore, is to nurture the new mother's body back to its prenatal form. The belief is that if the mother does not take care during this time, she will be predisposing herself to ailments that will surface later on in life.

Historically, it has always been the duty of the mother-in-law (MIL) to take care of the new mother. Part of the reason a MIL would be keen for her daughter-in-law (DIL) to recover quickly was so that she could conceive again and possibly add another name to the ancestral line. There is also a traditional belief that new mothers were not allowed to come into contact with their own parents because of the "stale blood" and "evil wind" inside their bodies which would bring bad luck to her family. I found this rather ironic because if that were the case, then wouldn't she also bring bad luck to her in laws?

In some instances, families will employ a "pui-yuet" (meaning companion for a month) or confinement lady to look after the new mother and baby. Pui-yuets are usually middle-aged women who have a great deal of knowledge on postnatal matters through her own experiences.

There are a number of strict confinement rules that are supposed to be adhered to by the new mother. I have noticed a lot of variations in these rules in the current day, but some common ones include: not being allowed to wash your hair during the confinement period and having to take sponge baths, and not being allowed to read or watch television because it would strain your eyes. A strict diet was enforced to help you remove the "stale blood" and "wind" from your system. You have to endure body binding and must rest as and when the pui-yuet commanded. You and your husband are also banned from having sex for 100 days after birth. There are a lot more rules, and these merely scratch the surface.

For more details on confinement practices, there's a good article from Nursing Center: "Postpartum Beliefs and Practices Among Non-Western Cultures". Unfortunately there is no explanation between the good and the bad of each practice.

Getting the Most Out of the Confinement Month

The confinement month is a very old practice that dates back a long way. As such, experienced confinement ladies are also very traditional in their practices and beliefs. Before engaging a confinement lady to help out, you should be aware that there are certain unspoken rules and expectations. Being aware of these rules will help you get the best out of your confinement month and maintain peace within the household.

  • A pui-yuet is only responsible for the mother and baby. Any work outside of those responsibilities are not part of her duty. That means, she isn't required to do any housework except wash the clothes that belong to the mother and baby, and the dishes that were used by the mother and baby. That also means she doesn't have to cook for the father, wash his clothes or anything else that belongs to the father. Some pui-yuets will do housework if you are willing to pay them extra. If you get a pui-yuet who is willing to take care of household matters without extra charge, count yourself lucky!
  • A pui-yuet's responsibilities does not include her own meals. Some pui yuets will overlook this point but the more picky ones will expect their meals to be provided for them. Some picky ones will also expect more money if they are required to cook for themselves.
  • A pui-yuet is employed for 28 days. It commences on the day the baby is born and ends on the day of the baby's full moon. Even if mother and baby are still at the hospital and cannot be discharged, the one month count-down has begun and the pui-yuet's time is ticking. So if you're stuck in the hospital for a week, you will only have a pui-yuet for three weeks (unless you get her to help out in the hospital).
  • A pui-yuet that is hired for a month that includes Chinese New Year has to be paid double. It is like working through Christmas or New Year's. An additional red packet is also given for Chinese New Year itself.
  • At the end of the month, a red packet is given to the pui-yuet as a token of appreciation for her efforts (this is additional to the amount agreed upon for her services for the month). There is no stipulated amount - it works a little like a tip. The happier you are with her services the more you can put inside the red packet - usually $100 - $200. Unlike a tip, you still have to give her something even if you think her services are poor, you just give her less. I think a red packet containing $1 shouts volumes about what you thought of her services. The purpose of this red packet is to balance the services rendered. Even though you are paying the pui-yuet for the month, her help is still considered a favour to you and this red packet is intended to return the favour and level your dues.
  • According to the traditional hierarchy, the pui-yuet is only answerable to the MIL. This goes even if the person paying for the pui-yuet happens to be you or your hubby. It also applies to your mother. Pui-yuets are not required to listen to your mother because she is answerable only to your MIL. This is because of the old tradition where a daughter marries into a new family and is no longer considered part of her birth family, therefore, her mother has no authority over the pui-yuet. It was quite amusing to observe that when my MIL was standing watch over my pui-yuet as she changed my son's diaper, her normally calm and experienced manner with which she handled him was suddenly all thumbs. That spoke volumes about who the real person in charge was.
  • For whatever reason, if you discharge the pui-yuet early, she still has to be paid the full amount agreed upon unless it was a mutual agreement to part ways before the end of the month.

There are also a few additional points that a new mother ought to be aware of when she looks for a pui-yuet which have nothing to do with tradition. From my understanding, most pui-yuets are generally not in favour of breastfeeding so it is best to be clear on your desire to breastfeed during your preliminary discussions. Please do not end up like a friend of mine who lamented to me that the result of her inability to breastfeed was due to her pui-yuet who sabotaged her efforts.

It is speculated that pui-yuets do not encourage breastfeeding because of the increased night duty involved. Breastfed babies are thought to require more nighttime responsibilities such as frequent stirrings for night feeds and diaper changes. Don't quote me on this - it is just a theory.

Pui-yuets also have their own way of doing things so if you have a specific way you want your baby to be bathed or handled, it is best to get this cleared up front to avoid battles during the month when you will be in no condition to argue your point. It is unfortunate but pui-yuets tend to bully the new mother if there are any disagreements on how the baby should be handled. This is a time when a stern talk from your MIL will come in handy.

The best way to avoid an unpleasantness is to discuss everything and outline your expectations before agreeing to sign on the pui-yuet. Hash out any potential problems you can anticipate before the actual month takes place. If your mother or MIL is engaging the pui-yuet on your behalf, make sure you meet her before hand because you are the one who has to live with her. One month is a long time to be with someone you don't get along with.

In addition to managing your pui-yuet, it would also be wise to get clued-in on the sort of foods that will be prepared for you. Some of the recommended confinement foods are cooked with herbs which may be contraindicated in mothers who are breastfeeding. For more information on this topic, there is a good article on Breastfeeding.com, on the consumption of certain herbs and their effects on breastfeeding, although the list is not a comprehensive one. Whilst it is okay to consume some herbs in small quantities, certain herbs are not advised for breastfeeding mothers. It is advisable to be aware of what you are consuming and to err on the side of caution where doubt arises.

Other than that, you should enjoy your month of being waited on. Your confinement lady is there to pamper you, so enjoy it!

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Comments 32 comments

G-Ma Johnson profile image

G-Ma Johnson 8 years ago from NW in the land of the Free

I think it is a good idea.  They rush our new mom's in and out and is not good for the baby seems to me, or the mom.  Good Hub my dear...G-Ma :o)


figur8 profile image

figur8 8 years ago Author

Thanks! Admitedly, I was rather skeptical about the practice when I first heard about it (yes, I know, I'm Chinese and I didn't even know about it!) but after going through it, I have to say that it was really helpful to have someone on board who knew what she was doing so that I could rest easier (well, as much sleep as possible in between nursings anyway).


pui yuet (confinement nurse) 8 years ago

we are a pui yuet (confinement nurse) center, please visit our website www.heihei.hk for more information


CC 8 years ago

Are there any places where Americans can have this service? Can Americans travel to Asia for this service?


figur8 profile image

figur8 8 years ago Author

I don't know about places in the States that offer confinement services, but I am sure there are places in Asia.

There is one that I heard about after I did my confinement. It is based in Kuala Lumpur, Malaysia. Here's the website:

http://www.peiling.com.my/

I have also had friends from Australia who apply for work permits to bring confinement nurses over to Australia for a period of three months, but you still need to find a confinement nurse. Most of the confinement nurses here operate by word of mouth.

Peiling.com is the first one I've come across that actually operates from a facility.


Jeannie 7 years ago

I am a confinement lady & has been working in this field for the pass 4 years. My age is 50 & I am a chinese lady from Ipoh, Malaysia. Language spoken are English, Mandarin & B. Malaysia. Dialet spoken are Cantonese, Hokkien & Hakka. I am interested in cooking & I can cook chinese dishes, western dishes & nonya dishes.I have been working in Kuala Lumpur, Johore, Penang & Ipoh. From 2009 onwards I am willing to work in Singapore and Australia.My job responsibilities are to cook 3 meals plus tea snacks. Nourishing breakfast will be prepare with care. Lunch & Dinner will have soup, meat/fish & vegetables. Tea snacks would be light desert. Herbal nourishing drink or double boil chicken essence for the new mothers to consume during the night.Baby hygiene is important. Bathe, change nappy & help to feed the newborns. Taking care of the babies throughout the night.I fully support & encourage new mothers to breastfeed. I will guide new mothers to breastfeed.When mothers are going back to work schedule will be provided for the new mothers to express their milk for the babies in the day time.Year 2009 I am already been booked for the month of April, May, June & Aug. I have 2 partners working along with me.My contact no : +6012 517 9748Email : jeannie.khor@yahoo.com


JQSydney 7 years ago

I grew up in Sydney and just had my first child and my first confinement month. Out of curiosity I did some researching on it while I was at it. Just a quick correction to the info here, Zuo Yuezi means 'Sitting' the month, as traditionally the new mother had to sit in bed for the month and refrain from moving about the house, and the practice traces back to the Han dynasty, which started around 206BC.

I did the month and couldn't be thankful enough that my mum did all the cooking and came over to look after me every day. My family paid for the confinement lady and she was great! Though I would strongly suggest that you still keep the baby in your sight 24/7.

If you can read Chinese I strongly suggest that you read on Zuo Yuezi in Chinese as there're some very important medical info that's very helpful. I wish I'd known about it before my confinement month.

What they said about keeping warm is SO TRUE! I stayed in hospital for 3 days, with the air con on full blast and temp is like winter. My arm felt a chill and got arthritic pains for 3 months! (I've always been fit and healthy and thought I was invincible...) Had my baby in the middle of winter and the hospital is as cold as winter! Am gonna go straight home after my next one.

As far as having a confinement lady goes, it's definitely extremely helpful, though I strongly suggest that you keep your baby with you 24/7 and do the night time feeds (as some confinement ladies offer to look after the baby through the nights, but it's most important for your baby's development as well as for your milk production that you do the night time feeds.


hellomoo profile image

hellomoo 6 years ago from Boston

I love that you wrote about it, as a British Born Chinese from the UK, I often got frustrated with my mother for going on about this old fashioned stuff, but it's good to see it written out in a language I understand. Thanks for sharing.


figur8 profile image

figur8 6 years ago Author

My pleasure. Though I was born in Asia, I was pretty much raised in a Western country so I didn't know much about confinement practices either - hence the reason why I tried to find out more about it. I'm a bit of a skeptic myself, but I hate to crush things I don't understand out of ignorance. I feel it is important to educate ourselves before making a decision about whether to believe or not.


Sandy 6 years ago

I know some were in NYC, there has a such Zuo-yue-Zi recoverly center. which in Flushing NY.


Rob 6 years ago

With the old blood thing, I think you might have missed something. The belief is that the woman's original parents bring "old blood" into the house of the new parents, which we would usually call the husband's parents. In the case of traditional marriage, they are now the defacto parents of the wife too, and when people say old blood will bring harm to the family, they mean to the husbands family, which now includes the wife and child. At the same time, they'res an understated sense that the new family doesn't want much involvement from the wife's old family. Traditional Chinese families were very clan-like with complex hierarchy of authority in the house. Children belonged to that family entirely, and not at all the families of their mother's parents.


figur8 profile image

figur8 6 years ago Author

Thanks for clarifying, Rob. I'm afraid I knew nothing about the confinement practice until I was about to undergo "the month" myself. Personally, I don't believe much of it, but I thought it was interesting to read about.

The information I found on "stale blood" came from an introduction to a confinement recipe book and there was no mention about hierarchies and I'm pretty sure the harm mentioned was to the woman's own family - as in her biological parents.

A lot of information I heard from the "elders" in the families were rather mixed up. I guess the confinement month has lost a lot of its true practices and meanings through the passing of time and the word of mouth.


Wendy 6 years ago

Hi Sandy, you mentioned some Zuo-yue-Zi recoverly center which was in Flushing NY, do you have more details? I am currently staying in NYC and am looking for a confinement lady in late sep or oct 2010...


Valerie 6 years ago

Dear Figure8,

I like the article you wrote and would like to connect with you on email. I'm currently researching Asian postnatal recovery practices. If you send me your email I'll write to you OR my email is val1lynn@hotmail.com.

I'm an American living in Asia.

Hope to connect!

Thank you!


Charm 6 years ago

Hi Wendy,

Have you had any luck in looking for a confinement lady? Could you forward me any contacts which you managed to find. I also live in NYC and am due in end Jan 2011.

Thank you.

Charm

charmbaby2011@gmail.com


jentweety 6 years ago

@ wendy & charm,

i'm doing the same research on finding a service, either a confinement lady or food delivery for postpartum. on the west coast (i'm in so. cal) seems there are more resources, but i did come across this site, it's an actual facility where you would spend your one-month, but anyways you may want to contact them to see if there are referrals for NYC resources. 888-802-0220, the web link: http://www.cowa-usa.com/index.php

hope this helps, jen jennhsieh@gmail.com


Debbie 5 years ago

Hi, I'm from Perth and looking for a confinement lady who can travel to Perth. Please let me know if you know any who are available August 2011? thank you.


Jennifer 5 years ago

Hi,

I am in Perth too looking for a chinese confinement lady to travel to perth and able to speak in english or mandarin. Please let me know any of you are available in August 2011. Thanks..

You can email me your details to jennifersng@ymail.com.


BkCreative profile image

BkCreative 5 years ago from Brooklyn, New York City

I wish we did more to acknowledge a woman for getting pregnant, being pregnant, giving birth, and after birth. Unfortunately, here in the USA a woman must take a vow of abject poverty because she gets no kind of financial or health support at all. A real injustice.

I lived and worked in S. Korea over a 4 year period and even if I got pregnant there I would be entitled to 3 months paid maternity leave after birth. This is not a right in the US. Something like the confinement month was a given and everyone pitched in to make sure the mother was fine after birth. Of course the right kinds of foods are essential. Here we are virtually ignored.

By the way, I had the pleasure of visiting a real Chinese doctor while in Beijing. Absolutely amazing. There were 10 of us and we saw 4 different doctors and just with a tongue and pulse exam they were able to exactly pinpoint our ailments - nothing invasive needed. Awesome (I wrote a hub about this)!

Thanks for such an informative article. Nice to meet you too by the way. Rated up! Wonderful!


Anti comfinement 5 years ago

Confinement is a dated practice and does NOT make sense in this day and age!!!


margaux  5 years ago

Hi,

I hope you are well.

Power Plate Australia is bringing the UK's most ground-breaking pregnancy & post-natal health and fitness specialist, to Australia from 13 - 18 April 2011.

International presenter Jenny Burrell www.burrelleducation.com, this women is AMAZING !

Jenny will be here to launch the new Power Plate Level II Post Natal Academy - a training course and fitness certification for those working with post-natal clients which will be taking place on Thursday 14 April 2011.

The course is strongly backed by thorough and extensive research carried out independently to help mother with the three major post-baby issues - fat loss, abdominal tone and strength, as well as pelvic floor reconditioning. We also discuss Women's health issues, ie Post Menopausal exercise prescription.

We would love to have you along to the Academy to broaden your knowledge and modernise the training options for post-natal women in Australia.

For more information or to book your place on the program, please email Clare on clare@en-core.com.au or call on 0410508101.

Thank you for your time and we hope to meet you at the Academy on the 14 April.

Kind Regards


Debby 5 years ago

Hi i'm looking for confinment lady willing to travel to perth my EDD is 26/08/11. Please email me at b112u@yahoo.com for anyone available and trustworthy. Thank you.


Daniel 5 years ago

Hi i'm looking for confinment lady willing to travel to regional area in sydney my EDD is 11/01/12. Please email me at danieluseless@yahoo.com for anyone available and trustworthy. Thank you.


Kammy 5 years ago

Hi I'm looking for a confinement lady willing to travel to regional area in Sydney called Bathurst and my EDD is 14/1/2012. Pls email me at kammyloi@gmail.com for anyone available and trustworthy. Many Thanks in advance.


Elaine 5 years ago

I am looking for a confinement lady in NYC. My EDD is Nov27, 2011.

Anyone knows where I can find one in New York? My email is echoochiu@gmail.com

Many thanks!


Felicia 5 years ago

Hi, i am looking for a confinement lady in Perth Australia. My EDD is February 12-02-12.

It would be a great help if there is any confinement lady who is available.

please e-mail me: pr3tty_08@yahoo.com

Thank you.


Cindy 4 years ago

I'm looking for a confinement lady in Melbourne Australia. My EDD is 29 May 2012.

She can either work full time 24/7 like most, or full time Mon - Fri, and only prepare the food on weekends as my hubby will be around to help.

I can be reached at cindygwk@yahoo.com. Thanks


Trish 3 years ago

Hi,

If you've had any good confinement lady experience, could you please email me at trishllc@gmail.com. Need help in 2014.

Regards.


Aunty Judy 2 years ago

I am a mother and grandmother....been doing confinement for my three grandchildren. I am a confinement lady. My age is 65 & I am a chinese lady from Kota Kinabalu, Malaysia. Language spoken are English, Mandarin & B. Malaysia. Dialet spoken are Cantonese, & Hakka. I am interested in cooking & I can cook chinese dishes, western dishes & nonya dishes. I fully support & encourage new mothers to breastfeed. My contact no : +016-8373566 Email : judy-chok75 @hotmail.com. I also have another friend who is a CL.


Mindy 2 years ago

Hi, I am looking for a good experienced confinement lady in Sydney. Do you have any recommendation? My email address is minw79@gmail.com. Thank you.


Alice 12 months ago

I am 60 years old Chinese lady coming to Sydney in DECEMBER 2015.I can cook and look after babies. I also do confinement work for mothers. my email address is alicecskuan@gmail.com.

Thank you.


Annie 12 months ago

My mom is an experienced confinement nanny and helped 3 families in Melbourne, do email me if you need more information.. lsy.annie@gmail.com

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