Congratulations on a successful pregnancy and delivery! Many women think their pregnancy journey is over as soon as they get their child is in their arms, but that is not the case. Deeply seated in Traditional Chinese Medicine is an extensive protocol for postpartum care called “sitting the moon,” otherwise known as the fourth trimester. This month-long endeavor is to help moms recuperate from the stress of pregnancy and the trauma of delivery as well as to help rejuvenate the body. TCM philosophy and many modern Chinese cultures believe that proper care in the first 30 days after delivery can also improve pre-existing conditions unrelated to pregnancy such as asthma, IBS, and frequent colds.
The three key pinnacles for proper care during the fourth trimester include:
- Staying warm and not overtaxing the body
- Eating warm and nourishing foods
- Chinese herbs and acupuncture treatments to nourish and rebuild the body
Staying Warm and Stress Free
This is probably the most commonly discussed part of the protocol and unfortunately, it is often easily dismissed. Traditional Chinese texts say a woman shouldn’t take a bath, shower, or wash her hair, and she should walk around barefoot or not eat or drink cold foods and beverages. While this sounds doable for January births, it’s a little unrealistic overall. All of these restrictions were to restrict cold from entering the body. In Chinese medicine, cold causes a multitude of problems in the body, from sharp menstrual cramps to chronic coughs to frequent diarrhea. Understanding this belief requires a brief history reminder: most of China is very cold and damp, and systemic heat wasn’t readily available until the late 1980s in most places (even large cities). In modern times, when we live only in a 20 degree temperature comfort zone, it is less likely that cold would enter the body so readily, so these strict rules are relaxed a bit. It’s still recommended to not bathe every day and make sure you dry off and get warm right away. Cold foods and drinks are still forbidden and socks or slippers are still recommended. When baths are needed, often there are Chinese herbs that help tonify (warm) the body added to the water.
New moms are also forbidden to perform physical labor and are encouraged to nap frequently and remain stress free. That is why the maternal grandmother often moves in for the first month postpartum to help with taking care of the baby. I remember when my aunt had her daughter, she was not even allowed to walk upstairs to pick up my niece. My grandmother or the nurse would bring the baby to her so she didn’t have to exert herself. As the lowest skilled laborer in the household, my job was to keep her hot water bottle constantly filled and hot. Not my most exhilarating job ever. This idea of minimal exertion is to help the body rebuild internally. Introducing external physical stress diverts nutrients and blood flow from internal recuperation.
Eating Warm and Nourishing Foods
While the first tenant is the most controversial, the second is the most difficult. For the month after delivery, moms are given warm, nourishing, and easily digestible foods such as rice porridge and soup and are instructed not to eat raw fruits or vegetables of any kind. While meat is used a lot for its iron-rich properties, many times it is incorporated only into the broth rather than on its own. Also involved in dietary considerations are the particular conditions of the pregnancy, delivery, and current and previous health of the mother. All moms will get foods that help promote lactation (pigs feet, raw peanuts, carp fish soup), foods that help build blood (red meat, red jujube dates), and foods that nourish qi or energy (black chicken soup). Moms who have adrenal fatigue or kidney deficiency (hair loss, dryness) may be given specific soups and foods to help build the kidneys. Whole grains like millet and Job’s tears (barley that is gluten free) are used in porridge frequently to help build up digestion. Often Chinese herbs may be incorporated into dishes as well for an extra boost of nourishment.
Foods that are not allowed include anything cold and raw (even cold water). Unclean meat or seafood are forbidden as well. The goal is to make food easily digestible so maximum nutrient absorption occurs. Cold and raw vegetables are harder to digest than cooked ones. Additionally, uncooked foods typically are at higher risk of carrying bacteria such as e.coli.
The postpartum diet may sound easy (how hard is it to eat soup?) but it can be exhausting, especially when juggling the demands of a new baby amongst other responsibilities. My friend who recently went through this in Hong Kong whined by the end of the 30 days she just wanted to chew something with flavor. Traditionally, the soups are cooked by aunties and grandmothers and brought over to the mom’s house to ease the burden on the new mom.
Chinese Herbs and Acupuncture Treatments
Chinese medicine and culture believes childbirth to be very draining on the mom in both blood and energy. There can also be many sorts of birth complications which can cause problems later on. Typically a new mom is given the standard post-birth herbal formula Shen Hua Tang (Generating and Transforming Decoction) before she leaves the hospital. This formula helps dispel blood stasis and warms the uterus. It is a gentle but effective formula that is taken for a week after birth. If the mom is breastfeeding then she would take the formula an hour or two before breastfeeding.
During the fourth trimester the mom may be given a variety of different formulas based on her presentation. Some mothers experience cramps and headaches, others experience fatigue and indigestion. Depending on what the body is deficient in, certain formulas are given to rebuild the constitution. Moms with lactation problems (too much milk, too little milk, or mastitis) can be treated with herbs and acupuncture as well.
It takes time for the hormones activated during pregnancy to go back to normal and new hormones are released during lactation to help the mother produce milk and bond with the baby. Acupuncture and herbs can help with this hormonal balancing act to make the mother and the baby feel better. In China, the herbalist will often give directions for food prep to the caretaker since food is seen as a form of medicine during this phase.
To learn more about how acupuncture and Chinese medicine can help with your postpartum journey, call today!
Ni, D. and Chen, J. Sitting Moon: A Guide to Natural Rejuvenation after Pregnancy. SevenStar Communications Group, 2010.
Ou, H., A. Greeven and M. Belger. The First Forty Days: The Essential Art of Nourishing the New Mother. New York: Stewart Tabori & Chang, 2016.