No showers or going outdoors: Why the Chinese put mothers into 'confinement'

The attitudes of some Chinese mothers are beginning to shift as some of the way confinement is practiced can lead to unhygienic conditions and even become dangerous.

Story highlights

  • In Chinese medicine women that have just given birth are more susceptible to cold air and should confine themselves to the house
  • Attitudes are changing about whether mothers should follow the custom of zuoyuezi or "sitting the month"
  • Numerous confinement centers have popped up to help women adjust to motherhood

(CNN)The recent death of a Shanghai woman has put the spotlight on the Chinese traditional custom of "postpartum confinement," a month-long period when new mothers are put on bed rest and advised to keep warm -- even in the heat of summer.

The mother, who was following the custom also known as "zuoyuezi," died from heat stroke after wrapping herself in a thick quilt and keeping the air-conditioning switched off despite high summer temperatures, state media reported.
A similar tragedy several months ago involved a new mother who refused to move and later died of pulmonary artery thrombosis.

    'Sitting the month'

    Zuoyuezi, literally means "sitting the month." Traditional Chinese medicine purports that women that have just given birth are more susceptible to cold air, so it's not uncommon for mothers to refrain even from washing themselves or their clothing.
    Mothers are not meant to leave the home and are encouraged to follow a diet of hot soups and avoid so called "cooling" foods.
    In fact, the Duchess of Cambridge Catherine Middleton sparked a debate on Chinese social media in May when she appeared with her second child publicly wearing light clothing just 10 hours after giving birth.
    By contrast, when 30-year-old Yang Xue delivered her daughter in a Beijing hospital two days later, she returned home and, following the principles of zuoyuezi, stayed there for more than a month without showering.
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    "It's horrifying to hear that women don't sit the month. I'd rather stick to the tradition," she said. "It was a bit uncomfortable at the beginning but I got used to it later on."
    Yang's parents and in-laws came to help but she also paid 8,000 yuan (US$1,265) for a "yuesao" -- a nanny dedicated to taking care of the mother and newborn.
    As a new mother, Yang was served a special meal plan. The yuesao cooked fish soup and pig feet soup for her every day, which was supposed to help her produce more milk.

    Changing attitudes

    But there are signs that attitudes are changing as some of the ways confinement is practiced can lead to unhygienic conditions and even become dangerous.
    For example, in July, a local Chinese newspaper quoted one traditional Chinese medicine doctor who talked about adapting the practice for modern life.
    The doctor said mothers should still steer clear of all drafts by keeping windows and doors closed but said if need be, they can use air conditioning or a fan, so long as it wasn't aimed directly at them. Not brushing teeth or washing hair however, "has entirely no medical basis," the doctor warned.
    Some mothers like Du Fei, a Beijing native who lives in Shanghai, have completely abandoned the tradition.
    Du had her child in June and did everything she was not "meant" to do as a new mother, like taking her baby outdoors the first week after birth.
    "I just didn't see the point of zuoyuezi," Du said. "I've never thought of childbirth as a big deal. The only thing I didn't do during the initial week was cooking, because I felt weak after childbirth."
    Du said although most of her friends don't practice traditional Chinese postpartum care, they do hire a yuesao to help around the house.

    Confinement centers

    For others, confinement can be a big business opportunity. Hundreds of maternity centers have popped up across China, Hong Kong and Taiwan -- some even offer plush environments and services not unlike a luxury boutique hotel.
    Gwo Dreyer twice stayed at a maternity center in Taiwan after giving birth to her two kids. She didn't particularly care for traditional Chinese medicine concepts but said she found the Asian approach to postpartum care much more supportive to parents.
    "I didn't grow up in Asia and my husband is not Asian. We're not that traditional," Dreyer said.
    "It's a lot of focus on the baby [in the U.S.]. In Asia, not only is it taking care the baby but also the mother," she continued.
    "Maybe you don't have the right support or maybe your family members don't know how to do it right. It's having adult supervision for the first month, basically from people who take care of not just one child but 50 babies at once," Dreyer said.
    Such confinement centers can be a huge help, especially in light of the changing Chinese family unit, which no longer sees multiple generations living together under one roof, and with respect to the country's one-child policy, meaning nearly all parents are first-timers.
    "You might get a midwife to come help you at home as opposed to a center but it's like home-schooling or school. Home school works very well for some people," Dreyer added.