Who came up with this? What good is it? Is there any science to this? What countries or cultures have such practices?

Welcome to The Odd Gratuitous Inquiry (TOGI), a podcast where I investigate unnecessary questions and speculate answers no one asked for.

Listen to this episode on Spotify and other platforms.

 

Having A Newborn Baby

Recently, my wife and I welcomed our firstborn. I went on paternity leave. Paternity leave means a father wishes he could leave his house for at least 5 minutes to escape the madness of dealing with a newborn.

Having a baby defies all expectations. TV portrayals of good looking parents dressed perfectly while cooing over a cute little baby are misleading. The reality is more like poop gushing out like the Merlion, washing poop from my clothes, changing baby’s poopy diaper, stuffing breast or bottle in baby’s mouth, and repeat that every 2-3 hours.

Thankfully, we had the help of a great confinement nanny for about a month. She cooked amazing food, washed the baby’s laundry and bottles, bathed the baby, patiently soothed the baby to sleep even if it meant going at it for hours in the wee hours of the morning, and prepared herbal soups and baths for the wife.

But as the name suggests, it means that we were also confined. CONFINED. Like in a prison cell.

So what is this postpartum or post-pregnancy confinement thing? Our respective mothers did not have it when they were new mothers. Apparently, they don’t have this concept in the West (and I don’t mean Jurong). It would probably be ruled illegal as torture in the U.S. Speaking of which, did you hear about the prison officers in the U.S. who were charged for cruelty–because they made prisoners listen to Baby Shark on repeat?

So is this post-pregnancy confinement some new Singaporean Chinese fad?

I dug a little deeper and found to my surprise that it is not uniquely Singaporean or Chinese and not a recent phenomenon.

I did some research and found academic articles that investigated and documented this practice through quantitative and ethnographic studies.

Confinement Practices across Ethnicities in Singapore

In Singapore, more than 90% of mothers from Chinese, Malay and Indian ethnicities observed some form of post-pregnancy confinement practices. (See also https://scholarbank.nus.edu.sg/handle/10635/154108.)

Chinese and Indian mothers tended to eat more special confinement diets than Malay mothers. Chinese mothers showered less and were more likely to depend on confinement nannies during this period than mothers from the two other ethnic groups. Malay mothers tended to make greater use of massage therapy (known as jamu or herbal massage originating from Indonesia). Indian mothers tended to have their mothers or mothers-in-law as assistant caregivers. Today, mothers tend to adopt practices from other ethnicities. Chinese mothers would have massage therapy. My wife, for example, had a jamu masseur lady come to our place to give her a massage every other day.

Chinese women were more likely to hire confinement nannies (31.0%), while Malay (13.5%) and Indian women (9.4%) were less likely to do so.

Chinese women were also more likely to have all of their meals prepared specifically for confinement (45.9%) as compared to Malay women (21.3%). The belief is that certain types of foods will promote or restore health and recovery from labour, purge out ‘wind’ in the body, and promote blood circulation, while other foods are avoided as they are thought to cause illness (https://www.healthxchange.sg/women/post-pregnancy/confinement-food-chinese-malay-indian).

The Chinese believe in ‘heaty’ and ‘cooling’ types of food. A mother’s body is believed to be ‘cool’ during the postpartum period and thus ‘heaty’ foods such as ginger and wine are consumed in larger quantities. I’ve heard friends who complained that when they ate their wife’s confinement food, they broke out in acne because of how heaty the food was. As it turns out, such beliefs are not only found in China and East Asian cultures, they are also found in many non-Asian cultures as well, including parts of Latin America and Africa.

Of course, there is also food that promotes lactation and milk production. Oat, salmon, fenugreek (in tea) were some food that even Western cultures recommended for nursing mothers.

A significantly higher percentage of Chinese women observed a ‘no bathing’ restriction during their confinement, whereas most Malay (96.8%) and Indian women (88.8%) showered daily. Malay and Indian would have a quick, warm shower without hair washing.

For the Chinese, cold showers were prohibited in the belief that they may lead to blood clots and sore joints. What is interesting is that this no-bathing rule is found in other countries and cultures as well. “In non-Asian cultures such as Guatemala, it is believed that bathing in cold water decreases milk supply, and that bathing too soon causes stomach pains or prolapsed uterus. In Mexico, bathing is restricted to protect the mother from cold or ‘evil air’. Warm baths and showers are often acceptable confinement practices in Asian cultures, however, particularly among mothers in Thailand, Malaysia and India.” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992357/)

What is often the case here in Singapore is that mothers would negotiate with their confinement assistants on alternative solutions, which may include the use of medical herbs added to hot water for their daily baths, a practice that has been adopted in countries such as Laos and China. This may serve as a potential compromise for mothers to observe traditional confinement practices while maintaining their general personal hygiene at the same time.

Well, my wife did shower daily with medical herbs in warm water during the confinement period. And that helped boost her wellbeing. A lot. I’ll speak more on that later.

Suffice to say, a SingHealth hospital website written by doctors assert that there is no scientific basis for the prohibition against women bathing or touching water to prevent wind entering the body, etc. They even say “On a personal note, it certainly ensures that the people around you find you more bearable.” (https://www.healthxchange.sg/women/post-pregnancy/confinement-after-pregnancy-myths-facts)

The Singapore study also found that true confinement, i.e. not leaving the house, was practiced among all 3 ethnic groups, with most mothers (63.7% of Chinese, 51.4% Malay and 60.6% of Indian) staying at home during the confinement period. This also meant not taking the baby out during confinement: 83.7% of Chinese, 66.1% of Malays and 79.9% of Indian infants stayed at home during the confinement period.

Practices Across Other Cultures and Countries

As I have alluded to earlier, traditional post-pregnancy confinement practices are not unique to Singapore or East Asian cultures. They have been practised for a very long time in other cultures in e.g. Latin America and Africa. At the very basic level, there is the notion of secluding a woman for rest for a period of time after labour. This has been apparently observed also in biblical times by Hebrew women in the Old Testament, in the Mayan civilisation, and in Japan, Europe, British Isles, Nepal, Bangladesh, India, Greece, Turkey, Myanmar, and by the Negev Bedouin in Israel (https://embryo.asu.edu/pages/doing-month-confinement-and-convalescence-chinese-women-after-childbirth-1978-barbara-lk).

Yet, some of the traditional beliefs and views about women and their bodies post-labour do not withstand scrutiny of scientific and medical findings, and can be counterproductive, harmful or wasteful. Many traditional views about women had this idea that they were impure and thus had to be secluded. In some cultures, such as in Nepal, India and South Asia generally, colostrum was  not fed to the baby because it looked like pus. Today, we know that colostrum, being the first form of milk from the mammary glands after giving birth, contains antibodies and some nutrients for the baby. Further, it is important for breastfeeding to start at the first hour of birth to stimulate milk production.

And then there is this whole notion of seclusion and confinement. A research study in Zambia found a statistically significant relationship between confinement and mental distress among new mothers. While the study rightly noted that hormonal changes, a traumatic delivery and other factors may result in mental health challenges to a postpartum mother, it is also observed from another study that elements of the confinement practice that might contribute to postpartum mental distress may include diminished social support during the seclusion period, conflict with a mother-in-law or confinement caregiver, and the tension experienced by modern women as they work to  balance traditional with contemporary practices and views. The study also notes that suicide is the seventh leading cause of maternal death within six months of delivery with an estimated 1.27 per 100,000 maternal deaths.

Navigating the Tension

Indeed, I recently learnt anecdotally of a new mother who fired her confinement nanny after the nanny doggedly prohibited her from showering, from drinking the soup that was painstakingly prepared by her own mother despite observing and allowing her mother cook the soup, and even refused to let the young mom handle her own baby, chastising her for her inability to do so. I’ve heard other stories of such confinement nannies from hell.

And such stories contrast greatly with my own experience with the confinement nanny that my wife and I had. She was supportive, not dictatorial. She suggested rather than prohibited. She taught and nurtured, rather than imposed. She read up on which confinement practices were contrary to science and which were not.

I guess that’s the thing about finding a balance between traditional practices and modern ones. They’re not at odds. The question always should be what benefits the parents and baby?

There may be scientific and medical basis for or against certain practices. There may be none. Clearly, those practices that are contradicted by science should be discarded. Those practices that are neither contradicted nor supported should be discarded if they lead to unhappiness, discord and poor mental health. As it is, pregnancy and labour are very difficult, perhaps even traumatic, for the mother. Physiological changes, social-economic conditions, and just the whole new experience of having a fragile dependent infant thrust into one’s hands, can be mentally and emotionally challenging. One might even have to tolerate unsolicited opinions and advice from family members, relatives or friends about everything from diet to the baby’s looks.

Strangely, because we had our firstborn during the Covid pandemic, the quasi-isolation during the confinement period was actually helpful in this regard. We did not have to entertain numerous visitors. We could be selective about who or when we have visitors. Otherwise, it would have been stress-inducing and overwhelming for us.

Reflecting on my experience, I realise how many traditional confinement practices might have developed in the past. Some were out of misconceived assumptions. Some were probably from observing certain outcomes but confusing causation for correlation. Some were from trial and error. I suppose they were generally with good intent. Although sometimes, the mother’s and baby’s best interests are not always the priority.

I believe that as confinement practices continue to evolve, it is important for parents to communicate early–even before delivery–and clearly their needs and boundaries to caregivers for the best interests of the mother and child. Clarify what practices should be adopted and what should not. Clarify roles and postures.

I also think that as a society, we can be more accommodating to parents of new children. For some, it is a very disorientating experience. There may be health and medical complications as well. Two weeks of government-paid paternity leave is hardly sufficient for the family to stabilise and recover. If we want to see a more equitable equilibrium of roles between men and women in society, we should want husbands and fathers share the burdens and joys of getting into the messiness of postpartum caregiving to both mother and child. And then perhaps, we will see more men respecting women for their true strength and worth. And then perhaps, we will have boys and girls looking up to such men as role models, as the fathers and husbands that we need. And then perhaps, more of our society will see labour and parenting not as a liability, but a way of life transformation towards virtue and wholeness.

Now, that won’t be a confinement. That would be liberation.