SingaporeMotherhood | Parenting

January 2012

Confinement: Reconditioning Yourself After Pregnancy

The first 30 to forty days after you give birth is the period where you are confined to a certain regimen comprised of nutritious diet, to-do’s and not-to-do’s, and lots of rest. It is also recognised as “masa nifas” in Malay, “zuoyuezi” in Chinese, “puerperium” in medical term, and “postpartum” or “postnatal” period in Latin, although “postnatal” refers more to the baby than to the mother.

This restoring period has three stages: early puerperium, the first one week, where mothers can start to walk around, intermediate puerperium, four to six weeks after delivery, the time it takes for the sore genitalia to recover, and remote puerperium, between six and 12 months, where your body returns to its original condition.

Hence resting and restoring yourself in this confinement period is not merely a traditional upkeep, but a necessity not to be belittled. According to Dewhurst’s Textbook of Obstetrics and Gynaecology, a classic text: “Serious and sometimes fatal complications may arise during the puerperium. The most serious complications are thromboembolism [the blockage of a blood vessel], infection and haemorrhage, as well as mental disorders, and breast problems”.

Brace yourself for Confinement!

Your “fourth trimester” may bring a long list of discomforts:

Physically:

  • Body aches
  • Perineum soreness
  • Abdominal cramps
  • Pain at the stitches
  • Urinary leakage
  • Vaginal bleeding
  • Constipation
  • Excessive perspiration or hotflashes
  • Hemorrhoids
  • Swollen breasts
  • Leg swelling due to water retention
  • Hair loss

If you had c-section, your scar may pucker and be tender for two to three months as it heals.

Mentally:

According to the Health Promotion Board, you ought to be wary of the tell-tale signs of postpartum depression and seek help before it affects your quality of life.

The symptoms include:

  • Persistent sadness or emptiness
  • Loss of interest in anything
  • Shifting appetite
  • Insomnia
  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Feelings of worthlessness
  • Thoughts of death

Proper care and rest during confinement period would be a solid foundation for your future health, whereas the lack of them could lead to postpartum conditions which include headaches, arthritis, immune deficiency, chronic fatigue, depression and insomnia.

One of the sources of discomfort is intestinal gas. Pregnancy turns your digestion system upside down with stress, hormones, and fatigue upsetting the balance of good bacteria in your stomach. It causes constipation, indigestion, nausea and vomiting.

New mothers would feel “gassy” because their digestive system is returning to normal. To help get rid of this “wind”, new Chinese mothers are fed lots of ginger. They drink ginger tea, eat fish, chicken, beef or pork cooked with ginger, and even bathe in ginger water.

Roni Kayan, a mother of two, remembered that her mother cooked ginger fried rice for her to eat in place of plain rice and that one of the must-have dishes during her confinement was pig trotters in vinegar and ginger. Pig trotters are said to promote blood circulation and are high in gelatin and collagen to fight hair loss.

In Singapore, the length of confinement time varies. For Chinese mothers, confinement means staying home for 30 days. During this period they cannot wash their hair, must avoid contact with cold water, not go outdoors, not burn incense, read, cry, or have sex. According to Dr Peiling Goh, a nutritionist and the author of Falling In Love With Confinement, “Washing your hair will affect the detoxification of the womb. When the lochias in the womb become clots, it will be very difficult to detoxify them, therefore the imbalance of hormones and internal secretion will cause health complications.”

It’s not readily comprehensible, but aren’t we glad to know there’s a scientific explanation behind the advice not to wash our hair? The mother of four recommends using dry shampoos, or if you really have to, washing hair with water only after 15 days post-pregnancy and drying it immediately.

The Malay version of confinement lasts for 40 days, with mother and baby bathed in herbal water, daily “jamu” drinks, and a “bengkong” wrap wearing around the tummy to flatten it back. New mothers basically have to keep warm, and avoid having sex throughout the period.

Nur Azlina, a first-time mom, remembers it as a pleasant experience. Her mother cooked her fish and soup-based dishes, prepared pandan water (for its antimicrobial properties and refreshing scent) for bathing, and everyday for a week, a masseuse came to rub her down and apply “pilis” on her forehead for good blood circulation.

The regimen for new Indian mothers includes avoiding food which is overtly spicy. New mothers also avoid going into the altar room as long as they are still bleeding… and here is where it differs, our Indian friends bathe three times a day!

In fact, if you are in India, you would have a special mid-wife who comes to bathe the mother and baby with special herbs. Turmeric is part of the herbs used because it is a natural antiseptic. You also continue to wash hair, but it has to be dried with a special incense smoke.

Sandhya Srinivasan, a mother of twins, revealed that since either the mother or mother-in-law of the new mom would sleep with her and the baby to help out during the first few weeks, sex definitely had to take a back seat!

All confinement rules consist of myths and facts, therefore it is best not to follow them blindly. For example, according to Dr Goh, new mothers can still enjoy the cool air from fans and air-conditioners (23ºC to 26ºC) as long as the appliances are angled away from them.

The wine used for cooking confinement food must be limited to 20 per cent alcohol content or below, and properly boiled. And although half-boiled eggs are nutritious, they may contain germs. So, stick to the thoroughly cooked ones.

20 Good Foods for Confinement:

  • Abalone for its protein and vitamin E
  • Angelica (dang gui) to enhance blood circulation
  • Black fungus to cleanse the arteries
  • Black vinegar to purify the blood
  • Blueberries as they are rich in antioxidants
  • Chestnuts to invigorate and resolve irritability
  • Chicken to improve mood
  • Chinese wolfberry to nourish liver, kidneys and eyes
  • Dark-coloured beans for being rich in fibre and folate
  • Dried longan to promote restful sleep
  • Eucommia bark (du zhong) for the kidneys, sinews, and bones
  • Eggs to nourish the body and complexion
  • Fish, especially salmon, as a source of protein and Omega-3 fats
  • Lean beef as it is rich in iron, for energy
  • Low-fat dairy products as a source of calcium
  • Old ginger to warm the body
  • Polygonum (he shou wu) to prevent hair loss
  • Red dates to improve energy and calm the mind
  • Sesame oil for being rich in vitamin E, iron and calcium
  • Turmeric for its antibiotic and anti-inflammatory properties

In countries like China, Taiwan and Malaysia, confinement hotels are popular. In Singapore new mothers and babies are usually looked after by confinement nannies. You have to arrange this a few months before your estimated delivery date. Popular confinement nannies can be booked out a year ahead!

One confinement nanny agency, JIA Employment, provides Malaysian Chinese live-in nannies for 28 days. A live-in nanny is very helpful for first-time parents, compared to a day nanny. The package starts from $2,000 excluding the red packets at the start and at the end of the period, and a foreign worker levy of $190 (at time of writing) payable to MOM (Ministry of Manpower).

This nanny is be responsible for 24-hour baby care, the cooking of confinement food, brewing of herbal tonics for the mother, laundry for the mother and her baby, and other simple household chores. If you only need to have your postnatal nutrition taken care of, you may opt to cater confinement food to be delivered to you daily.

New parents may also seek assistance from the Home Care Services provided by hospitals such as Mount Alvernia Hospital. For a fee, a visiting nurse from the hospital will provide breastfeeding consultation and answer queries on new born care.

Need a Confinement Nanny?

These agencies can help you:

  • www.pemconfinement.com
  • www.jiaemployment.com
  • www.gplsconfinementnanny.com.sg
  • www.confinementnanny.com
  • www.confinementnannyprepostnatal.com
  • www.a-team.com.sg
  • Thomson Medical, call: 6350 8848 or email: [email protected]

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Confinement: Reconditioning Yourself After Pregnancy