May 29, 2018

Dr. Jones: Every year, tens of millions of Chinese women observe a practice of staying inside for a month after giving birth. This custom is called, "Sitting the Month." Is it a strange custom? What do we recommend? This is Dr. Kirtly Jones from obstetrics and gynecology at the University of Utah Health and this is virtually the rituals we practice after having a baby on the Telescopic.

Announcer: Covering all aspects of women's health, this is the Vii Domains of Women's Health with Dr. Kirtly Jones, on The Scope.

History of Childbirth

Dr. Jones: All over the world, for the hundreds of thousands of years that we accept been humans, giving birth has been a very risky business. Until 100 years agone, i in 10 women died in childbirth. Of all the ways women met their decease, giving birth was one of the most common. If they survived a difficult birth, they were frequently left weakened and anemic with trauma to their pelvic tissues. If their babies survived, they needed to successfully breastfeed, equally in that location was no formula for babies. Mothers who found themselves barely alive had to too provide the milk for their babies to survive.

All over the globe, there are cultural practices around this very delicate time after childbirth for the mom and the baby. In fact, we yet use the give-and-take EDC, estimated date of confinement, as the term for the due date. But what is this confinement business? What practise Chinese adult female practise? I trained in obstetrics and gynecology at the Boston Lying-In. Lying in was the term for the rest catamenia for woman after giving nativity, and many obstetrical hospitals take that phrase in their proper name.

The laying in flow in the US was anywhere from two weeks to two months, even for healthy woman and it was their solitude. Of class, this was the luxury for adult female of some financial means. Many women in the 1800s had no choice but to get up shortly after birth, and take intendance of the baby, all the other children, and assistance out on the farm. Although, virtually women were attended by other women in their family, or church community, and hopefully, a skilled nativity attendant, they didn't have two weeks or two months to stay in bed.

Until Globe War I and Globe State of war II, women who gave birth in a hospital stayed in bed at the infirmary for a week or and then, recovering from the commitment. When hospital beds were needed for wounded soldiers, the time in the infirmary was decreased from two weeks to ane week, to four days, to our present 48 hours. The good news is that the frequency of a condition called Milk Leg, or blood clots in the leg from lying around that might have progressed to blood clots in the lungs, dramatically decreased when women got upward out of bed after nascence.

So what about those Chinese women in the practice of, quote, "sitting the calendar month?" Women cannot go out. Family cannot come in. The guidelines are set to aid women restore their free energy balance to their bodies and protect their babies. Women are non allowed to bath or shower or go outside, beverage common cold fluid, or eat spicy foods. They cannot eat raw vegetables or fruits or drink coffee. No coffee.

All fluids have to go betwixt room temperature or hot, and they have to bundle upwardly and stay very warm. These practices have been noted in documents going back 2000 years. Today's affluent Chinese women tin can go to special solitude centre, in that location's that give-and-take solitude again, and accept all their ritual needs met for $500 a day. So we know that women are often wearied and trounce up later the birth of a child, especially the first ane.

They're often wearied, bruised, and battered downwardly in that location. Their bladders don't work. And their hemorrhoids hurt. And breastfeeding every two hours doesn't aid with the sleep issues. About 70 percent of women have the infant blues in the first couple weeks postpartum, and almost five percentage of women will develop postpartum low. So what is good medical practice?

Postpartum Intendance: Recovery Timeline

The first two weeks are rocky. That'south the time that moms are establishing their milk production and their feeding schedule. They demand to drink a lot of fluids, and consume a balanced nutrition of whole grains, lots of fiber for that beat up bum, fruits, vegetables, and protein. They may continue taking their prenatal vitamins several weeks for iron replacement if they had significant blood loss, iron rich foods or iron replacement can be recommended.

Ladies need a lot of residual. But as presently as they're comfortable, later on the cesarean or difficult delivery, they need to get up and walk around. This is of import past, in decreasing the risk of blood clots. Family can help by taking on the cooking and cleaning responsibilities in the home for the first two weeks or mayhap the starting time two months or maybe ii years. Well, ii weeks at least.

In the US women are often given an appointment to see their OB six weeks after the birth of a child. That six-week thought was fabricated up as the time past which women should have her pelvic organs back to normal. This is a totally ridiculous program. By half dozen weeks, new moms accept either sunk or swum on their own. If they're suffering postpartum depression, they're already well into information technology. If they have a float problem, they've been suffering for over a month. If they're not breastfeeding, they may past already pregnant because they can ovulate at 4 weeks. And 50 percent of women resume intercourse earlier their, postpartum visit.

In Europe and Keen Britain, it's common for domicile nurse visit by a midwife, or a nurse, at about a week after discharge from the hospital. This offers support and answers questions for the new mom. A randomized trial of a midwife dwelling visit at ten days and three weeks, instead of a physician's six weeks visit, found women were more than likely to be using contraception, more likely to be breastfeeding successfully for longer, more likely to have their babies immunized, and less likely to be depressed, if they had a habitation midwife visit on that schedule.

So what'southward the half dozen-calendar week postpartum visit for? We used to practise a pap smear and start contraception at that visit. Just now, pap smears are done every two to three years, and women should have started contraception or had a plan before they left the hospital.

Family practice docs, who practice obstetrics and volition also be taking care of the infant, see the mom and the baby at ii weeks, a neat idea. Combined group intendance with the pediatrician and an OB or midwife at two weeks would make a lot easier for new moms to, not only have to pile all that stuff in the cart once, simply practise it over and over once again. So we're thinking about that here at the university and it's a keen thought.

What are the cultural practices effectually the postpartum menstruation in your cultural groundwork? We certainly should celebrate the birth of a new citizen of the planet, and the woman who put her body and her life at risk to accomplish this miracle. As obstetrics practitioners, we should give up the cabalistic and useless rituals like the six weeks postpartum visit, and see women and their babies in a more evident space timing and do a more family unit friendly combination of services.

And if you lot can get your family to accept over the cooking and cleaning for 2 years afterwards the nascency of a child, more power to you.

Journalist: Have a question about a medical procedure? Want to larn more than well-nigh a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance y'all'll find what you want to know. Bank check it out at TheScopeRadio.com.


updated: May 29, 2018
originally published: December 10, 2015

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