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Thursday, March 05, 2009

Thoughts on Confinement #3 : The rules

One of the biggest complaints that women have with the practice of postnatal confinement are to do with the rigidity of the manifold rules which they are forced to abide. Staying indoors for the whole month with a tiny squalling infant and a gaggle of clucking grandmamas, will often induce claustrophobia in an independant woman - not to mention having to endure the constant nagging on what to eat, drink, wear and do.

Most of these rules are centred around the concept of keeping the body of the new mummy as warm as possible. Traditional Chinese medicine symptomology is often described using the balance of body humours which are identified as 'cold' or 'hot'. During pregnancy, the woman retains 'heat' in her body, which is apparantly lost at an appalling rate during the postpartum period.

In truth, pregnancy is indeed a high energy state. During the 1st and 2nd trimester, a pregnant lady goes through a number of physiological and physical changes that are necessary to provide for the baby growing within her. The volume of circulating blood increases dramatically by nearly 50% by the end of the 3rd trimester, and even the size of the red blood cells increases by a third. The blood vessels within the body dilate to allow better circulation and heart starts working much harder leading to a rise in blood pressure. The speed of metabolism increases phenomenally, as the body tries to store up fat, protein and water.

After delivery, the new mum starts to shed all the previously stored up energy. In the first 24 hours, she rapidly loses body heat through bleeding (as remaining uterine contents are expelled from her body as lochia) and a raised core body temperature. Furthermore, not only does her body have to repair itself to its prepregnancy state, but also manufacture colostrum and milk to nourish the infant. These energy losses account for the so-called 'cooling' of the body.

Thus, the goal of keeping the mother's body 'hot' during confinement is in order to add or conserve as much energy as possible, so that more of it is directed towards healing and milk-production instead of regulation of body temperature.

As jadeite pointed out in the comments section of my previous post, one of these rules in postnatal confinement includes not bathing (or, in some cases, washing hair). A rather nasty thought, especially in our sweaty Singapore climate. I am personally unable to lead a bath-free existence, which is why I hardly ever go camping.

I suppose this rule sprang into existence because of the lack of hot water storage systems in Asia-that-was. A nice splashabout in icy water is a quick way to lose body heat and thereafter, lose energy via shivering. It is also a sure-fire way to reduce milk-production - indeed, cold compresses are used in the treatment of breast engorgement from overzealous lactation.

Additionally, a shower will wash away the natural oils and the traces of milk that scent a mother's skin. The newborn infant has rather poor eyesight - so the identification of people is dependant on senses of smell and hearing. This is why a crying infant will often be calmed by the sound of a mother's voice or heartbeat. Some mums even find that placing an item of clothing (such as a breastpad) in the cot will create a familiar environment for their little sleeper.

During my pregnancy, I discussed the rules of confinement with my mum who would be looking after me during that time. I think this really helped me to establish the boundaries of what I would or would not be able to tolerate during confinement, which led to a less stressful situation all round. I would recommend that all women do the same with their respective confinement caregivers! Less stress = happy mummy = happy baby!

(Thoughts on Confinement series: Part 1, Part 2)


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