Lying in, sitting the month, confinement — the practice of taking serious rest and time for recovery for the weeks following childbirth has many names. Now something of a lost art to those in the global west, until 100 years ago a month’s postnatal confinement was still quite common in most countries regardless of location or culture. Childbirth was risky, with around one in 10 women losing their lives while attempting to bring babies into the world. Mix in the serious risks of infection, anaemia and the slow healing needed after undergoing childbirth with no medical interventions, and a month of strict rest during this delicate period starts to make sense. But with the advent of modern medical practices and— later — the need for hospital beds to be freed up for war-wounded soldiers, this period of confinement steadily shrunk. Now many women head home within 48 hours of giving birth, often to other children and responsibilities. And with the advent of celebrities and celebrity spouses such as seven-time mother Hilaria Baldwin (née Hillary Lynn Hayward Thomas) parading their improbable instant ‘bounce-back’ bodies as something to be admired, the pressure is on to be back on our feet before we even know what’s hit us. But that’s not true everywhere.
An extremely important part of Chinese, Korean and many other Eastern and Southeastern Asian cultures, ‘lying in’ for a month is seen as essential to the future health of the mother, and therefore her baby. Practices differ, but the thrust is the same — rest, relaxation, nourishment and solitude all have a part to play in the mother’s full recovery from childbirth. Known as zuo yuezi in China, sanhujori in Korea and sango no hidachi in Japan, women are kept warm, quiet and sheltered by their families or in specialised postpartum clinics. The style of care varies from being provided at home by relatives or a live-in postpartum nurse, through to small independent clinics, lying-in wings of maternity hospitals and, a more recent advent, ultra-luxe postnatal clinics with all the trappings of a five-star hotel.
“The concept of yuezi is a good one,” says Louise Roy, director of operations at the Ferguson Women’s Health clinics in Shanghai and founder of women’s, parenting and perinatal support organisation Not Broken. “In the traditional sense, sitting the month was about resting. Before formula this meant someone else did the housework, cooking and cleaning, while you did the breastfeeding, nourishing yourself and the child. The idea of resting became paramount and the bonding, both physiological and emotional, could take place uninterrupted. Yuezi made a lot of sense, with its traditions around special foods, keeping warm and so on. The diet focused on very freshly killed and cooked protein, and a lot of soup — women do need to hydrate well after they have babies. When water wasn’t sanitary, soup would have benefitted vulnerable new mothers. The problem is that times have changed and, even in the home setting, yuezi is being honed into aspects that aren’t beneficial. There’s evidence that women who perform a traditional yuezi have increased chances of depression, bonding issues with the baby and interruption of breastfeeding. In China, paid yuesaos [confinement period nurses] are a huge business and there’s no real regulation. Most haven’t done much training and they override parents’ natural instincts, taking away their trust in themselves. Above all, their methods aren’t always evidence-based or the safest way to do things.”
However, Roy says that there is a place for the confinement period to be adapted to a modern setting —and there are postnatal retreats popping up all over the world catering to just that need. Boram Postnatal Retreat caused a splash when it opened in New York City’s five-star Langham hotel on Mother’s Day in March 2022. Bridging a gap between the very traditional postpartum practices and a more ‘in at the deep end’ western approach to the postnatal period, just how did the retreat come to be, and what does it aim to do? “After the delivery of my second child in 2014 in New York City, I had to deal with a tough c-section and depression,”says Boram Nam, the retreat’s co-founder.“This journey took me two years to recover from. I realised the absence of any kind of postnatal care services in the US, compared to the services my friends were getting in Korea at sanhujori won [postnatal care facilities], and in other countries where the mother is not put on the back burner after the baby arrives. This challenging experience convinced me of the necessity of a service to make postnatal care essential, offering a serene and supportive retreat where mothers can recover with their baby and partner.”
Ferguson Women’s Health also offers high-end postnatal services to Shanghai’s new mums and babies. So what can we expect from a fresh, modern and more luxe version of sitting the month? “The big yuezi centres in China include everything from flower arranging classes to live piano music, yoga, massage and even cosmetic surgery wings,” says Roy. “But even in some of the fanciest and most expensive clinics, professional training for the yuesaos can be lacking. At Ferguson Women’s Health, our approach is closer to a training centre to learn parenting skills, as well being a place to rest in an environment with properly trained and qualified nurses and doctors. We teach all the aspects of normal baby life, how to understand what the baby is trying to say, bonding, safe sleep and best feeding practices. Most importantly of all, everything we do is evidence-based, not just the result of tradition or culture.”
And on the other side of the globe, high above Manhattan’s famed 5th Avenue, Boram Postnatal Retreat has a very similar approach. “Boram provides a healing environment staffed by a team of professionals,” says the centre’s director of operations Sarah Mall in, RN IBCLC. “We have certified lactation consultants, doulas, and healthcare professionals who are there to provide 24/7 expert care and education. All of our care is evidence-based and our team has completed formal training to care for mums and babies. Mothers can choose whether to room in with their baby or use our professionally staffed nursery, or to formula feed or breastfeed. Whatever mum chooses, we support her. We not only take care of families, but we also provide support, education and even offer a virtual follow up programme to help you transition to home and continue to support you for up to a year.”
As the key role that proper postpartum care plays in retaining staff becomes more recognised by employers, many are choosing to include these services in their benefit packages — indeed, Boram provides its services to employees of publishing company Condé Nast and online retailer Boxed. But for those seeking their own slice of postnatal bliss, Roy counsels that a few key questions could mean the difference between lying-in heaven and hell. “What are the qualifications of the people taking care of you?” asks Roy. “How much medical supervision is there? Are there postpartum checks? What is the mental healthcare like? Where do they transfer the mother and baby to if anything goes wrong? And be sure to find out the process for refunds — it doesn’t always work out.” Once the answers to all these questions are clear, you can be safe in the knowledge that you won’t become just an after thought after that beautiful new babe is placed in your arms and motherhood begins. “The most important thing is that as an expecting person, don’t just think about your birth plan, but also think about your postpartum plan,”says Mallin. “Whether it’s a stay at Boram, a list of friends or family to call when you need support or hiring outside help, set yourself up for a successful postpartum journey. “This is so often overlooked and parents are surprised that postpartum can be more difficult than pregnancy and birth. Making sure you have a support system or plan in place is so important. Lastly, don’t forget that a healthy mother will translate to a healthy baby. Don’t forget to take care of yourself,”concludes Mallin.
As many experienced mothers will attest, once you have a small and helpless person to take care of it’s easy to put your own needs in last place. But with the correct kind of postpartum care, that can be one less thing for you to worry about. And if it’s good for mum, then it’s good for everyone.
