In this informative research paper, Birth Institute student Maya D’Costa gives us insight into the traditional ways women are supported during the postpartum period in India. Touching upon the topics of Ayurveda, diet, nutrition, massages, oils, belly binding and postpartum depression, this piece helps us to gain a better understanding of how we can provide more comprehensive support to women around the world, and in our own communities.
The Postpartum Period
In India, across cultures, the postpartum period is given much emphasis. This time is meant for the mother to recuperate after childbirth and for mother – newborn bonding. It is the time where they also establish breastfeeding. After childbirth, women stay at home for approximately 6 weeks/40 days (a period of 'confinement‘). Usually the woman returns to her mother‘s house for the end of pregnancy, birth and the postpartum. If she is unable to do so the mother will usually come and live with her during this time. This practice is indeed beneficial for a new mother who will need mothering herself. So, during this 'confinement‘ period the woman is well cared for by her mother and/or other female relatives. The woman is supposed to rest, rejuvenate and replenish. She is not to do any housework or other strenuous activities. Basically she is to be pampered with love for the next month at least. She is on a certain diet, which is specifically tailored to her body‘s needs postpartum. Childbirth Educator Simran Adeniji writes:
“In Ayurveda, a 5000 year old Indian healing tradition, this period is considered a sensitive time for mothers, particularly for the digestive system – hence the strong emphasis on simple, digestible foods. Traditionally, mothers are given hot oil massages daily. They are fed very simple but special foods and a number of herbal drinks to promote healing, boost their immunity and improve milk supply”
For interest sake we will have a glimpse at what some of these dietary guidelines may look like (taken from an article by Anita Premkumar):
“Savories made out of sesame seeds, dry nuts, fenugreek seeds/leaves, garlic, drumsticks & carom seeds are given to new mothers to increase milk supply. Edible gum cooked with dry nuts and wheat is given to strengthen the back and the reproductive organs post delivery. Fresh cow‘s milk is given first thing in the morning to enhance the quality of the new mother‘s milk.”
Veggies like beans, squash, carrots, beets, green leafy vegs, zucchini are cooked in ghee (clarified butter) in order to nourish the body and enable bowel movements. Lentils, cereals and whole grains are seasoned with whole spices and served hot. Gassy veggies like cabbage, potatoes and cauliflower are avoided for the first three weeks after childbirth, as they de-harmonize the five body elements and disturb the digestive system. Leftover food is avoided and organic fresh food is preferred. The new mother is directed to eat on time and not too much or too little, so that the digestive system is not unduly taxed. Chewing betel leaves after a meal helps in digestion.
In addition to a specific diet, the new mother is also given a series of Ayurvedic tonics like Sukumara kashayam to help in contraction of the uterus and pelvic area, Ajamamsa rasayanam to strengthen the bones and muscles and Dashamoola arishtam to improve immunity and enhance the quality of breast milk, for a duration of three months.
“My great great grandmothers and their descendants lived up to the ripe old age of 90 and above, despite giving birth to over 10 children. They were free of the usual complaints of rheumatism, arthritis, backaches, joint pains etc., because they strictly followed the traditional confinement practices...so my mother said and I am inclined to believe that because some of the women I know from my generation on wards, have been riddled with chronic back, joint and pelvic ailments, from the time their kids were still in preschool, on account of a lackadaisical attitude and skepticism towards ancient norms and practices. Most of their current health issues can be traced back to the lack of proper care during the postpartum period, not realizing that the first six weeks after childbirth is a pivotal phase in a woman's life, as medical science agree that it takes minimum six weeks for a woman to recover mentally and physically.”
As we know the diet is pivotal to the postpartum care, but let‘s takes a look at some of the other postpartum practices, so important to Indian culture. These women are given daily hot oil massages either by a family member or an experienced ‘maushi’ or ‘dai’. These massages are done with nurturing oils such as sesame, coconut, olive etc. as we learn from Geetu Vinod below and are followed by a warm, herbal bath.
Sesame oil (til ka tel)
Sesame oil is used for massages in many regions of India, especially in Maharashtra. Sesame oil is believed to control stress and blood pressure and has cooling properties.
Coconut oil (nariyal ka tel)
It is usually used for head massages. It gives a cooling hydrating effect on the body. When applied on pregnant belly reduces the appearance of stretch marks as it works as a natural moisturizer. Coconut oil smells pleasant and is quickly absorbed by the skin.
Olive oil (jaitoon ka tel)
Olive oil is increasingly being used in many regions, especially in urban areas. It is good for skin and hair. In case of C- section oil massage is done only after the stitch gets healed.
After oil massaging, hot water is used for bathing. Hot water is poured on the lower abdomen and the pelvic area.
Warm water that has been boiled with Neem leaves are used for bathing for other parts of the body, Neem leaves are a natural antiseptic. Lukewarm water can soothe tired and aching muscles. Commercial soaps are avoided to wash off the body oil. A paste of chickpea flour mixed with a pinch of turmeric powder and 1 teaspoon of milk cream is used as soap for the new mother and the baby.
After bathing the tummy is tied with a cotton sari or cloth. It is believed that it helps to push the uterus back and help to keep it in place. Belly binding also helps to get rid of the stomach gas. Some benefits of belly binding: promote healthy posture during breast feeding, gently push the stomach muscles back together, reposition the womb, and reduce stretch marks.
Post delivery, women are made to cover their head with scarf the whole day as a part of North Indian tradition. It is believed that body heat is lost primarily through one‘s head and that a new mother needs to preserve her body heat to recover. Covering your head is believed to keep you warm and protect you from infections.
A few restrictions are also advised to the new mom as a part of the North Indian postpartum care. It is believed that following these restrictions helps a mother avoid health problems such as backaches, headaches and body pains later in life: Avoiding ac or fan, as ac and fan can cause cold for new moms. No reading or watching TV (this results in headache). No shouting, crying or engaging in stressful conversation. No doing of house hold works. Staying in a room till the confinement period ends. Sleep when the baby sleeps (best advice ever heard).
Care of the newborn in Ayurveda is greatly emphasized as well. The mothers are taught how to give their babies massages daily and are encouraged to breastfeed on demand. These first few weeks of motherhood are not only important to mother‘s health and baby‘s health but is a wonderful time for them to bond and establish a loving relationship. As the baby grows, every few weeks there is a ritual, festival performed. The name-giving ceremony, the first time the baby goes out, the hair-cutting ceremony and other such ceremonies for their protection, health and longevity.
In India, the Holistic approach to the postpartum period acts as a preventative to postpartum depression. A mother‘s support system should be nourishing and supportive in such a way that she is able to get all the help and affection she needs in order to heal and recuperate well after birth both physically and emotionally.
With proper care, a mother would also deepen and gain the mental, emotional, and spiritual resources needed to carry her though all the demands of family life, without feeling depleted.
“In my experience, women who follow this practice – including receiving the help from others – have lower rates of postpartum depression.” – Simran Adeniji (Childbirth Educator)