In the United States, most births occur in hospitals and are followed by a two-night stay under the care of nurses who help manage pain, troubleshoot breastfeeding and keep an eye out for complications. Six or so weeks later, the person who gave birth has a postpartum visit with a health care provider, who examines them and — if all is well — clears them to resume having sex and exercising (things they probably aren’t excited to do just yet!).
After being carefully monitored throughout pregnancy, birthing parents in the U.S. are essentially left to sink or swim during a vulnerable time, sometimes known as the fourth trimester. The U.S. has a maternal mortality rate more than three times that of most other high-income countries, and the rate for Black women is nearly triple that of white women. Over half of maternal deaths occur in the year following birth, and the Centers for Disease Control and Prevention published data last year showing that 4 in 5 maternal deaths are preventable ― meaning that some of these deaths likely wouldn’t have happened with better postpartum care.
While visits from baby nurses and postpartum doulas are viewed as a luxury of the elite in the U.S., it’s common in other countries for midwives or other health care workers to provide home visits during the first weeks of a baby’s life.
This sort of close attention better resembles the norms of postpartum care throughout history. Most cultures developed some way of acknowledging the hard work of caring for a new infant, and a birthing parent’s need for care and rest after an intense physical experience.
In some parts of the world, you can still see families with newborns benefiting from these traditional types of support. Here are postpartum practices from eight different countries that we should consider emulating here in the U.S.
In Mexico and some other Latin American countries, new mothers have
traditionally observed a period of cuarentena ― a word that translates to “quarantine” but also contains the word “forty,” the number of days the practice is typically observed. During this time, a person post-birth stays home and refrains from their usual activities. They also eat a special diet that includes hot foods like broth and porridge.
The practice stems from the belief that a person’s body is “open” after birth and vulnerable to “air,” so they may be advised to stay away from the wind and refrain from bathing. This aligns with modern medical knowledge that the opening of the cervix during labor makes the body vulnerable to infection. Six weeks also approximately corresponds to the period that it takes for the uterus to return to its regular size after a birth. Other health problems, including postpartum depression, can also emerge during this period, further evincing the benefits of keeping a close watch on women post-birth.
Betty Hernandez, who identifies as Mexican and indigenous Mazahua, is a birth doula and community specialist at Open Arms Perinatal Services in Seattle. She told HuffPost: “It is believed that after the vaginal canal is
opened for the baby’s birth, the woman is also reborn and needs to rest to recover and return to the vitality she had before she was pregnant.”
At the end of the 40 days, Hernandez explained, “the woman receives a hot and steamy bath to finish cleaning the uterus and to mark the end of the entire gestational period.” The person’s abdomen is wrapped, and the cycle of the experience is complete.
In Japan, there is the tradition of satogaeri bunben, which involves the birthing parent and newborn baby returning to the family home or village for a period of eight to 12 weeks. There, grandparents and other family members can assist the new parent in caring for their baby — and give them time and space to rest and recover. Of course, this option may offer less restorative potential if you have other children coming with you, or your relationship with your parents isn’t healthy.
Whether you give birth at home or in the hospital, a trained professional called a kraamverzorgster will visit you in your home every day for eight to 10 days following the birth. They provide medical checks for birthing parent and baby, and help with any feeding questions or other infant care. A
A kraamverzorgster can also help other children in the family acclimate to life with their new sibling. These services are generally covered by insurance, and, when not covered, are available at low cost.
A kraamverzorgster might arrive in the morning, make you breakfast, hold the baby while you shower, entertain your older child while you feed the baby and take a nap, and then help you get ready to take a walk outside with the baby. While you may never want her to leave, this time with your kraamverzorgster should leave you feeling more prepared for the work of parenting.
In Germany, the term for postpartum rest is Wochenbett, which means “weeks in bed,” and the midwife who will visit you during those first weeks expects you to take that pretty literally. Your job is to stay in bed and recover. If you need a firm hand to keep you away from work, there’s even a law in Germany that prohibits you from doing any work during the eight weeks following your baby’s birth.
During this time, you’ll receive daily visits from a midwife for the first 10 days, then visits every two to three days. She will ensure that you are recovering well and help with breastfeeding and general infant care. Insurance generally covers pre- and postnatal visits with a midwife, but there are additional fees involved if you want a midwife to attend your birth at home or at a birth center.
The ancient Chinese practice of zuo yue zi, or “sitting the month,” also involves restricting activities and following a special diet to heal the body after birth. Because it is believed that the blood loss of birth brings the body’s hot and cold forces (yin and yang) out of balance, people are advised to avoid cold drinks and cool breezes. Other recommendations may include not showering or brushing your hair or teeth, but these days, people who choose to “sit the month” interpret this list of restrictions as they see fit. A person might still use air conditioning, for instance, but might stay away from the direct blast of cold air.
Dr. Anne CC Lee, a Chinese pediatrician born in the U.S. and a mother herself, told The Washington Post: “Many zuo yue zi traditions are beneficial for the mother and newborn, such as eating protein-rich foods, avoiding strenuous physical activity and restricting visitors to allow recuperation and reduce risk for infections.” Other traditions, such as taking unregulated herbal supplements, may not be beneficial, or may even pose a risk. Lee recommended balancing the pros and cons of each practice and creating an approach to zuo yue zi that is right for you.
While “sitting the month” is traditionally done at home, under the care of grandmothers and aunts, there is now a booming business in luxury confinement hotels, where women spend up to $27,000 to be pampered. Others hire postpartum helpers known as yuesaos to help care for the baby and complete household tasks.
Omugwo is the Igbo word for the postpartum caregiving that a mother provides for her daughter or daughter-in-law following birth. Other tribes have different names for similar practices, but, as in other parts of the world, nourishment and rest are key. New mothers are bathed in hot water, sat in sitz baths, and fed dishes such as spicy pepper soup and pap, a traditional fermented pudding made with corn, sorghum or millet.
The Korean word for the postpartum period is Samchilil, which means “three weeks.” During these first several weeks after delivery, people who give birth are often advised to rest, avoid the cold, and eat traditional foods such as seaweed soup, which some people consume several times a day. While traditionally cared for within their own homes, Korean birthing people now have the option of sanhujoriwon, postpartum care centers that offer a more luxurious, spa-like environment. At a price of $2,820 to $4,700for two weeks, stays at these facilities include all meals and round-the-clock infant care so that, when not breastfeeding, new parents can rest.
In Israel, there are a small number of postpartum hotels known as milonit, and new parents can make the most of a two- or three-day stay — although you’re advised to book early, as rooms are in high demand.
Prices are similar to a luxury hotel, at around several hundred dollars a night, although some state-run insurance plans will reimburse part of this cost. The baby can stay in-room or in the nursery, and lactation support and newborn care education are available. Two or three daily meals are also included. One second-time mom told The Times of Israel: “This time I got two full nights of sleep before coming home, and it put me in a better mindset as a mother.”
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