Tien Sheng-feng (田聖芳) first developed an interest in the traditional Chinese custom of zuoyuezi (坐月子) when she began working as a maternity nurse specializing in postpartum care at the Mackay hospital 20 years ago. Tien — who is currently the director of Mackay Medicine, Nursing and Management College — found herself constantly bombarded with questions about the practice. More often than not, she didn't know the answers to the questions being posed, which began a life-long research interest in zuoyuezi and promoting its study to nursing students.
"Nursing education in Taiwan doesn't emphasize Chinese culture. We are educated in Western medicine and learn very little of the local culture," she said.
Variously translated as "doing the month," "sitting for a month" or "one month confinement," zuoyuezi is a traditional practice whereby the new mothers rest for one month directly after giving birth. The rite can be traced back to the Song Dynasty (960-1279AD) but its conceptual origins may date as far back as two millennia. In addition to Taiwan, the practice can also be found in Japan, South Korea, China, Thailand and Cambodia.
"It is still very rare for people to study zuoyuezi," Tien says, adding that knowledge about the ritual is passed down from generation to generation through word of mouth, the mothers generally knowing more about the practice than the nurses caring for them.
As with many traditional Chinese rituals, zuoyuezi has a variety of complicated practices of which the concept of yinyang (陰陽) — or the balancing of opposing forces such as hot and cold — and Chinese medicine are the most important. Traditional Chinese medical theory holds that the nature of females is yin, or cold, and this makes them vulnerable.
"Because postpartum women are quite weak and become very yin, [they] need energy, [they] need yang to supply energy and nutrition," says Heh Shu-shya (賀姝霞), assistant professor of maternity nursing at Fu Jen Catholic University.
Keeping it in the family
Though doing the month at home is generally considered to be the best option for the recovery of postpartum mothers because they are close to their husband and family, problems can occur if the mother or mother-in-law works outside the home.
Annie Hong chose to spend her zuoyuezi at her husbands' parent's home because of its large size and Annie's close relationship to her husband's family. However, because her mother-in-law works during the day and wasn't able to keep an eye on the infant, within three days her baby became sick and had to be rushed to hospital. As it turns out, Annie wasn't breastfeeding often enough, a circumstance that may have been avoided had her mother-in-law been there to provide more help.
As the mother-in-law is the expert on the ritual, it becomes her responsibility to care for the both the postpartum mother and infant. This can often strain good relations between relatives or make bad ones worse. Going to a center can ensure that these minor details are dealt with because they have staff to take care of the infant and postpartum mother.
Zuoyuezi centers (坐月子中心), or postpartum nursing care centers (產後護理之家) as they are officially known, have become increasingly common since the early 1980s. People who have moved to large urban centers are sometimes unwilling to return home for zuoyuezi; increased affluence and the fact that most women work during the day are reasons for the increased popularity of the centers. Currently there are two kinds of centers that women can go to three days after giving birth.