Should You 'Sit the Month' After Childbirth?

The first month after Catherine Sun Chitayat gave birth to her daughter, she tried not to surf social media, work, cook, do laundry, watch much TV or even go outside for fresh air. What did she do? "Literally just sit in bed all day, breastfeed and ... get up to eat," says Chitayat, now a 30-something writer in Shanghai.

Chitayat wasn't depressed, deprived or behaving like a diva; rather, she was practicing some aspects of "confinement," an ancient Chinese tradition also called zuo yue zi, which means "to sit the month." It involves doing as little as possible to let a woman's body recover from pregnancy and childbirth.

[See: 12 Little-Known Things That Happen to Your Body After Giving Birth.]

The custom, variations of which exist in many Asian countries and Asian communities in Western countries, is estimated to be well over 1,000 years old and is based on the belief that childbirth disturbs the body's balance between yin (cold) and yang (hot), says Elizabeth Rochin, vice president of nursing and clinical services at the Association of Women's Health, Obstetric and Neonatal Nurses.

Avoiding physical activity, cold food and drinks, showers, sink water for teeth brushing and even the cool breeze of an air conditioner -- while consuming warm drinks and foods like soup that are often formulated with Chinese herbs -- helps restore that balance, promote recovery, prevent disease and slow aging, the theory goes, says Chitayat, whose Tawainese-American parents raised her in Los Angeles and Taipei.

"The whole idea of confinement is that you really just rest in bed, you take it really easy, you don't go out, you protect your reproductive system, you stay away from 'air con[ditioner], '" she says. "The idea is that your pores are still open; everything in your reproductive system is still open, and so you don't want any 'yin' to get inside your system."

Evolving Traditions

Generations ago, confinement was more practical, Chitayat says. That's because extended families were more likely to live together, and the new mom could rely on her mom or mother-in-law to prepare food (typically soups), care for the baby when she needed to sleep and handle other household duties.

Today, however, new moms in Asia like Chitayat often hire "confinement nannies" to do the job. Meanwhile, those in the U.S. may pay thousands of dollars to stay in a zuo yue zi center or turn to some combination of nannies, meal delivery services and care from postpartum doulas, or professionals who help new moms breast-feed, bond with their babies and learn other facets of newborn care -- though their training is rooted in European, not Asian, traditions.

In the U.S., professional postpartum care "is not available to anyone who doesn't have the means," says Ruth Callahan, the owner of Doula Care, a postpartum care service in New York City, who charges $50 an hour for her services. American women also tend to be inhibited from seeking such support by their employers, who rarely offer as generous of maternity leave plans as those in Europe, Callahan adds.

Still, if American women can afford to adopt some of the practices of confinement, they may benefit, experts say. For example, eating lots of soups made with vegetables, broth and organ meat is healthier than the typical American diet, and provides the body with loads of B vitamins, iron, magnesium, phosphorus, zinc, selenium and vitamins A, D, E and K, says Meghan Sylvester, a nutritionist at the Wellness Center at Shady Grove Fertility who mostly works with women preparing for fertility treatments. Such nutrients, she says, "are all essential pre- and postpartum to help nourish and heal a woman's body."

[See: The Fertility Preservation Diet: How to Eat If You Want to Get Pregnant.]

There's also a lot to be said for confinement's emphasis on postpartum support, which is well-known to be associated with positive outcomes like higher breast-feeding rates, Callahan says. "Having help after you birth in your house -- it doesn't seem like it needs a lot research," she says, just like spouses don't need studies to prove that hiring a cleaning service will help alleviate their spats about chores. "It's common sense."

Ultimately, it's the spirit of confinement -- one that honors what new moms' bodies have gone through -- that's most worth recognizing, says Dr. Scott Sullivan, director of maternal-fetal medicine at the Medical University of South Carolina. "The best thing about this idea is that it does give moms time to recover from the process of pregnancy and childbirth, which ... can be an exhausting process," he says, noting potential complications like tears and anemia. "[In] Western cultures ... we expect people to go home from the hospital and be ready to go, and that's not true or paying attention to physiology."

One Size Doesn't Fit All

On the other hand, some aspects of confinement are not evidence-based at best, and they're risky at worst. For example, going on strict bedrest after a cesarean delivery can raise the risk for complications like deep vein thrombosis, Rochin says. "After a surgical birth, to not move would be antithetical thinking," she says. Same goes for people with diabetes or a history of blood clots, Sullivan adds.

[See: 10 Things No One Tells You About Breast-feeding.]

Avoiding air conditioning in sweltering heat, swearing off (cool) fresh fruits and vegetables, and taking herbal supplements without medical guidance isn't recommended either, experts say. "There is very limited research or oversight on the products, their ingredients and possible interactions and complications during pregnancy and lactation," Sylvester says. And if women practice confinement in the strictest sense and don't appropriately clean tears or wounds from a cesarean delivery due to fear of cold water, they could acquire an infection.

There's also some concern that isolation might raise the risk for postpartum depression, although the evidence is mixed on how the emphasis on rest might counter that, says Rochin, who points out that both long periods of seclusion and a lack of adequate sleep have been linked to postpartum depression. "It certainly needs to be looked at at the individual level," she says.

Indeed, Chitayat says, the whole concept should be approached from an individual perspective; that's the essence of traditional Chinese medicine. She, for one, loosely followed the rules of confinement after her first child's birth -- brushing her teeth, for example, and leaving the house during the first week to visit the baby, who was recovering from a complication, in the hospital. "A lot of American women may take it with a grain of salt -- it feels like old wives' tales; not scientifically proven," she says. "So I think: to each their own."