Chinese women struggle to overcome cultural differences in postpartum care

Wellington’s Yaodan Wang was shocked to receive a box of ice cream after the birth of her second child.

“When I gave birth to my second child, the hospital provided me with cold water and a small box of ice cream,” Wang said. “I definitely didn’t eat it. My husband ate, so nothing was missing.”

Similar experiences are common among young Chinese mothers giving birth in New Zealand, who are unfamiliar with Western practices that are very different from their centuries-old approach to confinement recovery.

Postpartum birth is a tradition that many Chinese mothers follow for one month to aid recovery after childbirth.

The tradition, called zuo yue zi, or “month sitting” in Mandarin, forces new mothers to abstain from strenuous activities such as housework, heavy lifting and, in many cases, leaving the house for a month after giving birth.

They are also expected to avoid certain foods during this period, especially “cold” or “wet” foods, which are believed to upset the balance of the body and interfere with healing.

Some young Chinese women in New Zealand struggle to follow the prescribed set of lifestyle and dietary recommendations in line with tradition as they navigate the country’s Western-style healthcare system.

Postpartum diets

Postnatal nutrition, or “yue zi cai”, is believed to be an important part of a new mother’s recovery as ingredients are selected for their nutritional and “warming” properties to promote healing and restore nutrients lost during childbirth.

However, Chinese mothers may find it difficult to access such utensils while recovering in a New Zealand hospital after giving birth.

Wang followed strict guidelines when choosing foods to help her recover after having three children.

“I didn’t eat any condiments or salty foods during the entire labor period after the birth of my eldest daughter,” Wang said. “I also avoided cold and raw foods when I had my second daughter because the weather was cooler. Even now, after the birth of my little (two-month old) son, I warm up any fruit before I eat it.”

Wang struggled to find the “warm” foods served with meals during each of her short hospital stays.

“The milk served was cold. The hospital had a microwave, so I asked my husband to heat it up before drinking,” she said.

“It would be ideal if the food provided by hospitals were more in line with Chinese dietary habits, offering light, flavorful and warm meals to postpartum mothers.”

Lu Yan from Auckland experienced similar difficulties with eating after giving birth.

Yan’s eldest son was born in China, which gave her access to fresh, lightly seasoned, low-salt, low-oil dishes that were served warm.

However, after giving birth to her second child in New Zealand in January, she found herself faced with a very different postpartum environment.

“Meals provided by New Zealand hospitals are everyday foods such as bread, porridge, mashed potatoes and pasta – anything that tastes good, including cold and salty options,” Yang said.

“I tried to eat hospital food during the day, but in the following days I returned it because I didn’t want it to go to waste,” she said.

“My mother took it upon herself to prepare postpartum meals for me (in the following days) and my friends also brought suitable food to the hospital.”

In addition to the lack of traditional Chinese food after giving birth in hospital, Yan also struggled to find a qualified nanny in New Zealand.

A postpartum nanny, or yue sao, in China typically cares for a new mother and baby in the first month after giving birth.

“I found a postpartum nanny before my eldest son was born in China,” she said.

“The nanny accompanied me to the hospital, returned home with me, prepared various postpartum meals throughout the labor process and helped care for the baby.”

After her daughter was born, Jan struggled to find an affordable and experienced postpartum nanny, so she asked her mother to fly to New Zealand to help.

Ian said there were several commercial agencies in New Zealand offering specialized nutrition for pregnant women and children, but charging high fees for their services.

“I contacted one of the more affordable services (for a quote), but they charged about $140 a day to prepare postpartum meals,” she said. “Postnatal care is much more expensive in New Zealand than in China.”

Achieving balance

Grace Ryu, group manager for Asian and ethnic health services, said postpartum traditions exist in several Asian cultures, including “sanhujori” on the Korean Peninsula and “jaappa” in India.

However, she was concerned that language barriers and cultural differences often prevent Asian women from sharing personal or sensitive issues.

“They may be uncomfortable or unable to communicate in English,” she said. “Even for mothers who are fluent in English, there are still concerns that their cultural preferences or customs may not be understood.”

Traditional Chinese medical beliefs are an example, she said.

“In traditional Chinese medicine, there is a concept called qi xue (vital energy and blood), which refers to two important components,” she said.

“These components weaken after childbirth, leaving the mother vulnerable to disease. As such, many Asian women value traditional postpartum practices that provide a holistic approach to restoring balance to the mother’s body after childbirth.”

“Due to the loss of hot qi, many (new mothers) avoid cold foods in order to restore balance and return hot qi to the body through hot food.”

Vartika Sharma, a senior lecturer and research fellow in the Faculty of Health and Health Sciences at the University of Auckland, said her team conducted a research project looking at maternity care among ethnic women, including those from Asia, the Middle East, Latin America and Africa. backgrounds.

The study found that women from ethnic groups have several common postpartum practices.

For example, Indian women typically observed a labor period of about 40 days after childbirth to recover and heal from the process.

Sharma said many women not only stuck to traditional diets, but also took extra precautions to avoid infections, such as staying home and limiting the number of visitors.

For women observing traditional methods of confinement, one of the biggest challenges was finding a balance between such customs and whatever was available in their new environment, she said.

“You are trying to do something that is an anomaly in the New Zealand system,” Sharma said. “For example, if you have to go to a doctor’s appointment, but your tradition says that you really can’t leave the house.

“These women have to navigate what the health care system tells them, but there’s the opposite advice you get from your family and your own culture.

“It’s about constantly moving between two different systems and trying to find a balance between the Western healthcare system and traditional practices.”

Sharma said a lack of understanding about postpartum traditions sometimes leads to stereotypes about women.

“In interviews we did, one participant talked about how women were treated like princesses, in a very derogatory way,” she said.

“It can make women feel quite uncomfortable because it (makes them feel like) they’re doing something that they don’t think other women are doing.”

Sharma said New Zealand’s health system needed to strengthen “cultural safety” for ethnic women who followed traditional birth practices.

“We often talk about what we call cultural safety, which essentially means understanding your patient’s expectations,” she said.

“It’s about whether the services you provide reflect their worldview and their expectations of the healthcare system.

“How do you make sure that you don’t reject anything that’s not Western and create a space where women feel comfortable and (open) to those discussions.”

Sharma said maternity services must go beyond language support, emphasizing the importance of creating an inclusive environment.

“Specialized maternity services need to go beyond the language part.” she said.

“If I walk into a room and there’s a midwife looking after me, I know I’ll be heard and I can make a choice – that I won’t be dismissed for who I am.”

Ryu agreed, noting that Asian and ethnic health services work closely with families and cultural connections to provide comprehensive care that meets the unique needs of mothers in ethnic communities.

“By ensuring clear communication between health care providers and patients regarding cultural practices, we can avoid misunderstandings and impact on care,” she said.