Can a month of Chinese postpartum confinement (zuo yuezi) prevent a woman from suffering from postnatal depression? This is a question that I wanted to explore during zuo yuezi.
I have thankfully never suffered from postnatal depression, the mental illness that often strikes new mothers without warning. I did, however, go through some fairly intense episodes of the baby blues with my first son. The worst was when he was a five days old. Born premature, he was still recovering from an infection when due to a shortage of beds I had to go home from the hospital without him. I was utterly inconsolable. It also happened to also be our wedding anniversary the same day, and I worried that Mr Taiwanxifu must have thought he had married a nut case.
This time around my outlook has been much more positive. I could have been upset by having to go home without baby number two (extended hospital stay due to jaundice). Or perhaps by his constant howling while establishing feeding: having a baby constantly cry and recoil away didn’t exactly make me feel like a natural mother. Yet none of these things were able to unhinge me. I only got a bit emotional one night after getting tired from doing too much around the house. Perhaps I should have instead headed the basic tenet of zuo yuezi to stay in bed and get rest.
So does the support a new mother receives during zuo yuezi such as having someone help with housework and look after the baby prevent postnatal depression?
While I am not a psychologist (and I welcome comments from people who are experts in this field), I understand that it is less than clear whether doing zuo yuezi makes a difference. For starters, there is no clear picture about what causes postnatal depression. It is not a disease that you catch, although there are a number of risk factors including things like emotionally upsetting issues (relationship problems, moving house, a death in the family etc), social problems (lack of support and/or being surrounded by negative people), recovering from a traumatic birth, dealing with a sick child, or (quite common) berating oneself for not being a perfect mother. And A type overachievers like myself often struggle with the change from an intellectually challenging and time pressured career to a seemingly thankless and non-ending routine of constant feeding and nappy changing.
Some proponents of zuo yuezi claim that the support a woman receives during the first thirty to forty-five days after the birth of a child help to prevent symptoms of postnatal depression. Having practical help can deal with some issues, such as providing reassurance about one’s parenting skills and ensuring the new mother gets enough sleep. My own experience with a confinement nanny convinces me that getting enough shut-eye and having an independent expert on parenting issues has been a blessing.
But there doesn’t seem to be a strong correlation between zuo yuezi and reduced postnatal depression. One study that compared the instances of postnatal depression between women in the UK and Taiwan showed that there was no noticeable difference in the rate of depression. Another study noted that zuo yuezi potentially provided valuable social support for a new mother, but that the ritual itself was not enough. Instead, the social support a mother received depended to a large degree on the caregiver, with women generally prefering care by their own mother rather than inflexible care from a mother-in-law.
I also wonder about how well postnatal depression is reported in Taiwan. It didn’t feature in any of the material I was given at hospital, and there are no home visits or maternal health follow-ups other than a six week check with your obstetrician. Unfortunately, many women in Taiwan undergo some fairly invasive birthing experiences that leave them upset and angry. My sense from talking with people is that they put up and deal with this expecting to ‘recover’ during zuo yuezi. But for some people not being ‘allowed’ to go out and about duirng confinement is a curse rather than a blessing. And I suspect not many families are well equipped to identify and deal with symptoms of postnatal depression in a new mother — even if the mother was willing to ask for help and receive treatment.
So for now, I don’t have a conclusive answer to this question. But I am interested in finding out more. Do you know anyone who has undergone postnatal depression in Taiwan? If so, did zuo yuezi help or hinder?