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I tried the Chinese practice of ‘sitting the month’ after childbirth

After the birth of her fourth child, Leslie Hsu Oh spent a month without the pressure of fixing meals for her family. (Angie Gray)

When my aunt learned I was pregnant with my fourth child, she begged me to respect the Chinese tradition of zuo yue zi, or “sitting the month.” Traced back to as early as the year 960, zuo yue zi is a set of diet and lifestyle restrictions practiced after birth to restore a woman’s “broken body.”

Traditionally, your mother enforces zuo yue zi. But my mother died when I turned 21, and I was raised by a father who championed all things Chinese but ridiculed the zuo yue zi restrictions he’d heard about: Do not wash your hair. Do not take showers. Do not brush your teeth. Do not carry your newborn baby, climb stairs, shed tears, drink or eat cold foods. Do not have sex, use the air conditioner, leave the house, read, watch TV or surf the Internet.

Zuo yue zi is somewhat controversial because the advice to take a month’s rest can be interpreted widely. For example, the ideas that one shouldn’t wash hair, take showers, brush teeth, use an air conditioner or leave the house all stem from the belief that childbirth brings significant amounts of fluid and blood loss. According to traditional Chinese medicine, blood carries chi, your “life force,” which fuels all the functions of the body. When you lose blood, you lose chi, and this causes your body to go into a state of yin (cold). When yin (cold) and yang (hot) are out of balance, your body will suffer physical disorders.

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Some folks, such as a woman in China who died of heatstroke last year, follow the restrictions to an extreme. Others are more relaxed, taking showers or using air conditioning as long as cold air does not blow directly on them.

Born and raised in the United States and a graduate of the Harvard T.H. Chan School of Public Health, I could not resist examining the evidence relating to zuo yue zi — and I found inconsistent results. On the plus side were findings that a long recovery period improved a mother's health-related quality of life and led to better bonding with her child. But a 2014 study of Chinese women found that limiting physical activity for a month was bad for muscular and cardiovascular health and increased postpartum depression.

Another study found that while sitting the month helped some women return to their pre-pregnancy weight, it also seemed to cause high cholesterol and high blood glucose and created feelings of "extreme sadness" from being homebound.

About the only thing scientists seem to agree on is that zuo yue zi is popular in East Asian and Southeast Asian countries and among migrants from these countries, and that health professionals should understand zuo yue zi to properly advise those who are practicing these cultural beliefs.

Despite the need for more studies to determine whether zuo yue zi adversely affects maternal physical and psychological health or, as its adherents believe, protects against diseases in later life, I was willing to try it. I had already had three rough postpartum experiences, where only my husband helped me — and only for about two weeks each time — with the cooking, cleaning and child care. I never got to stay in bed.

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I’m still somewhat traumatized by the third postpartum experience: With our house in various stages of being boxed up for an unplanned move while our newborn wailed in her crib, I worked a nit comb through our older daughter’s long tangled hair, tears running down my face as my husband lathered up head-lice shampoo for our son and me.

For my fourth child, I hoped there was truth to what Shuqi Zhuang — reportedly the first woman to become a traditional Chinese medicine physician in Taiwan — called the “golden opportunity.”

Zhuang believed that proper postpartum recovery every time is critical for a woman’s health. One time would hopefully help repair damage done after previous pregnancies and save me from a future of hemorrhoids, uterine prolapse, urinary incontinence, weight gain, premature aging and body aches.

I figured there must be a reason that affluent women in China are willing to spend 27,000 in luxurious centers that specialize in zuo yue zi. In the United States, some friends have spent about $7,000 to stay at zuo yue zi centers, $3,000 (plus food and transportation expenses) to hire a nanny for 30 days or $2,000 to $4,000 to have a month's worth of special postpartum meals delivered to their home.

So when my fourth child, a girl, was born, my aunt gifted me 30 days of meals delivered by Jing Mommy, a California-based service that promises "delicious and convenient meals for the postpartum recovery."

A box large enough for my 3-year-old to enjoy as a playhouse arrived the day after I returned home with our newborn. This 94-pound box contained seven freezer bags, one for each day of that week. Each offered a daily pre-made meal of breakfast (congee, egg), lunch (fish soup, entree made from “yang” foods such as ginseng, vegetables and rice), dinner (a specialized soup of internal organs such as pig trotters or liver, a sesame oil soup, vegetables, rice), two desserts and herbal drinks. It was enough for all of us; we just had to microwave the meals.

I hopped onto Skype to show my aunt the generous spread I would receive each week. “So lucky! Pig feet are very good for joints and milk production,” she said in Chinese, peering through the webcam to see the various foods. Because the English labels read the same each day — “Lunch Fish Soup,” for example — I asked her to translate the Chinese labels. “Bass soup with mushrooms, bass soup with red dates and gojis. . . . ” She disappeared into her kitchen and returned with a shriveled-up red berry about the size of a raisin. “Goji,” she said with respect. “Anti-aging, anti-inflammation.” In between her thumb and forefinger, she held a red date about the size of a grape. “I put this in all my soups. Protects the liver.”

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Nicole Huang, chief executive and co-founder of Jing Mommy, hosts free tasting parties and seminars. While her meals are based on Zhuang’s rules of detoxification (Week 1), repairing (Week 2) and rejuvenation (Week 3 and Week 4), Huang modifies them by watching the reaction of her customers. Her cooks start preparing meals at 5 every morning in a professional kitchen and deliver them before noon to local moms. Fluent in English and Chinese, her customer service staff members say a typical day begins at about 7 a.m. — when they start answering frantic texts — and lasts until 10 p.m. Jing Mommy’s meal plans range from $2,030 to $3,390 (and, in our case at least, provided enough food for all of us!).

Huang said: “I feel fulfilled when women recover their health from my meals. I want women to enjoy their postpartum time. This is not a business to me but about education and explaining why zuo yue zi is important.”

So does it work?

According to acupuncturist Lia Andrews, author of "The Postpartum Recovery Program," too many new mothers rush back to their daily routines after birth. They expect that their weight, energy levels, mood and libido will miraculously bounce back without any assistance; they also believe it is normal for their bodies to feel wrecked from childbearing. Some "modern mothers never fully recover from having children. Instead, they suffer from depression, lack of libido, weight gain, hormonal imbalances, inability to conceive more children, urinary incontinence and other complications," she writes in her book.

Anne CC Lee is a pediatrician in the department of newborn medicine at Brigham and Women’s Hospital, a Harvard Medical School teaching hospital. Like me, she’s an ABC — an American-born Chinese — and a mother of four. And, like me, she said she responded to emails through labor, worked during what was supposed to be her maternity leave and repeatedly ignored relatives who tried to help her follow zuo yue zi.

Unlike in my case, though, Lee’s mother was still around to help her through all four postpartums. She reveled in her mother’s chicken soup, congee and child care — but passed on the pig trotters.

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The food and the parental help “provided me with the much-needed rest and energy to be able to better care for my newborn and return to family and work stronger,” Lee says. “My parents are Westernized and liberal with the interpretation of zuo yue zi, and fortunately allowed air conditioning — as long as it wasn’t blowing directly on the baby — showers and surfing the Internet.”

Lee points out that Eastern and Western cultures share common customs in the postpartum period — promoting nutrition, hydration and rest, and avoiding infectious exposures. “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,” she says.

“On the other hand, some traditions may have less clear benefit or even potential harm. Herbal supplements are not regulated by the FDA, and there is little information on their active ingredients, transfer into breast milk or effects on breast-feeding infants. Thus, it may be best to tailor the postpartum experience for the individual, considering a mother’s particular needs and circumstances, while balancing the potential benefits and potential risks of the practices.”

By standards of traditional Chinese medicine, I probably didn’t eat enough pork liver to replenish the blood lost during childbirth, pork kidney to heal back pain and pig feet to increase my milk supply.

By reading Andrews’s book, I also discovered that I had ignored a key piece of equipment for zuo yue zi that had come in the Jing Mommy box: a roll of stretchy cloth for a new mother to wrap around her abdomen. Had I known that the binding was supposed to minimize organ prolapse, improve my waistline and return my internal organs to the correct position, I would have tried it. “Without binding, new mothers can be left with a permanent puffy pouch,” Andrews writes.

Looking back, my husband and I regret not having given zuo yue zi a chance with our other children. Even though most women do not have the luxury of staying in bed for a month, we can at least try to rest and eat well. The prepared zuo yue zi meals alone made this postpartum experience much more enjoyable and less stressful than the previous ones. Not having to argue about who was going to prepare a meal or what to eat (fast food being the usual default) allowed us to focus on the health and well-being of everyone in the family. Zuo yue zi removed the exhaustion, anger and resentment that had clouded my ability to bond properly in those critical first months of postpartum.

Now three to four months after giving birth, I can more clearly see the long-term benefits. When my baby cries or needs a diaper changed, I am not so exhausted that I’d rather have my husband handle her care. And while I can’t prove that zuo yue zi is the cause, this newborn seems to have the most wonderful disposition: infectiously joyful. Best of all, as a relaxed, unstressed mother, I finally had the luxury of making my baby laugh first — instead of ceding that delight to my husband.

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