Modern and Traditional Means to Care for Mother and Child

By Morana Lefilliatre

September 2022 FEATURE
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THE JOURNEY OF motherhood, from conception to pregnancy, birth and then raising a child, can be a daunting prospect for a first-time mother. So how does a woman prepare herself for such a journey? Traditional wisdom and modern science have much to say about what a mother should do—and should avoid—along the way.

Modern Natal Care

Prenatal care (pre-pregnancy), antenatal care (during pregnancy) and postnatal care (after birth) are essential to ensure a mother’s and her baby’s health and wellbeing.

According to Dr. Grace Tay from Gloria Confinement, prenatal care revolves around optimising a woman’s health before she is even pregnant, in order to maximise her chances for a healthy pregnancy. Holistically, antenatal care is about looking after the physical as well as the mental and emotional health of the mother during pregnancy and monitoring her and her unborn child’s development for a good and smooth delivery. Regular check-ups are vital during that period; a pregnant woman’s body experiences physiological changes that can sometimes lead to complications. For instance, high blood pressure, if left unattended, can result in pre-eclampsia, a condition that is life-threatening for both mother and child.

Dr Grace Tay, medical doctor and lactation consultant at Gloria Confinement.

Having a natural birth, when possible, is also encouraged; the postnatal recovery is much faster then, and infections as well as complications for future pregnancies are reduced. However, if the mother has undergone a Caesarean delivery (C-section) before, it is important to ensure adequate spacing to the next pregnancy to ensure the scar has completely healed and the uterus has fully recovered.

Postnatal care, which generally lasts for six weeks, aims to monitor both mother’s and baby’s health to detect any clinical conditions and promptly and effectively respond to them. It is also a time for the mother and the household to adjust to the new family dynamics. The learning curve for new parents at this stage is steep, as they fumble and learn how to feed, soothe, clean and care for the newborn.

Traditional Natal Care

Many Malaysian women, regardless of their ethnicity, practise traditional antenatal and postnatal care to varying degrees, even as modern natal care gains prevalence. 

During pregnancy, herbal medicines are utilised to facilitate labour and improve overall health (Sooi & Keng, 2013) while some types of food such as pineapple, sugarcane juice and “hot foods” are restricted. Research conducted by Mohamad & Ling (2016) shows that 70.2% of Malay women avoid certain foods during pregnancy as they believe that consuming these could result in miscarriage, extreme bleeding while in labour, or birth defects.

According to Ms. Kodiswary, a traditional natal Indian practitioner, prenatal and antenatal activities such as yoga, meditation and breathing exercises can strengthen mental health. Nourishing and healthy food are also recommended during and after pregnancy.

Confinement

Postpartum confinement practices are commonly observed by the different ethnic groups in Malaysia. While medical confinement centres targeting Chinese mothers have experienced a surge in recent years (Boo, 2013), many still choose to undergo traditional confinement, which has its own set of rules and rituals. 

Traditional Chinese Confinement

Madam Teoh, an 83-year-old former teacher, went through a traditional Hokkien cho guek lai (confinement) after each of her three pregnancies. Each confinement lasted for one month and was held at her mother’s house under her strict supervision. The fan/air conditioner was banned for one month to make sure that her body was kept warm. She was also not permitted to take daily baths, and could only shower with water boiled with lemongrass, traditional herbs such as daun kaduk (Piper Sarmentosum) and ginger, and wash her hair weekly after the start of confinement.

Madam Teoh ate mainly meat dishes for the first two weeks, then some vegetables such as kai lan, broccoli and cauliflower. Foods considered to have a “cooling effect” had to be eschewed. At the same time, ginger was incorporated into every dish to remove wind and warm up the body while Dom, an herbal liquor, was poured into a small cup and given three times a day after meals to improve blood circulation. Fruits and plain water were not permitted. Instead, water had to be boiled with black Chinese dates, pounded ginger, dried longan (skin removed) and black beans. Twice a week, the juice of scraped and steamed turmeric roots would be given to her to drink to clean the womb and expel blood clots from the uterus. 

Ginger is incorporated into every dish to remove wind and warm up the body.

Most of the time, Madam Teoh stayed in the bedroom and was told to rest and fully recuperate. She could only sit up for short periods of time when eating, with legs crossed for the wound to heal. She was prohibited from going out of the room, and watching television, reading and crying were discouraged to avoid stressing the eyes.

On the baby’s mua guek (one-month birthday), a gift basket with four pieces of ang ku kueh (red tortoise cakes in the form of a peach symbolises a baby girl while those in a round shape symbolises a baby boy), two eggs dyed red, and nasi kunyit (turmeric rice) were given to all those who had blessed the baby with ang pow (envelop with a gift of money). 

Traditional Indian Confinement

Homemaker Madam Sunderi Arumugam is now 68 years old. She remembers that her confinements also lasted for one month during which she had to rest and allow her body to heal. She was not allowed to cry and cook, being considered “unclean”. Like Madam Teoh, she was given a special diet; fruits and foods which were considered “cold” were not permitted. On every alternate day when she would wash her hair, her mother-in-law would blend different types of herbs and spices such as nutmeg, fennel seeds, cumin seeds, coriander seeds, black pepper, thippali (Indian long pepper), ginger and cardamom into a paste and prepare these with chicken, meat or fish into a curry. Water was to be consumed in moderation while a small cup of Dom liquor would be given on the days her hair was washed; this was to boost blood circulation and warm up the body.

Balls made of black cumin seeds and jaggery.

Madam Sunderi Arumugam’s mother-in-law bathed her for the first 16 days, which began on the third day of confinement. Water was boiled with noni leaves, nochi leaves (white-chaste tree leaves) and beach morning glory petals and splashed on her stomach to expel blood clots from the uterus. This would be followed with steaming of the genitalia by smoking charcoal with neem oil, traditional herbs and garlic skin, to reduce inflammation.

After 16 days, prayers as well as dishes such as salted fish curry and chicken with unlaid eggs were offered to the Periyachi Goddess to bless and protect the child. It was also during that time that the baby’s naming ceremony was performed. 

Traditional Malay Confinement

Both of Ida’s* confinements were at home and each one lasted 44 days. During that period, her mother and a bidan (midwife) stayed with her to help care for her and the baby.

Ida’s meals were nutritious and rich with ginger. Foods that were deemed “itchy” and “cold” such as eggs, cabbage and cucumber were removed from her diet and replaced with ulam (indigenous leaves and herbs). Fruits and spicy food especially were discouraged since she was breastfeeding. 

Her daily routine consisted mainly of traditional urut (massages) and light stretching exercises. The bidan performed the bertungku twice a day by pressing a heated egg-shaped river stone wrapped with mengkudu (noni leaves) and a few layers of cloth on her stomach to reduce discomfort and pain. Massages on the entire body were done daily using coconut oil, minyak angin (medicated oil) or minyak urut (massage oil) to expel discharge, reduce fatigue and help stimulate breastmilk production. Tangas (vagina steaming) was also performed daily to return the uterus to its pre-pregnancy size and position. Lastly, a hot bath infused with traditional herbs was given to relieve muscle soreness.

Ida is thankful for the experience as she was able to observe and learn how to look after her child from the bidan. She also felt that the traditional confinement helped her body heal. Ida still goes for traditional massages as it helps her feel relaxed, light and rejuvenated.

On the other hand, Syafiqah* did not have quite the same experience. Her unexpected delivery a month early caused her to feel unprepared physically, mentally and emotionally. She recuperated at her parent’s home and followed all the rituals on her grandmother’s advice.

Despite this, Syafiqah was overwhelmed and developed postpartum depression. Her stress was aggravated by her mother’s anxiousness in handling the baby as he was her first grandchild and was born premature. She did not know who to turn to and found it regrettable that the nurse who visited her did not provide emotional or mental support. She hopes that this can be improved upon and included in the care of new mothers in the future.

*Note: Not their real names.

Morana Lefilliatre

She holds a Bachelor of Arts Degree (Hons.) in Business Management from Sunderland University, United Kingdom. Some of her interests include environmental, heritage, and cultural issues.


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