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Postpartum Doulas of the East: Sitting the Month

The Chinese tradition of “sitting the month” is a combination of medical, behavioral and dietetic practices designed to maximize recovery from the adverse effects of childbirth and pregnancy in postpartum women during the first month after childbirth. According to Chinese Medical theory, two main issues afflict all postpartum women: qi/blood deficiency and blood stagnation in the area of the uterus. These two deficiencies, if not properly attended to, can give rise to any number of illnesses – sometimes illnesses manifest instantly, others begin in the post-partum period but do not surface until later. Common afflictions include anemia, insufficient breast milk, lightheadedness, constipation or oliguria, a bloated sensation, and immune system deficiency. If the symptoms are left untended, more serious illness, such as hypothyroidism, depression, rheumatoid arthritis, lupus, and debilitating menopause may result. “Sitting the month” uses a combination of personally tailored Chinese herbal formulas, food therapy and lifestyle changes to alleviate the above symptoms and ensure that more serious illness does not result from the temporary weakness which all women experience in the early postpartum stages.

Due to some of the more anachronistic practices associated with “sitting the month,” – a moratorium on showering, air conditioning and going outside in the wind, a diet of relatively bland foods, etc. – the tradition had all but vanished, but new “sitting centers,” which cater to the needs of modern women, have helped foster an unprecedented resurgence in popularity all while retaining the core theoretical principles on which the practice was founded. Today in Taiwan, the top sitting centers have waitlists backed up for years – perhaps this can be attributed to the fact that treatments not only restore health and vitality, they also help women to recover their pre-childbirth physique using herbal therapy and acupuncture.

Now, as interest in “sitting the month” continues to grow, new research has put the old tradition to the test of modern “evidence-based” standards with highly positive results. A new retrospective cohort study conducted by the China Medical University of Taiwan found that a standard “sitting the month” regimen - including herbal medicine, dietary restriction and lifestyle change- significantly raised erythrocyte levels, increased breast milk, decreased lochia elimination time and decreased likelihood of depression in a group of post-partum women compared with a group of post-partum women who had not sat the month. [1]

In recent times, commentators have compared sitting the month to the increasingly popular western practice of hiring a “postpartum doula.” In fact, the two practices do hold a lot in common, but with some key differences. Both practices honor the importance of the mother’s health postpartum and work to recover and maintain health during this crucial period. Both practices also decrease the demands and stress on the mother directly following birth by providing cooking and cleaning services throughout the first month. Sitting the month is distinguished from having a postpartum doula insofar as it incorporates a system of medical knowledge into the recovery and care process. According to Chinese medical gynecology, the body is in a weak and deficient state following birth: sitting the month is designed to not only assuage the daily stresses associated with new-motherhood, but to treat the specific imbalances that afflict all postpartum women. In this regard, sitting the month is actually a more holistic, multi-faceted approach to postpartum care.