Certain ritual activities are observed by the new mother and those caring for her in order to restore her body heat and chi. These include:

* Washing her clothes separately from the rest of the family

* Feeding her many spicy and ginger-laden foods

* Offering her special tonic wines

* Not washing her hair for one month

* Celebrating the baby's twelfth-day and one-month


* Making a special occasion of the baby's first haircut

The postpartum woman typically has several helpers during her confinement period. These may include her husband, her mother or mother-in-law, or a "confinement maid." The attitudes of these helpers toward breastfeeding has been found by researchers to have the strongest impact on whether the new mother decides to breastfeed or not. Breastfeeding rates are quite low among Chinese women living in Hong Kong today because postpartum women are viewed as weak and in need of rest and rejuvenation. Breastfeeding is often viewed as something that will sap a mother's energy and prevent her from returning to a state of balance and good health.

Written with assistance from Doris Fok, BASocSc, GradDipEd, IBCLC.



Josephine Enang is a nurse, midwife, and Internationally Board Certified Lactation Consultant. She left her home country of Nigeria several years ago, but while there, she practiced midwifery in the rural communities of southeastern Nigeria among several tribal groups, including the Efik, the Ibibio, and her own kin group, the Ekoi.

Enang says that in her experience, tribal Nigerian women today give birth in small health clinics which are located within their agrarian communities and are managed by local nurses and midwives. Midwifery continues to flourish in Nigeria and most low-risk women never see a doctor during pregnancy or childbirth. The midwives refer patients with potential complications to regional hospitals and the physicians found there. When no trained midwife is available, traditional birth attendants assist women during pregnancy and childbirth. These attendants are generally older women from the community with a lot of hands-on experience. It is considered a serious taboo for a young woman to give birth without having undergone a ritual circumcision ceremony, which is thought to initiate her into womanhood.

According to Enang, Nigerian women do see labor as a painful process, but don't believe that it requires the use of narcotics or other analgesia. Women who endure pain in labor with quiet dignity are considered "strong." She says that during her six years of practice in Nigeria, she never once used any pharmacologic pain relief measures for a birthing woman. Women do receive childbirth education from other women and they learn to depend on natural pain relief measures during labor such as breathing, movement, and distraction.

No men are ever present during childbirth, explains Enang, because birth is considered to be solely a woman's domain. Older women of the family are usually there to assist the birthing mother. Other family members are rarely allowed in the delivery room. Women most often give birth in a squatting position because it is believed to be most comfortable and because gravity facilitates descent of the baby. Episiotomies are sometimes done by the midwife, and sutures are completed with the use of a local anesthetic. If a woman gives birth before twenty-eight weeks, no special lifesaving measures are taken with the baby because this is believed to be a miscarriage or a spontaneous abortion.

Newborns are considered extremely delicate and are handled with the utmost care. Mothers begin breastfeeding within an hour of birth and it is considered very strange if a woman chooses to bottle-feed. Most mothers breastfeed their babies for several years. In the weeks after birth, mother and baby are never separated: the baby sleeps with the mother or in a small cot at her side.

Women are usually discharged from the local clinic within twenty-four to forty-eight hours of delivery, and are then cared for at home by family and community members. These support people assist with household chores, meal preparation, and teaching the new mother basic baby care. When the baby loses the stump of his umbilical cord, it is used to plant a family tree. Baby girls generally have their ears pierced within a week or so of coming home.



Many mainstream, middle-class American women learn that they are pregnant within the first week after a missed menstrual period. Comprehensive prenatal care usually begins during the first trimester of pregnancy, with monthly or even bi-weekly visits made to an obstetrician's office. At these visits, the woman is weighed and has her blood pressure taken. The doctor's office nurse usually listens for the baby's heartbeat, and in many cases, the pregnant woman is able to learn her baby's sex by the sixth month of pregnancy with the use of ultrasound or amniocentesis.

American women choose their birth attendants based on factors such as what hospital the doctor is affiliated with (ninety-four percent of American births take place in a hospital), where his office is located, and whether he is recommended by friends or family members. Often, the woman has a very cursory relationship with the doctor who will attend her at birth. Office visits are often extremely brief and in group practices, the woman may see a different phsyician at each visit with no idea who will actually be with her on the day she goes into labor. A woman's partner, if she has one, usually accompanies her to some or all of her prenatal visits.

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