Women in China take a very different approach to their menstrual cycles compared to women in America. Not only do they believe it is imperative to take certain precautions to manage their menstrual cycles, they carry that belief over to postpartum.
Deficiency & Excess
Many Chinese women are aware of the concepts of deficiency and excess. Deficiency describes a state of weaknesses or vulnerability. It can arise from ongoing illness, trauma, or develop gradually as we age. Our intrepid friend who fears no cold is an example of someone who has no deficiencies and is able withstand these challenges to her body. (But like all bad habits, they will eventually catch up with her.)
Excess refers to pathologies that may come from outside the body, such as wind, cold, heat, dampness, or develop within the body as part of other pathological processes. One cause of this type of excess is emotional volatility, particularly the emotion of anger. As a result, in Chinese medicine gynecological clinics all over China, one can hear doctors admonishing their patients: “You must not let yourself get angry.”
We may find it hard to wrap our minds around these concepts. But probably every woman who has given birth to a child, who has experienced the incredible physical changes of pregnancy and the intense pain of labor and delivery, will intuitively understand the postpartum state as a condition of deficiency. In Chinese medicine, we usually say that this period is characterized by “blood deficiency” and complicated by “blood stagnation” (a type of excess). For this reason, women in China tend to be almost religious about “resting for a month” after giving birth.
Many families will prepare special nourishing foods for the new mother, who usually has the additional physical challenge of nursing a newborn every three hours. Women will be extremely cautious about exposing themselves (and the newborn!) to the elements. Even bathing, and washing one’s hair in particular, will only be done with great caution. It may take many months for a woman’s body to recovery from giving birth, and the older one is the longer the recovery. Even though we don’t have the tradition of “resting for a month,” most American moms would do well to embrace the spirit of this practice. All the precautions discussed above about exposing oneself to cold are particularly pertinent to this delicate postpartum state.
The concept of deficiency, particularly as it pertains to the postpartum state, can help us resolve one of the great mysteries of modern obstetrics and gynecology: postpartum depression. The emotional state can be debilitating, and most Ob/Gyn doctors can’t explain why some women suffer from it. Chinese medicine gives us some real leverage on this problem.
The root of postpartum depression is the deficiency of the postpartum state. Depending on age, the particular circumstances of each individual woman, the specifics of each woman’s pregnancy, labor, and delivery, and many other factors, this deficiency will manifest in different ways for different women. Postpartum depression is just one possible outcome.
Recently, I had a 31 year old patient who was 9 months postpartum with her first child. Like all first time mothers, she was adjusting to all the physical challenges of being responsible for a small infant, including being awakened multiple times a night. Emotionally, she was both madly in love with her child but also struggling with a deep sense of loss for her former life. At the same time, she was struggling with low back pain and general joint and muscle aches.
I explained to her the Chinese medicine perspective on her condition. I encouraged her to make adjustments to her sleeping arrangements, so she wouldn’t be awaken so easily at night, and we decided to treat with acupuncture. She responded immediately to the first treatment. Her pain went away entirely for a couple days and her spirits were notably lifted. When she came back for her next treatment the following week, the pain and her depression had both returned. I explained to her deficiencies don’t resolve immediately. They take time to develop and likewise take sustained intervention to reverse. Despite that general principle, we only did four acupuncture sessions altogether. About 6 weeks after our last treatment, I bumped into at the grocery store and asked her how she was doing. “I feel great!” she exclaimed.