"I think the custom of postpartum confinement probably got started because the vagina inevitably suffers some damage in childbirth, and in ancient times, before there was surgery to wounds or antibiotics to prevent infection, they had no alter-native but to let women rest quietly, waiting for the damage to heal," says Dr. Cheng Cheng-chieh, of the Department of Obstetrics and Gynecology at Mackay Memorial Hospital.

Lie still, don't budge! That practice, combined with the concepts of tonic foods, herbal medicine and health nostrums, became more and more complicated over the ages, forming a fascinating link in the traditional customs of the Chinese.

"Lying in involves two main areas: protective injunctions and prohibitive ones," says Han Wen hui, a lecturer in nursing at Shih Chien College who has studied the practice in some depth.

In terms of protection, the principles that everyone is most familiar with are keeping warm, avoiding drafts and eating nourishing foods. The most popular food for new mothers in Taiwan is sesame oil chicken. Chicken is the most digestible form of high-protein meat, while sesame oil is rich in vitamin E, calcium and iron and is said to help the uterus contract and eliminate lochia, or the discharge of blood, tissue and mucus after childbirth. The two main seasonings in sesame oil chicken--ginger and rice wine--are supposed to remove cold from the body and stimulate circulation. In fact, the ancients were so concerned that new mothers avoid chills and drafts that they weren't even allowed to eat chicken wings (which flap in the wind), causing many new mothers to miss out on a tasty treat.

"Sesame oil chicken is a favorite with people from southern Fukien," Han Wen-hui points out. "In the rice and fish country south of the Yangtze, new mothers are served perch soup cooked in ginger and rice wine. In Kwangtung they eat pig's feet stewed in peanuts. And Hakkas, who are hard up financially, give them scrambled eggs with ginger. The ingredients vary with the place, but the idea's the same."

The devastating "lying-in flu": As part of keeping warm, mothers in confinement are careful not to eat raw fruits and vegetables. Watermelons, pears, spinach, cabbage and other fruits and vegetables considered by the Chinese to be "cold" in nature are on the no-no list, and mothers are even urged to decrease their water intake because it "builds up damp and cold."

The same principle of keeping warm governs what to wear. Li Ya-chen, who has stayed at the postpartum confinement center associated with her hospital twice after giving birth, found that the women there may not have wrapped themselves up airtight as new mothers of earlier generations used to, but that long sleeves, long pants and a pair of socks were still standard garb for most. Some followed the strict orders of their motheror mother in-law and even wore a wool cap.

Even in the sweltering month of August, most women in confinement don't dare turn on a fan, although air conditioning, which creates an "even cool," is exempted. "But if the air conditioner has been on for too long, my mother will turn it off," says Li Ya-chen, adding that even though she doesn't completely believe in these ancient precepts of Chinese medicine, she's still afraid to "buck them myself."

Han Wen-hui points out that it is traditionally believed that the worst thing that can happen to a woman during confinement is to come down with a cold or the flu (called the "lying-in flu"). As a result, they aren't supposed to go outside, wash their hair, bathe or touch cold water, and doors and windows must be kept shut. Actually, these restrictions have some basis in medical fact.

"Some people believe that women exert them-selves so much in giving birth that their joints loosen up, and they become more susceptible to catching cold," Han Wen-hui says. According to medical science, pregnant mothers produce 30 to 50 percent more fluid than usual to supply the fetus with nutrition. This excess fluid is expelled from the body after childbirth through perspiration (sometimes called "night sweat"), and since the pores open up during perspiration, new mothers should keep out of drafts to avoid catching cold.

Better to believe and go along: Chen Hui- ling, who has worked in mass communications for many years and is proud of her health and physique, didn't believe in these rules and strictures at first. But the winter before last, after going back to her parents' house in Hsinchu to recuperate after having a baby, she forgot to turn on the space heater before taking a bath once and was so cold when she took her clothes off she started shivering and almost fainted. Another time she didn't wear socks and wound up with "everything from a headache to vomiting." Given that experience, she moved from "total disbelief" to feeling that "the protective measures of traditional confinement make a lot of sense."

In addition, it is traditionally believed that women in confinement should avoid getting out of bed, even to eat, since giving birth is so taxing and leaves the body weakened. Nor should they lift things or climb the stairs (to avoid sagging of the uterus) or sew or even read (to avoid hurting the eyes) . . . they really are subject to a plethora of well-intentioned restrictions.

Medically speaking, the muscles and ligaments of the pelvic area gradually distend during the course of pregnancy to facilitate childbirth, becoming loosest just before parturition. "It takes about six to eight weeks of rest afterwards to recover," notes Wu Hsin-hui, a gynecologist and obstetrician under special engagement at Taipei Municipal Yangming Hospital, adding that if a new mother works too hard before recuperating, she may suffer from uterine sagging, back pain or other consequences.

Unique to Chinese? Even though keeping warm and resting have a basis in medical fact, the full-blown concept of "sitting out one's month" with all it entails seems to be uniquely Chinese. Professor Yang Ling-ling, of the Pharmacognosy Institute at the Taipei Medical College, says that, based on her experience at Sendai in northeastern Japan, Japanese women who have just had babies often drink water straight out of the tap and eat the same foods they do normally, such as "cold-natured" pickled cabbage, sashimi, etc. And new mothers in Europe and North America are not only apt to regale themselves with a glass of champagne or a bowl of ice cream, it's no big deal when some of them leave the hospital the same day and push a lawn mower around the yard a week later.

The difference in customs is hard on Chinese women giving birth in the West. Lin Shu-fen, who was once a social worker in the Chinese community in London, says that when British nurses at several hospitals there found out that new Chinese mothers had the "problem" of not bathing, they would keep an eagle eye on them until they went into the bathroom, ending up in a big game of hide and seek. Some of the women even went to the community service center to ask for help.

Overseas Chinese women of an earlier generation living in Chinatown could "sit out their month" more or less according to tradition, but the fate of Chinese women living overseas today is a matter of luck.

One month determines a lifetime? Many young Chinese women giving birth overseas beg their mothers to come over and help them during confinement. The sheng-hua soup (helps contraction of the uterus), sesame oil, rice wine and other necessary tonic ingredients usually have to be shipped in by "care package" from Taiwan, although they're available in some larger Chinatowns.

As for women without family members for support, who have to look after the baby, do the housework all by themselves--and deal with raw vegetables and cold meat sandwiches on top of that--they can't help worrying that if they don't sit out their month properly, they'll suffer from endless complications in the future.

Will improper confinement really lead to a string of problems? It is traditionally believed that a woman who receives a chill during her confinement will suffer arthritis and headaches when she's older and that a woman whose uterus doesn't properly recover will be prone to all kinds of ailments after menopause. Correspondingly, women who were weak and frail to begin with yet lie in well are supposed to be able to change their constitution. But all that is based on hearsay.

"There's been very little medical research in this area so far, so it's very hard to draw conclusions," Yang Ling-ling points out. Stooped backs are relatively common among older Japanese women, for instance, an affliction which in Chinese medicine is related to an excess of "cold" in the physique. But rather than say that's because the women didn't lie in properly 20 or 30 years ago, it's more reasonable to attribute it to long-term habits instead.

As Han Wen-hui points out, life is a continuous process and so is taking good care of oneself. Proper nutrition during a month's confinement may work to greater effect than normal, but that doesn't mean that "one month determines a lifetime." There are just too many variables to consider in how healthy a person is and in whether or not they suffer from pain or disease.

Act according to the circumstances: Be that as it may, the Chinese, after all, are Chinese: They don't dare treat lightly the experience accumulated by their ancestors over the ages. A chief nurse surnamed Hsu who has worked for many years in the gynecology and obstetrics department of a major hospital says that women today often take the medicine given them by their doctor to spur vaginal contraction and also eat the sheng-hua soup brought by their family, which is designed to do the same thing. They eat the fruits and vegetables in the hospital food as well as the sesame oil chicken and yao-tzu soup brought by their family. They do light postpartum exercise yet still lie in bed at home for over 16 hours a day. . . .

Caught between tradition and the modern age, young women clearly don't know which way to go.

"In fact, being able to adjust according to the time, the place, the season of the year and her own constitution is what characterizes an intelligent modern woman," Han Wen-hui says, adding that blindly accepting all the rules and restrictions of "sitting out one's month" without understanding the reasons behind them may well be counter-effective.

The practice of eating more meat and fortifying foods during confinement instead of vegetables "is because people rarely ate meat in the old days and were often poorly nourished, so they tried to make up for it during confinement," Yang Ling Ling says. If modern-day women follow blindly along, they may eat too much meat and end up constipated or having to spend a lot of money to lose weight afterwards.

Eating for two: The main reason that mothers in confinement are traditionally supposed to eat foods rich in calories and protein is that they're "eating for two"--the idea is to increase lactation to aid in breast-feeding. But women who don't breast-feed shouldn't gorge themselves until they can't digest any more. If they don't wind up with a large ring of fat, they may break out in pimples. Furthermore, most women today give birth in a hospital, where any damage to the vagina can be immediately repaired, so that the basic reason for "lying in" no longer exists. According to Western medicine, the earlier a mother gets out of bed and moves around, the better for uterine contraction and eliminating excess fluid. Lying in bed too long leads to poor uterine contraction, constipation, phlebitis and other ill effects.

And with modern electric appliances, which allow us to get hot water at the twist of the tap, to take a shower, to dry off with a hair dryer and a big towel and to turn on the heater in the winter, the chances of catching a chill or being exposed to a draft are much lower. "In surroundings like these, appropriate bathing or shampooing is naturally all right," Yang Ling-ling points out. At the same time, she says that modern-day working women lead busy lives: From studying for exams in school to using the computer in the office or reading the newspaper at the dinner table, they constantly strain their eyes. It isn't a bad idea to go along with what their mother or mother-in-law says and give their eyes a rest during confinement.

Women need to take a break! "Traditionally, the main significance of lying in is as a 'reward,'" Yang Ling-ling says bluntly. For Chinese women, the purpose of "sitting out one's month" goes beyond simple health and medical reasons and entails more complex social and psychological aspects.

During the nine months of pregnancy, a woman's body goes through enormous changes, and in the old days, before the advent of modern medical science, ten or more hours of painful labor was a hellish experience. By successfully giving birth and bringing joy to the family, they deserved to be rewarded and made much of. At the same time, lying in also signified a chance for women to take good care of themselves after having a baby and encouraged them to carry on and have more.

Confinement reflects the norms of traditional society. Men were deemed more important than women. Young wives worked hard all day long serving their parents-in-law and taking care of the children, eating the poorest food and sleeping the least. "Lying in was the only justification a daughter-in-law had to eat the meat and fortifying foods she normally never touched. And to avoid gossip parents-in-law wouldn't make her do any chores. It's the only chance a woman had to take a breather," Han Wen-hui says.

Li Yih-yuan, a professor of humanities and social science at National Tsing Hua University and a member of the Academia Sinica, analyzes the symbolism and implications of postpartum confinement at a deeper level, from the perspective of life customs and rituals. He likens it to an initiation ceremony. Just as boys coming of age among the Atayal aborigines of Wulai go off to live in the mountains for a month and receive painful facial tattoos to mark the entrance to adulthood, Chinese women in confinement follow rules different from the norm to prepare themselves psychologically for starting out in their new role as mothers. The position of mother naturally gives them a higher status in the family, but it also involves heavier burdens and responsibilities.

Friends and family keep away? Interestingly enough, even though pregnancy is traditionally viewed as a "joyous event" and a large family is considered a happy blessing, childbirth itself is taboo and women in confinement are subject to numerous restrictions and prohibitions.

Even today, women in confinement aren't supposed to visit other people's homes, sacrifice to their ancestors, worship the Buddha or enter a temple, and most people who plan on celebrating a wedding or taking a trip don't like to enter the home of a mother in confinement to avoid "picking up bad luck" and meeting with misfortune.

Wang Hsiu-mei, who had a little boy just this year, encountered the strength of the taboo herself. She had thought that her parents-in-law would love to see her after she gave them a grandchild, but for a whole month after she left the hospital her mother-in-law wouldn't let her set foot in their house, saying they "had just put in a new statue of the Buddha."

"I couldn't believe that in this day and age there is still superstition like that!" she exclaims. She had felt ill treated until she heard about some villages in mainland China that "don't permit women to bear children at home but send them off in the wilderness to give birth and live in a tent for a month" and decided her own fate hadn't been so harsh.

The reason that women in confinement are seen as inauspicious is related to the high death rate among childbearing women in the past as well as to the traditional taboo of menstrual blood and the belief that women are unclean. Fortunately, with advances in medical science, people today have gradually come to see these things as natural biological processes instead of objects of fear and mystery, and more and more women are getting out and taking part in social activities during the first month after childbirth. The taboos are falling.

Le coeur a ses raisons: The social significance of confinement is also changing in today's world. In the large, multi-generational families of the past, how well a young mother-managed to lie in depended mainly on the attitude of her mother- in-law. But with more and more nuclear families, women have more choice--they can check in at a NT$2,000-a-day confinement center, go back to mother's, live with their parents'-in-law or just stay at home and hire a nursemaid. But at the same time, the whole process has become even more of a test of a woman's family relationships.

Chen Hsin-wen, 32, has lived with her parents-in-law ever since she married. When she had her second child earlier this year she at first wanted to go back to her parents' and ask her mother to look after her. "To tell the truth, my mother's a better cook," she told a friend. Unfortunately, it never came to anything. She came to feel that her mother- in-law would lose face if she went back to her mother's, and she finally opted for a compromise--going to a confinement center!

"Many young women have never lived with their mother-in-law day in and day out for any length of time before, and it's not easy for either of them. Also, some women use it as a way of testing how sincere their husband is in taking care of the family and being tender to them," Li Ya-chen says. Even Westernized women who don't really believe in it aren't likely to be pleased to hear their husband retort, "Who believes that rigamarole in this day and age?" when they ask him to pick up some groceries after work and cook dinner for them because they can't touch cold water or climb the stairs.

"Sitting out one's month" is indeed marvelous in many ways.

[Picture Caption]

If you want to "sit out your month" properly, a helpful mother or mother -in-law is indispensable.

Postpartum confinement centers are spacious and comfortable, with staff to handle everything, but a room doesn't come cheap. (photo by Diago Chiu)

Even today, when people eat food that is too rich anyway, recipe books of fortifying foods for new mothers are still widely popular. (photo below by Huang Li-li)

(Left, below) The Eight Treasures, the Four Foodstuffs and other ingredients believed to have a fortifying effect are important elements in the diet of new mothers. (photo below by Huang Li-li)

The modern invention of "dry-cleaning" shampoo means that new mothers nolonger need fret over not being able to wash their hair.

This chicken soup from the postpartum center has been fortified with ginger, rice wine and sesame oil. (photo by Diago Chiu)

This is the industrial strength version made by mother-in-law.

Just out of the delivery room, a new mother finds it hard to rest with a bed full of advertising brochures and samples.

With delivery of the traditional gifts of oily rice and red eggs to mark Baby's first month, "sitting out one's month" is finally over.

Postpartum confinement centers are spacious and comfortable, with staff to handle everything, but a room doesn't come cheap. （photo by Diago Chiu）

（Left, below） The Eight Treasures, the Four Foodstuffs and other ingredients believed to have a fortifying effect are important elements in the diet of new mothers. （photo below by Huang Li-li）

Even today, when people eat food that is too rich anyway, recipe books of fortifying foods for new mothers are still widely popular. （photo below by Huang Li-li）

The modern invention of "dry-cleaning" shampoo means that new mothers nolonger need fret over not being able to wash their hair.

This chicken soup from the postpartum center has been fortified with ginger, rice wine and sesame oil. （photo by Diago Chiu）

This is the industrial strength version made by mother-in-law.

Just out of the delivery room, a new mother finds it hard to rest with a bed full of advertising brochures and samples.

With delivery of the traditional gifts of oily rice and red eggs to mark Baby's first month, "sitting out one's month" is finally over.