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The 4th Trimester

Updated: Oct 31, 2023

Chinese Medicine and “The Fourth Trimester”

Having a baby is a wonderful and exciting time, but it is also one of the biggest physical, emotional, and spiritual transitions that a woman will go through in her life. The Chinese culture emphasizes the importance of this transition and it is recognized and a period of 4 to 6 weeks is set aside as the postpartum recovery period. The mother has just endured a massive trauma, the dispelling of the placenta which is like an organ weighing 9 to 11 pounds, she has lost a lot of blood and that makes you very deficient, and of course giving birth to the baby which is a lot of energy on its own. This time or "sitting period" is meant for the mother to rest and recover to be strong and present for the baby. During this time, family and community members step in to care for the new mother and baby, feeding her deeply nourishing foods while she rests, recovers, and adjusts to her new role. In China, this tradition is called “Zuo yuezi” or “sitting out the month.” Restrictions, such as avoiding cold, bathing, hair washing, or going outside were created to safeguard the new mother’s recovery back to health, in part to preserve and improve the family lineage. A newer version of this exists today with wealthy women staying at "baby hotels" where they are pampered and encouraged to rest. In contrast, our culture does not acknowledge or allow time to absorb the importance and impact of major life events, such as birth and death. Often stressed and without support, the new mother is expected to care for a newborn, prepare meals, do housework, regain her pre-pregnancy body (and of course, libido!) and return to work in a short period of time. Medical care is focused primarily on the baby, with no one checking on the mother until her 6-week postpartum visit. It’s a missed opportunity to support breastfeeding or catch early signs of depression. Preparing in advance, we can incorporate the best of Chinese postpartum traditions (rest, staying warm, eating nourishing foods, help with housework and the baby) without the restrictions that we find too limiting.

How Can Chinese Medicine Help?

  1. Moxa or “mother warming’ starting at 4-5 days postpartum to warm up a depleted new mom. You most likely will not be up to coming into the clinic, I do offer home visits and/or make sure to use a hot water bottle/heat pad on your lower abdomen following birth. I can give you a moxa stick during your cervical ripening appointments if you wish to do this at home.

  2. Chinese herbs to promote healing, replenish the body, improve digestion, and support milk production.

  3. Acupuncture to reduce pain and soreness, improve energy levels, encourage lactation, stabilize emotions, balance hormones, and ease recovery from childbirth. A visit approximately 10-14 days following birth is suggested, ideally having one treatment a week for 3-4 weeks.

Chinese Medicine Can Treat:

  • birth trauma

  • sore and swollen breasts

  • mastitis

  • not enough breast milk

  • urinary problems

  • vaginal soreness

  • hemorrhoids

  • constipation

  • edema/water retention

  • hair loss

  • fatigue

  • body aches & pains

  • headaches

  • insomnia

  • depression​

Postpartum Depression and Anxiety

Symptoms include:

  • Anxiety that increases in severity

  • Frequent, uncontrollable, or severe crying spells

  • Sleep issues – insomnia or excess sleep

  • Lethargy, hopelessness

  • Guilt, self-doubt, feeling inadequate

  • Panic attacks

  • Chest tightness and/or heart palpitations

  • Thoughts of hurting yourself or the baby

Postpartum depression and anxiety occurs in about 1 out of 7 (15%) of new moms. Due to its similarity to “baby blues,” most women do not seek treatment. If symptoms persist beyond 2 weeks, medical help is necessary. Interventions may be holistic, allopathic, or a combination. Studies have shown 1 out of 10 men suffer from postpartum depression as well which I believe is a result of lack of sleep.

Acupuncture is recognized as one of the most successful natural treatments for postpartum depression and depression symptoms in general. If you need to take medication, you will still benefit from acupuncture; they can be done at the same time.

Researchers from Stanford University found that 63% of women receiving just 8 weeks of acupuncture therapy for postpartum depression responded well to the treatment.

First Month Postpartum Tips

  1. Lie down and rest frequently - especially the first two weeks!

  2. Stay warm, well-nourished and hydrated - avoid cold foods and drinks

  3. No housework or cooking

  4. Learn to receive, let others care for you

  5. Ask for and accept help from family and friends

  6. Limit visitors

Foods to Promote Lactation

Drink plenty of water!!

Eat organic foods as much as possible

Bone-in meats or fish (always organic)

Dark leafy greens

Gelatin (from grass-fed sources) or pig trotters (in a soup)

Seaweed for trace minerals

Sweet potato or Chinese yam

Grains: oats, millet, barley, sweet rice

Legumes: adzuki, chickpeas, lentils, mung beans

Papaya (especially green) - eat one a day, if possible

Fennel and fennel seed - increases supply

Herbal tea, especially mint, rose, and barley

Coconut water

Young coconut meat

Herbs: basil, marjoram, anise, dill, caraway, turmeric (also helps reduce inflammation)

I highly recommend the book 'The First Forty Days' by Heng Ou - so many wonderful recipes and insights on how to prepare and nourish yourself when the baby arrives!

I hope this helps ease the journey of postpartum and beyond.

Kelsey Bru is a licensed acupuncturist and TCM Herbalist in the Comox Valley, British Columbia. She loves working with pregnant mama's, mama's to be, postpartum care, fertility and women's health through her online articles and at her clinic, The Remedy Room, on Cliffe Avenue, Courtenay. Call for an appointment at 250-800-7738.

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