Author: Hana Halim
The traditional postpartum care through traditions handed down from generation to generation was designed to provide support and care, which is believed to have helped to prevent postpartum depression as complications may arise in the postnatal period. A traditional Malaysian postpartum ritual will see the mother receiving a head-to-toe treatment to encourage rest to recuperate after her tiring pregnancy and childbirth. A full treatment includes, herbal bath, bertangas, a whole-body massage, bertungku and binding which usually begins after 3-7 days post normal delivery depending on the condition of the mother. Each session lasts from 60-90 minutes and can extend up to 3 hours for her final ritual called ‘Penutup Pantang’ which translates to ‘Confinement Closure’.
There are three (3) major features in Malay postpartum care, which are:
- the use of herbs
- the use of heat
- Malay postnatal massage
Different types of herbs are usually used during confinement. It can be taken internally in the form of decoction, capsule or ground and cooked with honey (makjun/jamu). It is also common to use herbs in herbal baths, as extracts added to ointment, or as a herbal paste.Some of these herbs include kaffir lime, lemongrass, citronella, turmeric, tamarind, betel leaf, Morinda Citrifolia, java ginger, ginger, galangal and many others. They contain intrinsic properties uniquely blended to create a soothing and healing effect for the new mother, internally and externally.
Heat is used in the form of direct exposure in one of the rituals called ‘bertangas’ which is a form of vaginal steaming using selected herbs to help with anti-viral/anti-bacterial properties to reduce infections to tears and helps speed up the healing process of wounds. Its astringent and drawing properties of the herbs assist to get rid of odours from lochia and discharge.
Another form of heat is called ‘bertungku’ – a form of hot compress using heated river stone that the confinement lady would use similar to a hot stone massage around the body, stomach and joints. It is now commonly replaced with an herbal compress for mothers to safely handle when doing the ritual on her own.
A bath is also always done with warm water despite us being in the warmth of the tropics. Cold water is never allowed for the mother especially during the early days post-delivery. This is to avoid the mother going into shock and shivers considering that her body has lost a lot of blood during the delivery.
Heat is also found in indirect exposure such as the consumption of ‘hot food’ during confinement. Mothers are not allowed to take ice, or cold food. There is a special diet for postpartum mothers using herbs and ingredients deemed as ‘safe’ which makes up the ‘confinement food’.
MALAY POSTNATAL MASSAGE
Malay Postnatal massage includes whole body massage during the confinement period. During the postpartum period, forced massage is never practiced. Body massage is done in a very patient manner – tender touch, firm yet caring. Full body massage can be conducted as early as 3 days after delivery, on a weekly basis for at least six to seven times during the confinement period. However, an experienced confinement lady or postpartum therapist/practitioner will know how to look at the mother’s appearance – rosy or pale – which indicates her blood level to determine whether the mother is ready for massage or not.
After a body massage, a traditional binder made of cloth will be tightly wrapped around the women’s waist. Also known as barut or bengkung, the bengkung is usually worn after an application of infused oil or an herbal paste called param, which would be rubbed onto the abdomen before wearing the binder.
These binders provide lower abdominal support, help to realign the spine, and place back the bones after the delivery. Now, modern binders have been developed to allow cesarean mothers to achieve the same support for her body as those who have gone through normal delivery.
Mothers who undergo this carefully structured regime of confinement practices will diligently observe the practices for about 6 weeks, or 44 days to be precise. All the practices mentioned above is a tradition that has been handed down from generation to generation, from mother to mother and is focused on restoring the physical and mental health of the woman.