On the diversity of scientific culture and the tradition of postpartum confinement in China

Meifang Zhang

University of Science and Technology Beijing,China

Abstract This paper observes the practice of postpartum confinement by urban women in China with high educational levels from the perspective of cognitive conception and behavioural practice.It reveals the cognitive conflict and self-adjustment in these women between‘modern health notions’and‘traditional medical practices’,and analyses the rationality of the long-standing presence of and local differences in the practice as a traditional postpartum nursing behaviour for Chinese women.Moreover,this paper emphasizes the important value of postpartum confinement as a kind of local knowledge and holds that adhering to and advocating the locality and diversification of knowledge,including scientific knowledge,is conducive to the long-term coexistence and sustainable development of different knowledge traditions.

Keywords Postpartum confinement,local knowledge,diversity,scientific culture

1.Introduction

With the introduction of modern science into China and its popularization,the concept of science(including modern medicine)has produced great impacts on Chinese lifestyle and has also caused conflicts with some traditional life practices.One example that has been controversial in recent years is the issue of ‘postpartum confinement’ after women’s childbirth.Postpartum confinement is one of the few traditional practices that persist in Chinese daily life,although the practice conflicts with modern scientific concepts in some ways.

Postpartum confinement is a traditional practice that shows a distinct localization and remains popular amid today’s wave of economic and cultural globalization,as it is an important part of Chinese women’s lives.Taking as the object of investigation the local knowledge associated with postpartum confinement,this paper discusses the practice’s collision with modern scientific knowledge and the resulting changes it has experienced.The paper also analyses the process of pregnant women’s conceptual and behavioural self-adjustments.Finally,it reveals the important value of this special,local,knowledgebased practice in the current context of scientific popularization.

As women with relatively high educational levels,female teachers in colleges and universities have generally received some education in modern science,medical care and health.When faced with the traditional conception and practical requirements of postpartum confinement,their cognition and behaviours can typically reflect the collision between local knowledge and so-called universal knowledge.Compared with obstetricians and other women who have lower educational levels,an investigation of female teachers’ understanding and behaviour involving postpartum confinement can better reveal the vitality and value of local knowledge.Therefore,I conducted in-depth interviews with 30 female teachers who had postgraduate educational levels at a university in Beijing from 12 March 2015 to 19 June 2015.This small sample cannot entirely present the overall situation of postpartum confinement and the cognition of female intellectuals regarding the practice.Nevertheless,this microscopic lens permits a glimpse of the entirety.

2.Theories and practices involving postpartum confinement

The following questions were asked in the interviews to analyse the interviewees’views and personal practices regarding the custom of postpartum confinement in China: What do you think of the phenomenon that Europeans and Americans do not practise postpartum confinement while Chinese women generally do?What do you think of the conflict between commonsense ideas about modern health care and the taboos observed during the month of confinement?What is your own experience of postpartum confinement? Do you think the practice of postpartum confinement can be evaluated and regulated with the standard of modern science?

2.1 Theoretical basis of postpartum confinement

Why,we ask,has the practice of postpartum confinement maintained its vitality as a traditional form of local knowledge? The most direct way to answer this question is to understand the practitioners’thoughts.Regarding the fact that new mothers in Europe and America do not engage in postpartum confinement while those in China generally do,the interviewees’ explanation is that traditional Chinese medicine emphasizes the necessity of postpartum confinement for postpartum recovery.

When asked whether and why they participated in the practice of postpartum confinement after childbirth,only one of the 30 respondents thought the practice was unnecessary,but she was confined at the insistence of her elders at home.The rest of the interviewees considered postpartum confinement a necessary practice and took it seriously.This result shows that even today young women in China with high educational levels still adhere to the practice of traditional postpartum confinement.They believe the main reason for adhering to this tradition is that childbirth is detrimental to a woman’s vitality,herqi(energy) and blood would be weakened,and her bones would endure great change.Therefore,the woman’s body needs the period of recovery known as postpartum confinement.Otherwise,the woman would contract ‘postpartum diseases’ that are difficult to cure and may last a lifetime.

The respondents were also asked ‘Why do you think new mothers in Europe and America do not need postpartum confinement?’ Most of the respondents thought it is because Chinese women have weaker physiques,caused by differences between Chinese and Western diets.For example,Chinese women do not consume as much animal protein as do Western women.Among the respondents,some also believed that Western women do not treat diseases like rheumatism as postpartum diseases because they do not believe in such a thing as postpartum confinement.

In addition to referring to traditional Chinese medicine,some respondents believed that postpartum confinement is an old tradition,and it naturally makes sense for it to be popular for so long.Some also believed that postpartum confinement was helpful for the new mother as she adapted to her new identity,clarified her position in the family,and laid the foundation for subsequent engagement in professional work.These replies help to show that the practice of postpartum confinement has continued due to many factors,such as medicine,society and culture.Conversely,as a kind of knowledge-based practice,it is involved in the construction of the cultural norms and social relations found in local societies.Additionally,as an experiential,knowledge-based practice,postpartum confinement has pervaded individual experiences and social networks,creating a unique cultural space for practitioners.Through the practice of women in postpartum confinement and their families,its effect and efficacy are recognized.Therefore,it constitutes a powerful tradition that is difficult for the tide of modernity and science to sweep away.

2.2 Experiential practices in postpartum confinement

In ancient times,new mothers learned or acquired practical knowledge related to postpartum confinement mainly from female elders at home,and the knowledge was primarily passed down by personal demonstration.At present,however,there are various channels to acquire such knowledge.Such knowledge is increasingly becoming commercialized,as manifested in obstetricians,traditional media and new media,which are convenient sources for obtaining this kind of knowledge.In addition,the spaces for those in postpartum confinement have changed from private families to public spaces such as confinement centres.Caretakers for new mothers in postpartum confinement are no longer limited to a family’s female elders but also include confinement nurses hired from housekeeping companies.This reflects the commercialization of the practice.This situation means that confinement nurses,like obstetricians and relevant media outlets,have become sources,competitors and even new authorities in postpartum confinement knowledge in addition to a family’s female elders.

However,since the Song Dynasty,most of the taboos involving postpartum confinement have been largely followed.The practice of postpartum confinement mainly consists of three aspects (diet,exercise and health care,and environmental control) that constitute the core of the knowledge and practice.Diet mainly encompasses two categories: one is to meet the need for maternal physical recovery and health care,and the other is to promote the mother’s milk generation.For the latter,dishes mainly include pig trotter and peanut soup,crucian carp and bean curd soup and so on.For the former,Coixseed and red bean porridge,millet porridge andsheng hua tang(a special Chinese herbal soup used to clear blood stasis after childbirth) are used.When asked about dietary taboos,the respondents generally said that they should not eat raw,cold or hard food,which they thought would damage their health.Regarding exercise and health care,the respondents mentioned that they refrained from brushing teeth and washing hair,reading books and electronic products,and getting out of bed and walking around.Although many of them knew that it was neither sanitary nor scientific not to wash their hair,bathe or brush their teeth for one month,they still followed those practices to make their elders feel at ease and to maintain peace in the family.As for environmental control,almost none of the respondents strictly abided by the old practice of closing doors and windows and having no ventilation,but they all stressed that,even if premises were ventilated,it was necessary to avoid the brunt of the wind.

In summary,the knowledge sources,practitioners and spaces for postpartum confinement have changed with time in modern society,but the taboos during confinement have been largely preserved and have persisted as the core of the practice.The social function of postpartum confinement is also fully affirmed by its practitioners.Most of the interviewees are glad that they conformed to various taboos about confinement.They believe that because they conformed with the traditional requirements they have not been burdened with such postpartum diseases as dentine hypersensitivity,wrist pain or lumbago.Ju(2021) noted that local knowledge is an integral part of culture,and is formed,expressed and contributed to by members in a certain cultural background through the times.It serves the functions of judging and narrating the surrounding world,conducting exchanges and initiating actions,and it meets the needs of local people for survival and development.From this perspective,as a local,knowledge-based practice,postpartum confinement is obviously part of China’s traditional culture.The practice is inherited generationally by women and plays an important role in explaining and building a healthy body and a good family relationship.In addition,the practice shows strong adaptability and functionality,and its effects have been continually confirmed and strengthened by its practitioners throughout the ages.Therefore,even amid today’s globalization,the practice remains vital.

3.Postpartum confinement and the diversity of scientific culture

3.1 local knowledge as a part of a specific culture and its stability

Chinese women’s tradition of postpartum confinement has lasted for thousands of years as a kind of local knowledge.Its endurance is not only because of the theories and conceptions present in traditional Chinese medicine but also because of complex social and family contexts,which have caused the women in postpartum confinement to naturally concede to and accept those practices and pass them on from generation to generation,forming a cultural tradition.As women with high educational levels,the 30 interviewees agreed that postpartum confinement is necessary for postpartum recovery.Although they were not very clear about the relationship between the various practices and taboos for physical recovery and specific Chinese medical theories,they insisted on their importance.The major reason for this belief was their fear of suffering from incurable postpartum diseases,although they could not establish a clear causal relationship between postpartum diseases and not undergoing postpartum confinement or not doing it well.In addition,some interviewees mentioned the need to use postpartum confinement to transform their familial role as mothers,to obtain spiritual comfort,to establish their position in the family,or to strengthen their body condition for subsequent professional work.They followed the practice of postpartum confinement for fears of health detriments,because of respect for their family elders,or because they hoped to confirm their family status and social identity.All of these considerations indicate that their cognition of and attitude towards the practice were influenced by multiple social and cultural factors.Postpartum confinement is a kind of culture and lifestyle beyond the scope of medicine and health care.It is a hybrid of knowledge,culture and belief that is not only the product of a specific cultural tradition but also an organic part of the whole culture.

Therefore,as local knowledge in a specific cultural tradition,postpartum confinement is a strongly stable practice.Almost all the interviewees thought that taking care of a woman in postpartum confinement is a female’s duty.Only two of the interviewees hired specialized postpartum nurses,while the others were taken care of by their mothers or mothers-in-law,and all the postpartum confinement spaces were within the family’s space.The interviewees can acquire knowledge about confinement through various channels,and they are armed with modern health-care concepts;they also know that no postpartum confinement tradition exists in Europe or America,and that many confinement centres engage in scientifically guided confinement services.However,they essentially followed the practices outlined by their female caregivers even if they engaged in arguments and negotiations.Those few respondents who did not comply with or strictly follow the requirements of their mothers or mothers-in-law experienced relatively low satisfaction regarding their postpartum confinement,and some even felt regret.

In this context,modern science,which advocates a unified and standardized knowledge criterion based on mathematics and experiments,has encountered difficulties.The respondents made their choices and adjustments between modern scientific knowledge and health concepts and traditional confinement rules based on their consideration of complex factors besides science.This shows that the acceptance of a certain knowledge or cultural tradition is not based solely on science.Furthermore,there exists no pure science or knowledge that is divorced from social culture and practice.Additionally,the negotiations and arguments about the practice of postpartum confinement have shown that power relations permeate knowledge activities;that is,theoretical knowledge is understood in use rather than in static conformity(or inconsistency) with the world,and power relations constitute the world in which specific actors live (Rouse,2004).The long-standing tradition of postpartum confinement shows that specific cultural and social factors and even power relations constitute internal parts of knowledge,and that there is no universal knowledge independent of a specific culture.Therefore,the power of knowledge is manifested in its overall strength after its integration with culture and society.Moreover,that power is often consolidated by and manifested in long-term practices in daily life,thus gaining tremendous stability.As Tian (2021) states,‘The longer the history of a knowledge system,the stronger its historical basis;the value of traditional knowledge is endowed and developed in practice.’

3.2 The contextuality and heterogeneity of knowledge and the long-term value of cultural diversity

The dependence of knowledge on culture or context leads inevitably to knowledge heterogeneity and diversity.Even within a certain local knowledge found in a particular culture,obvious heterogeneity can be found.In this study,which takes as its object only a small number of women with high educational levels,although the traditional taboos associated with postpartum confinement are basically similar,different new mothers showed differences in their confinement practices due to such factors as personality,dietary habits,locality and caregivers.Regarding the diet,a major difference is that rice is a staple for those in the south of China while wheat is mainly consumed in the north.The south and the north also differ in how the diet should affect a new mother’s milk production and postpartum recovery.For example,drinking more rice wine is advocated in the south,while millet porridge is favoured in the north.These differences become more prominent when a mother-in-law in the south takes care of her daughter-in-law from the north or a confinement nurse from the south cares for a new mother in the north.The process requires mutual accommodation and compromise between the mother-and daughter-in-law as well as better communication between the new mother and the nurse.In other words,how to conduct the confinement depends on negotiations between each new mother and her caregiver,so the ‘confinement diet’ will be different.The same is true for the practices of shampooing,bathing,brushing one’s teeth and exercising.Therefore,in the greater custom of postpartum confinement,a number of small traditions are local and have strong contextual characteristics that vary by person and place.For this reason,when they were asked ‘Do you think it is possible to evaluate and standardize postpartum confinement with modern health care as the standard?’,most of the respondents held that it would be difficult to evaluate the practice by a single scientific standard of modern medicine.Moreover,they held that it would be difficult to implement in practice a modern medical standard to uniformly guide and standardize postpartum confinement.

Joseph Rouse explained Martin Heidegger’s concept of ‘understanding’ as follows: ‘Understanding is local and concerns survival,which means that it is subject to specific contexts and embodied in the tradition of explanatory practice handed down from generation to generation,and exists in people shaped by specific contexts and traditions.And understanding is not a conceptualization of the world,but a performative grasp of how to deal with the world’(Rouse,2004: 65).This explanation illustrates well the different understandings of postpartum confinement traditions and practices among the interviewed women as well as their understanding of and persistence in the diversity of the traditions themselves.As revealed by Bruno Latour and Steve Woolgar in their ethnographic research on the science laboratory,the constructive,contextual and heterogeneous characteristics of knowledge have also been demonstrated in this investigation and analysis of postpartum confinement.

The interviewees’different attitudes and the constructive,contextual and heterogeneous characteristics of knowledge show that any kind of arbiter’s knowledge that proclaims to be universal does not exist.Thus,the rationality and value of knowledge need to be understood and explained in the cultural tradition on which it depends for survival and continuation;and local knowledge in a particular culture cannot be measured against a so-called arbiter who is divorced from any context.The survey reveals that authority over postpartum confinement knowledge remains with a family’s female elders and new mothers;however,that authority is facing increasing challenges.For example,as postpartum confinement institutions are established,such a service market becomes more popular,and various scientific postpartum nursing manuals are published.Women’s postpartum confinement has increasingly become a competitive field for the rights to make statements,claim power and earn capital.From a local knowledge perspective,the so-called universality of knowledge is a process of knowledge’s standardization or generalization;that is,the process of a power struggle for knowledge (Liu,2021).While recognizing this fact,one cannot devalue other knowledge-based traditions (including women’s experiential knowledge traditions) in the name of science;nor can one deprive women practitioners of their choice among daily life practices in the name of science.Furthermore,the diversity of knowledge,like that of genes and culture,has long-term significance for the overall sustainable development of human civilization.

Declaration of conflicting interests

The author declared no potential conflicts of interest with respect to the research,authorship,and/or publication of this article.

Funding

The author received no financial support for the research,authorship,and/or publication of this article.