Mental and physical healthcare crucial for postpartum mothers

KUALA LUMPUR - Confinement, or commonly known as ‘pantang’ in the Malay community, refers to a post-pregnancy ritual that helps new mothers recover and recuperate after giving birth.

Throughout the postpartum period, the new mother would be "confined” to her room and observe traditional postnatal care methods that ensure proper recovery of her body. It usually involves rules, regulations, guidelines, taboos and diet requirements based on traditional post-natal knowledge.

During this time, women experience significant physiological, psychological and social changes. As such, besides physical care, mental healthcare considerations are also crucial for the postpartum mother during the pantang period. In fact, they have to adhere to the ‘adat pantang-larang’ practices or the do’s and don’ts even during pregnancy and immediately after delivery.

The pantang period or the traditional postpartum care is an ‘exclusive’ process for the mother as it is believed to rejuvenate the body, help restore her body figure, health and energy to pre-pregnancy levels. It is also said to improve blood circulation, restore the uterus to its original size and position and help her regain hormonal balance.

The traditional pantang culture has since evolved and today the process is no longer the ‘domain’ of family members such as the mother or mother-in law in providing after-birth care for the daughter or daughter-in-law.

Among the alternative practices are going through confinement at home with the assistance of certified confinement nanny or checking into confinement centres which are now mushrooming across the country.

Sharing her experience, a housewife Fara Liyana Idris who is a mother of three, said there is a significant difference between confinement at home and at care centres.

"For my first child four years ago, I chose to spend my pantang days at home. Although my mother-in-law and my own mother came over to help, I could not relax as there were other household chores to do, causing me to have body aches.

"Later, for my second child two years ago, I opted for a five-star confinement centre for a month. Throughout my confinement there, I only focused on the recovery process,” she told Bernama.

Satisfied with her postpartum recovery experience, Fara Liyana, 32, opted for similar services for her third child last August at NARQES Wellness and Confinement Centre for three months.

"Here, your baby is well cared by certified midwives and nurses, besides being treated like a ‘princess’ as we are given nutritional food specially catered for those under confinement for six days, in addition to receiving traditional massage such as ‘bertungku’ (a form of point massage using heated objects) from a professional masseuse.

"Besides that, my husband and children were also allowed to stay here and were given equal treatment as enjoyed by five-star hotel guests. In fact, I didn’t have to worry about household chores such as cooking and washing clothes as they were all taken care of during my pantang period....on the whole, I am very satisfied with the service here,” she shared.

PHYSICAL, MENTAL CARE

It is a normal practice for most postpartum mothers to focus on physical care to restore their pre-pregnancy figure such as going through the traditional rituals such as bertungku, traditional massage, taking ‘jamu’(traditional herbal medicine) and nutritional food for those undergoing their pantang period.

Every treatment and pantang procedures should be conducted in a systematic and organised manner, failing which they could have negative effects on the mother, such as virus infections on the wound and severe bleeding besides affecting the mental health of the mother in confinement.

An obstetrician and gynaecology (O&G) expert at PrimaNora Medical Centre, Datuk Dr Nor Ashikin Mokhtar said failure to plan an effective postnatal recovery for new mothers can also lead to various risks and complications for both the mother and the child.

Among others, new mothers could face risks including infections, especially for those with C-section wounds and episiotomies.

"What concerns the most is that severe internal bleeding or hypertension may occur without being noticed by the mothers or their families.

"Lack of guidance and support in managing these emotional challenges can impact new mothers and contribute to difficulties in breastfeeding, such as issues like breast milk shortage or mastitis,” said Dr Nor Ashikin, who was a panellist at forum on ‘Peace of Mind for New Mothers: Confinement Centres for Mental and Physical Recovery’ at the official launch of NARQES Wellness and Confinement Centre, Alam Damai branch, Cheras, here recently.

She said most first-time mothers expect their family members to provide aftercare for them at home given that they had no previous experience in managing the newborn baby and self-care after childbirth.

"However, there are potential risks if the inexperienced caregiver provides postnatal care as poor handling or lack of oversight on certain procedures could have adverse effects on the mother.

"Among the common mistakes are taking the recovery period lightly and many family members thought that the new mother would recover quickly after delivery.

"However, the period of recovery can take weeks and even months, and could also have effects on the body for the long term (due to poor afterbirth care). Hence, the postpartum period is crucial for recovery,” she added.

To a question from the audience on the attitude of some parents, especially among the generation Z, who regards the confinement process as a waste of time, Dr Nor Ashikin said, "We are fortunate to continue the practice of traditional confinement among Asians, in contrast to Western countries where this tradition has been largely abandoned for postpartum care.”

"Nevertheless, there is a need for proper education and awareness among young parents about the significance of postpartum care for their health, particularly during periods of significant hormonal changes," she added.

Dr Nor Ashikin also advised married couples who are planning to have a baby to maintain a nutritional diet and healthy lifestyle, as it all starts with the gut.

"If the food that we eat does not pass through the proper digestive process, the body will not be able to produce ‘happy hormones’ as any changes in the hormone levels may have a potentially negative impact on both physical and mental health,” she explained.

MENTAL HEALTH

Dr Nor Ashikin also stressed that normally during the confinement, the mother or caregiver is more focused on body care to the extent that they often tend to neglect mental health.

As a result, the mother tends to suffer from depression and anxiety after delivery, but often, her family members could not detect the signs and failed to seek assistance.

"Depression and emotional instability during the confinement process is normal, there are times when the postpartum mother can experience stress when she runs into breast milk shortage or if the newborn baby won’t stop despite all efforts in caring for them.

"However, if the situation persists for months, they must seek psychological assistance from a counsellor or expert,” she added.

A clinical psychologist and Fellow at the Institute of Islamic Understanding Malaysia (IKIM) Khairul Azhar Idris said postnatal depression or known as postpartum depression (PPD) is a serious condition and could affect certain individuals after childbirth.

He said this is not merely a case of having ‘baby blues’ that is feeling sad and overwhelmed, a common mood disorder experienced by the mother for several days or during the first week after the birth of her baby.

"Postnatal depression can persist and becomes acute for weeks or months if no professional counselling is sought,” he said.

"In fact, the real causes of depression after delivery are not fully understood, a combination of physical, emotional and lifestyle factors can contribute to the disorder.

"These include hormonal changes, lack of sleep, stress, a family history of mental health issues, employment and various social and environmental factors,” he added.

SYARIAH-COMPLIANT CONFINEMENT CENTRE

Confinement centres are gaining popularity of late, with many mothers choosing to stay at one rather than staying at home. These centres are comfortable retreats that provide special care for mothers and their newborns, enabling the mother to rest and fully recuperate without having to worry about other matters.

According to the founder and Managing Director of NARQES Wellness Confinement Centre Datin Narqes Mohd Raimi said she was encouraged to provide such service to new mothers after the birth of their child given that awareness is lacking in postnatal care, noting that it should not merely be focused on the new mother’s postpartum body, but the baby and family members as well.

"At home, postnatal care is usually informal and dependent on assistance from the family or domestic helper. There are also traditional methods that the older generation felt that are (still) effective today are not acceptable for the present generation who regarded the traditional practices as orthodox.

"At NARQES Confinement Centre, we provide a daily routine and more structured environment as well as syariah-compliant to ensure mothers can rest and recover in a serene and comfortable environment without having to worry about having to do household work while in confinement,” she said.

In addition to providing traditional Malay postnatal care by certified professionals, the centre also offers services such as laundry, spring cleaning and cooking to ease the family’s responsibilities.

"Here, we provide healthy meals six times a day, clean clothing, and a comfortable bedroom that is tidied and cleaned daily.

"We provide effective round-the-clock postnatal care for both mothers and the baby with the assistance of certified nurses, hence allowing mothers to focus on their own recovery and baby in a relaxing atmosphere.

"At the same time, we also provide meals that are specially prepared for the mother’s physical recovery, including a balanced diet that is based on traditional practices and the suitability and health requirements for every postpartum mother,” she said.

She said that the centre is backed by professional staff with over 20 years’ experience, noting that women especially first-time mothers can breathe a sigh of relief when faced with difficulties in managing their baby.

"What’s more important, you will not be stressed out over such matters and can focus on body recovery.

She said the centre provides five types of confinement packages with a starting package of seven to 44 days’ stay at reasonable rates from RM5,000.

"Besides providing five-star hotel treatment with a traditional massage package, confinement mothers can also enjoy our spa facilities and receive advisory service on breastfeeding the baby throughout their stay with us,” she added. - BERNAMA