There are always pieces of wisdom to be learnt from traditional cultures around the world. From cultural beliefs and rituals to traditional foods and practices, when we take the time to connect with ancient wisdom, it allows us cultivate a different perspective and perhaps implement what feels true in our daily life.
Postpartum care in Laos is integrated and weaved into the fabric of families and society. They have particular rituals and practices to support mothers during the early weeks of postpartum period. One of my friends had the opportunity to connect deeply with the traditional postpartum care practices of Laos and has kindly shared her experience and images with us.
I hope you enjoy learning more about her experience and reflections of postpartum care in Laos and the West.
An interview with Maude Vezina, Doctor of Public Health, about traditional postpartum care practices in Laos
In 2017, I have been blessed to be able to spend 8 months in Laos for a research study around postpartum care among women. The answers I give here are based on what I observed, have been told, and have interpreted subjectively, as well as what my research helped discover.
What does postpartum care in Laos look like
In Laos, postpartum care is mostly organised around families. Maternal leave lasts 3 months. And during the first month or so, the new mother usually practices a postnatal ritual that encourages her to rest and care for her newborn. If medical follow-up is possible for new mothers, the care they receive is mainly through the practice of a ritual called the hot bed, and from families and friends.
What are the beliefs and rituals performed during the postpartum period
In Laos, balance in energetic forces is important, both within individuals and throughout the population. Spiritually, blood is associated to a heating energy. So, when the woman gives birth, she is seen as having lost a lot of heat, thus needing an energetic rebalancing (or … re-heating!!).
The postnatal ritual called the hot bed, or yu kam, in lao language, consists of laying on a bamboo bed above a coal fire. The woman usually practices the hot bed right after giving birth, and up to one to two weeks, sometimes even up to a month. The woman also bathes in hot water and drinks hot infusions, as well as eat a special diet (rice, some white fish/chicken in broth – the broth must not be too spicy; it can be moderately spicy, depending on the beliefs). The cradle with the newborn baby is usually placed nearby the woman’s bed, allowing her to feed the baby and care for him/her.
The hot bed ritual is practiced among 90% of women or so in Laos, data still being imprecise about the exact proportion. It is a practice that every family knows because the whole family is often involved in the practice. Why? Because practicing the hot bed ritual requires a lot of help around the woman. The coal fire must be fed regularly, for it to be lit all day long, for the duration of the practice. Mothers also need help for chores, such as preparing food, cleaning the house, and help with the newborn and/or other children, if she has more than one. Families and friends thus organise themselves around the mother, each member playing a role in the ritual. When I went to visit women during their hot bed ritual, I saw a brother cooking for her sister, a mother visiting, a mother-in-law helping, a friend bringing diapers and clothes. It all felt like a well choreographed dance.
What are the positive or negative impacts of this type of postpartum care on women/mothers/families/babies/society
The impacts of the hot bed ritual can be observed on many levels. On the physical level, no research has really been carried to determine if the effects were overall beneficial. Most women said that the heat from the coal placed underneath the bed helped relax their uterine muscles and helped the skin regain some elasticity. Because the heat level emanating from the coal fire cannot easily be regulated, some women have also faced some serious injuries (skin burning of exhaustion from the heat) from practicing the hot bed in an unsafe way. The heat can also be suffocating, because the coal fire is combined with the already hot temperature, creating an overall quite intense effect.
On the psychological level, my master’s research has tried to determine if such a practice could help prevent postpartum depressive symptoms. The results suggested that the social support mobilised around the women through the hot bed ritual had positive effects on the overall psychological well-being of the mother. The effects on the newborn babies are still imprecise. We think it must be dangerous for the newborn to inhale coal fire during the first weeks of his/her life. But being able to spend that much undivided time with the mother most probably help in solidifying the mother-infant bond.
This practice also brings families and friends together around a same objective. I believe that this coming together meaningfully helps deepening social values within the community.
Comments, reflections, observations from your experience in relation to postpartum care in the west
What shocked me the most during my stay in Laos was how collective everything felt. It was as if everyone was devoted to the community. As if the base unit of the society was the family and not each of its constituent. That felt weird at first. And I remember thinking that it would oppress me, that I would not want to live in a society when your voice does not truly exist.
But when I came back to Canada, I was shocked for a second time. This time, I realised how weird it felt to observe people and families interact without a sense of engagement and interdependence between one another. The value of independence and self-sufficiency is valorised and reflected in almost every aspect of our lives in the West, including in postpartum care. In Quebec, when women give birth, they are pretty much left to their own afterwards. Sure, a midwife or a nurse comes a few times and makes sure things are in order. But in the day-to-day stress and struggles of figuring out a whole new life and taking care of a human being, the mother, the parents, are their own resources and answers. They can ask for help, they can receive some, but no system is installed around them to care for their psychological and emotional well-being.
In a lot of corners of the western world, there seems to be a lack of mental healthcare around women (parents) in their postpartum period. In Laos, the mental healthcare was also poor (there were approximately 10 health professionals in the whole country back in 2017!), but the social support is manifested in numerous ways, including through a ritual is still practiced by most of the population. The society has taken on a responsibility that helps relieve some discomforts. It does not replace mental healthcare, but social support helps in exponential ways that can sometimes prevent mental healthcare needs.
I do not think that being surrounded by families and friends is what every parent in the West would want after giving birth (!!). But having the opportunity to be cared for by people who can help relax some of life’s burdens can be beneficial. And if being alone is what some parents need, they should also be able to access mental healthcare if needed.
What I realised, is that no extreme is truly healthy, long-term wise. Individuals and communities should both exist, as well as interdependence and independence. Society does not have to be responsible for its new mothers, nor should governmental institutions. But if both parties do not want to take on the responsibility, then the result is what I observe in Quebec: there is no real access to psychosocial healthcare or social systems that help take care of the new parents and the newborn. Some services now start to appear to fill the existing gaps. But I do think a wider reflection is needed to create a positive change in postpartum care.
About Maude Vezina
Maude Vezina is a Doctor of Public Health, professor and researcher. She spent close to a year in Laos studying traditional care practices and has written her PhD on the impacts of midwifery care services in Quebec, Canada. She is the author of Yu Kam, a fictional novel based on her experience of the postpartum care ritual of the bed in fire in Laos.
To find out more about Maude's work, please refer to her publications below:
VEZINA, Maude, Yu Kam, Montréal, Éditions Québec Amérique, 2023
Damus, O., Vézina, M. & Gray, N. (2022). Valuing Indigenous Health Promotion Knowledge and Practices :The local dialogue workshop as a method to Engage and Empower Matrons and Other Traditional Healers in Haiti.
Global Handbook of Health Promotion Research, Vol. 1. Yaya, S., Idriss-Wheeler, D., Sanogo, N. D. A., Vézina, M., & Bishwajit, G. (2020). Self-reported activities of daily living, health and quality of life among older adults in South Africa and Uganda: a cross sectional study. BMC geriatrics, 20, 1-11.
Ngangue, P., Robert, K., Ly, B. A., Traoré, F., & Vezina, M. (2022). Evaluating the effects of an intervention to improve the health environment for mothers and children in health centres (BECEYA) in Mali: a qualitative study. medRxiv, 2022-04.