Friday, 14 October 2011

#5 Getting a flat stomach after birth

FACT OF THE DAY: After giving birth in Malaysia, many women are massaged daily by their midwife and have their stomachs bound to help them regain their shape
As I found out researching a previous post (#3), not all birthing experiences around the world are that enviable.

However if I had to give birth somewhere outside of the Western world, from what I’ve read so far, a rural Malaysian village might be my choice. The traditional Malaysian midwives (called bidans) seem to take such gentle and nourishing care of the women they look after. Just the sort of ‘natural birth’ that we romanticise.

The bidan gives expert care during pregnancy and labour, but what really strikes me as so lovely is the postnatal care that the mother receives in the weeks after she has given birth.

While some of the experiences of pregnancy and childbirth around the world that I read about make me cry in sympathy, this moves me in a different way. It makes me lament my own experience, I yearn for this in retrospect, and I can feel how much my postnatal self would have benefited from this type of postnatal care.

The bidan visits a new mother daily after she has given birth for a month or two (sometimes 44 days precisely - the time after birth that a Muslim woman is meant to keep to various postnatal restrictions), and each time she massages the mother’s stomach with her own home-made coconut oil and wraps a long cloth around her stomach. This binding is believed to return the internal organs to their correct size and place, and help the woman to regain her figure.

The first massage immediately after birth is symbolic, with onions, garlic and fire ash  included in the binding.  After this, the binding is taken off every day when the mother has a bath, and put back on again after the bidan’s massage (no onion, garlic or ash subsequently). They even wear the binding in bed.

A woman called Jacqueline Vincent-Priya spent time with some bidans in Malaysia watching their work and technique. She vouches for the effectiveness, one of the women who had given birth a month previously and had been massaged and bound since, “had a beautiful flat stomach and there was no sign that it had ever been distended with pregnancy”. I wish I could say the same of my own stomach!

She met with midwives from various different cultures in Indonesia, Malaysia and Thailand and they all told a similar story. Some used a heated metal ball for the massage, others did it for less days after birth, but they all gave regular, physical, hands-on care to the new mother and bound their stomachs.

Two things strike me about this postnatal experience.

Firstly, I don’t know why, but it surprises me that regaining shape is thought important. I slightly associate the idea of a postnatal girdle with the 1950s and outdated concepts of restraining underwear. In our culture today there is an idea that only the vainest of celebrities are that bothered about regaining their pre-pregnancy shape (and do it through starvation and personal trainers rather than binding), while the rest of us accept that we’ll just be a bit misshapen for a while after birth, possibly forever... 

1950s girdles

Secondly, how wonderful to be looked after in that way after giving birth. Not the binding or the stomach massage particularly, but having someone else care for you and being encouraged to sink back into their capable hands. Like that feeling of abandoning your cares when you lean your head back into the basin at the hairdresser. I can’t help feeling that it’s highly unlikely that these Malaysian women would suffer postnatal depression (sadly no data available).  Any equivalent we might arrange here would be viewed as a huge indulgence (plus what would you do with the baby) and would be too expensive for most women.

In our culture, or at least the way I experienced it, the postnatal time would be summed up by phrases like “childbirth is not an illness, you don’t need to lie in bed” and “back up and on your feet”. The midwives that came round to visit me after the birth concentrated on the baby’s health, and perfunctorily with my wellbeing. I got the distinct impression that I had done my bit and they had moved on.

Maybe I am the one romanticising the Malaysian experience, maybe they think  “oh no, here comes the old biddy to do my massage and binding. I’ve got too much to do and don’t want her hands all over me”. But somehow I doubt it, especially given that even middle-class Westernised women are likely to use a bidan’s services if not for labour, then for the massage during pregnancy and after birth. One of my friend’s sisters gave birth in a state of the art hospital in Kampala under Western medical care, but then was visited by a traditional bidan regularly at home afterwards.

Shall I start petitioning the NHS now for daily postnatal massages for all women?

*   *   *

Just in case you want to read more yourself, have a look at:

Jacqueline Vincent-Priya  (1991) Birth Without Doctors: Conversations with Traditional Midwives London : Earthscan Publications

For a nice photo of a Malaysian bidan, see:


  1. A daily massage sounds great to me - I'll sign that petition!

  2. This binding has a lasting benefit - when travelling in Malaysia on the trains, I noticed how enviably flat the tummies of the women of all classes were and how beautifully they carried themselves

  3. Hi Janet,

    Interesting note - as far as I am aware both Indian and Chinese cultures advocate a 6 week post-partum rest period. In Indian cultures I understand this is referred to as the red tent, where the mother and new baby would recuperate massaged and tended to by other women from the extended family or community. Binding is also advocated to encourage the uterus, other internal organs, and lower ribs to return to their pre-pregnancy position, my reference is from Dr Gowri Motha's "Gentle First Year".

    Hope all is well, best, Hannah (another of Sej's friends)

  4. Yes I read that Gentle First Year too, and because of that I then read a book called 'The Red Tent' by Anita Diamant which I was enjoyed a surprising amount given that its fictional account of Dinah from the Old Testament! But lots of interesting references to midwifery practices in those parts of the world.

    Yes, many cultures have quite strict rules about the weeks or months after birth, although sometimes its because the mother is still thought to be impure (and its to protect her fellow villagers), rather than for her own recuperation.

    Janet x

  5. Hi Janet, really enjoyed this! I am an anthropologist who lived her two first pregnancies in the Amazon. I learnt a lot from forest women and also became apprenticed to a local midwife-shaman. As a result of this, years later I founded an organisation called Birthlight to pass on this knowledge. Because I am a yoga practitioner we use the cultural idiom of yoga but a lot of the practices are from popular Asian and Amazonian traditions. We have a great postnatal programme that women can use right after birth in bed, it's gentle and effective to restore not just abdominal tone but real core strength that prevents depression from creeping in. Our website is all best wishes with your blogs, looking forward to reading the next one...

    1. Thanks very much Francoise. I would love to hear more about your pregnancy experiences in the Amazon. I will email you directly, Janet

  6. Hi Janet, I am so happy I found this post. I am from hispanic descendance and somewhere back in time, my grandma also practiced this tradition. She passed the tradition among us, so now for 3 generations the women in my family have taken care of their bodies after pregnancy. I am the 3rd generation that has followed it. Of course now there are so many more technologies and options. I really enjoy telling my friends about a simple natural tradition and now I can extend my recommendation to not only my family tradition but many other cultures. One more thing, the massage thing is awesome!.. I massaged my belly every day for a month with a mix of oils and even my husband helped me just massage my tummie.. it really was the treat of the day... I have pictures of my family in this website: I know is commercial, but I hope you are ok with me posting it because of the pictures of my grandma, mom and me and the stories in it. It also talkes about the oils to use for massaging. You can do it yourself!

  7. hiyaa Janet, i live in indonesia, and i'm indonesian.
    even malaysia and indonesia is near (culture, beliefs and location) but in fact there's no such a massage like that here. it's surprisingly because we called the lady bidan too! but bidan is kind of a traditional doctor but they're legitimate.
    good to know! thanks ^^

  8. Hi janet, hope u still read this. Im from kuala lumpur Malaysia and now in my third week post partum. I had a week of daily body massage after 4 days of my normal delivery. The massage by bidan included a check on whether the uterus has shrunken and paid attention on specific painful areas. She even cooked red dates drink for me. I had a time table on what food is prohibited and allowance during this confinement period. Through out 44 days im expecting myself to be like in a sauna- warm internally. I have so far lost 10 Kg. All of my friends practised bidan service and 'confinement set' ie herbal drink supplements etc of various brands

    1. what does your time table of allowable food looks like? Are the red dates made into a tea to drink?

  9. Hello - yes I still read it although I haven't posted anything for quite a while. That is so interesting to hear about your experiences, thank you for sharing. It does sound as though it could be really beneficial - I wonder if you chose to have this treatment or if it was something you felt you should do? The word "confinement" has negative connotations in our society, as it sounds like the new monther is being restricted and confined. However, the actuality of being massaged and cared for daily post partum does sound like it could be very beneficial. The normal experience in the UK is of little contact with any midwives after birth. Ordinarily the midwife will visit you at home for a week or two after birth but that is mostly to check on the baby than to look after the new mother. I sometimes wonder if this contributes to the high levels of postnatal depression we have. I wonder how prevalent postnatal depression is among your friends? Best wishes.

  10. That is amazing and i so appreciating you sharing this. I am 3 years post-partum and longed for all of that care that was not typically talked by my midwives. My abdomen separation is still so large (4 fingers width in the lower part, then 3 and 2 fingers width moving upwards), and i am so grateful to have met a woman last week who knows about belly-binding in other countries and the strengthening of the core. I just started wearing my "belly band" which is one use by physical therapists. i have just found out that the abdomen separation is most likely the cause of many of the health issues i have been experiencing since giving birth and am excited to see what happens once these muscles begin strengthening again.'s never too late to give ourselves the post-partum care we need and deserve (i was just talking about this yesterday with a friend who recently had her first baby). There is an awesome book about this that my mid-wife lent to me, although I am not sure it is actually publlshed, called "Mothering the Mother: 42 days for 42 years" (i think that was the number, or it may have been 40 days...something in the 40's. i highly recommend this book for anyone who can find it. I believe it was written by an Ayurvedic post-partum doula who teaches/certifies women in doing this post-partum work. Even if you can't get a hold of it, the point is in the title: we deserve to be mothered for a long time and I am so glad it just occured to me that 3 years post-partum is NOT to late to ask for the care i need and to give that gift to myself (and, therbey, to all mothers and our families). it is never to late! Much love to all of you mamas out there.

  11. very informative and helpful blog i really appreciate to you Thanks for sharing Pregnancy Tips

  12. We have the same massages in Pakistan too