Why Won't This New Mom Wash Her Hair?
The fascinating postpartum customs of women from around the world.
"It's about food, about sex, about rest." Evelyn, a 34-year-old Dominican immigrant who recently gave birth, is explaining the Latin American custom called la cuarentena ("quarantine"). It's a 40-day postpartum period during which mothers recuperate from labor and bond with their babies. Minutes earlier, her bouncy 7-year-old daughter let me into their apartment, on the second floor of a two-story house on the outskirts of Boston. With delicately pretty features and a thick ponytail, Evelyn (who prefers to withhold her last name) is the picture of new maternity: Her black-haired infant is wrapped in a pink fleece blanket and planted at her breast.
Her summary makes the cuarentena sound like a hedonist's dream, until she elaborates: food, sex, and rest are subject to a constellation of taboos and prescriptions. Sex is a no-no. Rest is mandated and traditionally facilitated by female relatives who take over errands and chores. Foods are divided into the approved (carrots, chicken soup) and the forbidden (spicy and heavy fare). The new mother's body is considered vulnerable or "open," and to protect herself, she must cover her head and neck with garments and wrap her abdomen in a cloth called a faja; she might also avoid washing her hair. Many women believe that proper observance leads to good health in old age, while lapses incur all sorts of problems, from headaches now to illness later in life. They would no sooner skip the cuarentena than a Park Slope mom would prepare her toddler sippy cups of Coke.
Versions of the tradition are practiced throughout most of Latin America. In much of Asia, an uncannily similar custom with entirely different origins, known as "doing the month," is widely observed. In the United States, immigrants and their children carry on these rituals to varying degrees. Last month, a "birthing center" in Los Angeles, which served Asian tourists who came to give birth to U.S. citizens, made news when it was shut down for building code violations. Part of the center's role was to provide accommodations for clients to "do the month." So where do these postpartum rituals come from and are they good for new moms?
Researchers have traced the cuarentena's history back to the Bible. A passage in Leviticus stipulates 40 days of purification after the birth of a son (double for a daughter). As in menstruation, the woman is considered ritually unclean during this time and is barred from entering the sanctuary. In Europe and America, the "lying-in" period may have had the same roots, but that practice died out long ago. Presumably it was a colonial import to Latin America, where it survived and evolved to include the other rules and beliefs.
Despite its beginnings—which suggest that a woman may be more in danger of contaminating her surroundings than vice versa—its more recent incarnation has been widely seen as a sign of motherhood's high status in Latin American countries. Anthropologist Kate Masley hypothesizes a link between the ritual and the so-called Latina paradox, which refers to the unexpectedly good birth outcomes (relative to socioeconomic levels) enjoyed by Latina mothers in the United States. While postpartum activities cannot, of course, retroactively affect the birth outcome, Masley believes the two reflect the same culture of care and support. One 1998 study likewise concluded that the ritual "instills parental responsibility, incorporates individuals into the family, and integrates the family."
In China, "doing the month" emerged independently in the Sung Dynasty. The tradition comes from Chinese medicine, which promotes a balance between yin and yang in the body. According to this system, giving birth disrupts that balance, and the mother must restore it by consuming food classified as yang, such as chicken, ginger, eggs, and rice wine. Women are supposed to avoid cold water, as well as bamboo shoots and turnips, all yin. Other frowned-upon activities include going outside, bathing, and brushing teeth. Scholars have speculated that these last two prohibitions arose at a time when water was likely to carry diseases.
Are these rituals beneficial for moms and their babies? Academics and health professionals offer a mixed bag of verdicts—reflecting the eclecticism of the customs' components, which range from the eminently sensible to the harmless to the ill-advised.
Some journal articles urge cultural sensitivity: Let's make sure, they reasonably exhort, that Latin American women can cover their heads in the hospital and that Chinese women are not served ice water. At the same time, as even some of these ambassadors of pluralism agree, elements of each tradition may carry risks. In the cuarentena, there is concern that wrapping the abdomen too tightly with a faja could occlude blood vessels. The alcohol in rice wine involved in doing-the-month can get into breast milk. One study found that staying indoors could cause vitamin D deficiency and rickets in women and babies. Rest is good, but too little activity can be problematic, as can the restrictions on bathing.
Observers have tended to assume that the customs protect against postpartum depression, but the evidence is inconclusive. A meta-review of studies of doing-the-month found no clear protective effect, and in some cases a negative one, particularly when mothers-in-law were the primary caretakers (imagine your opinionated MIL or bossy aunt camped out in your guest room for a month). In researcher Lisa Waugh's study of Mexican-American mothers, the subjects expressed appreciation for the cuarentena, but also anxiety about the perils their mothers invoked. Like any tradition, it can be both comforting and constricting, and plenty of women pluck the parts they like and discard the rest.
Americans who hear about the customs seem to be most envious of the support womenreceive from relatives. Familial tensions notwithstanding, many women in studies (and in my informal survey) are very grateful for the help—with everything from laundry to child-care coaching—they receive. Yet this aspect may be eroding, as immigration separates family members, and as traditions inevitably fade in a new country. Another twist is a move toward institutional arrangements. In Taiwan, pricey hotel-like "doing-the-month centers" have become popular among affluent women.
There are a number of such centers in Los Angeles, like the one that was recently busted. In January, I visited one of these. Smaller than the one that closed, it housed five women and their husbands and babies. In a ground-floor nursery, five carriages were lined up against the wall. Older Chinese women staffed the center, cooking, cleaning, and showing the new mothers how to change diapers. In addition to foreign visitors, these centers typically also serve immigrants who have no family in the area—or who prefer a center and can afford it.
Evelyn's cuarentena may be a quintessentially modern example. Her mother and two of her sisters live nearby, but they haven't had time to offer much assistance. Her husband does what he can, helping to clean and picking up Chinese food. While he's at work, her help meet is her 7-year-old daughter, watching the Disney show Suite Life on Deck in the bedroom and drawing, but ready to answer the door for guests like me and fetch bottles of ibuprofen for her mother. The newborn is calm for the duration of my visit, either nursing or asleep, her only motion to yawn charmingly.
Despite the tranquil scene, Evelyn says, "I never rest like I'm supposed to rest." As for the other aspects, she is resolute about abstinence (to her husband's half-mock chagrin), but otherwise less strict. Her version of a faja—traditionally made of cotton or muslin cloth—is a pair of lycra stretch pants. Although she hasn't washed her hair yet, she's confessed that she may cave any day, overriding her grandmother's admonitions. After all, she has to go out in public to shop for groceries; her grandmother didn't.
Rebecca Tuhus-Dubrow is a writer in Somerville, Mass.
Illustration by Mark Alan Stamaty.