Megan Cutler and Dr. Lynn Clark Callister, Department of Nursing

Chinese childbearing women living in Taiwan have cultural beliefs and practices, including the common practice of “doing the month” after giving birth. Similar practices can also be found in Japan, South Korea, the People’s Republic of China (PRC), Thailand, and Cambodia. There are an increasing number of immigrants from Asia living in the United States, and many women from these places bring with them traditions and customs that are unfamiliar to many. Considering the great diversity of America, it is important that nurses working with childbearing women provide culturally competent care for Asian childbearing women and other culturally diverse women. Many nurses have never even heard of the practice of “doing the month,” or other practices espoused by Chinese women and consequently would not be able to provide satisfactory care were they to care for a woman wanting to follow that practice.

In Taiwan, there are many cultural beliefs and prohibitions related to expecting a child. Some examples of these are the belief that a pregnant woman should avoid eating dark foods such as chocolate and eat more white foods in order to make their child’s skin whiter, and the belief that pregnant women should not pick up needles or scissors in order to avoid giving their child a cleft pallet or some other handicap. After women have babies, they are supposed to do something called “the month,” which involves a 30-day confinement to their home where they are supposed to recover from having a baby. They are usually cared for by their mother or mother-in-law, who prepares several “month meals” each day that are intended to help the woman’s body renew itself. These foods include kidney, liver, soups, and chicken. Chinese medicine is also included in most of these “month meals.” During this month, the woman is supposed to lie in bed, and is not supposed to shower or wash her hair.

In order to collect data regarding the perceptions of Chinese women of giving birth and their adherence to cultural practices such as “doing the month,” I needed to interview Chinese women who had recently had a baby. My main intent in interviewing these women was to find out to what degree women in Taiwan follow the ancient practice of “doing the month”, and to learn more about “doing the month” and other cultural traditions followed by Chinese women. I also wanted to interview women from Taiwan who had immigrated to America and given birth recently to see if cultural traditions would still be carried on despite environmental change.

My first task was finding women to interview. I spent several weeks in Taiwan, and through a variety of ways was able to find fourteen women to interview. When I returned to America, I continued my search and was able to interview four Chinese women from Taiwan who had immigrated to the western United States. These women had all given birth in the past year to a healthy term infant. I conducted audio-taped interviews in Mandarin Chinese or English depending on the preference of the mother. The mothers were all very willing to share their experiences of child birth, and were also happy to teach me about their cultural practices. They were delighted that an American wanted to learn about their practice of “doing the month.”
After all of the interviews were conducted, I transcribed and translated them. This was by far the most daunting task of all as most of the interviews were 30 minutes to an hour long. After transcription was complete, my mentor and I reviewed and analyzed the transcripts, and identified themes that arose from the narrative data.

Themes included expecting a child; defining birth expectations; experiencing giving birth; and sitting or doing the month. The profoundness of the birth experience was identified. One woman stated “Childbirth is an experience of life. It makes it so you can be a mother. It helps fulfill the purpose of being a woman.” All of the women talked about the practice of “doing the month” and the degree to which they followed it.

I had hypothesized that because Taiwan has recently become highly westernized, the age old practice of “doing the month” would be less commonly practiced. However, I found that all of the women I interviewed followed the practice of “doing the month” to at least some extent. Many of them gave examples of how doing the month had benefitted them. Several expressed that they though some of the practices surrounding “doing the month” were superstitious, but most followed them to at least some degree to avoid getting a “month disease.” One woman said, “My mother-in-law said I shouldn’t wash my hair. I heard a lot of examples of people who washed their hair and their head really hurt when they were 40 or 50 years old. During the month I was amazing. I didn’t wash my hair at all.” Although many of the woman did break away from tradition and did things such as wash their hair, walk around their house, or eat foods not considered “month foods,” all of the women avoided leaving their home during this month period and changed their diet somewhat to be more in accordance with tradition.

Although my sample size was not very large, I feel that my data points to the conclusion that “doing the month” and other Chinese cultural traditions surrounding childbirth are still very much alive in Taiwan. Although many things have been adapted, the idea that a woman should follow certain traditions in order to be healthy and have a healthy baby remains. There are several “month houses” in Taiwan catered to women who don’t have a mother or mother-in-law to help them, and several businesses that offer “month food” delivery to women for the month after they have a child.

Because many Chinese women who have immigrated to America follow cultural traditions and practices surrounding childbirth that our different than ours in the United States, it is important for nurses to become familiar with these practices should they care for women wanting to follow them. Continued studies should be done to find out more about the cultural practices of Chinese childbearing women, and this data should be made readily available to nurses who may care for Chinese women. By doing this, nurses caring for childbearing women will better understand Chinese cultural beliefs and practices so they can provide culturally competent care, and help the women they care for have a satisfying birth experience.