Written by Amélie Keyser-Verreault.
Image credit: IMG_9492 by Jerry Lai/ Flickr, license: CC BY-SA 2.0.
In Chinese culture, the tradition of yuezi (月子) or the practice of postpartum care for the mother, is a longtime established practice. In Taiwan, this practice underwent and continues to undergo the vicissitudes of social and interpersonal relationship changes. Before the 1970s, the birth rate in Taiwan was extremely high, and the idea of “more children, more grandchildren, more good fortune” (多子多孫多福氣) was widely accepted. The large family size also meant sufficient human resources for agricultural-related field labour. The practices of yuezi were already crucial at that time. Mothers in the postpartum period had some privileges like a long rest and special food, particularly meals containing meat like chicken, a precious food at that time.
The importance of yuezi could be partly explained by the high mortality of mothers and babies during childbirth. There was thus a traditional Taiyu proverb saying that “If you survived to delivery, you enjoy the smell of chicken in sesame oil, and if you did not, you have only four wooden boards [a coffin]” (生得過雞湯香 生不過四塊板). The main goal of yueziwas the mothers’ recuperation from physical force to restart the domestic and fieldwork on the one hand and restore women’s reproductive capacity on the other. Traditionally, it was mostly the mother-in-law who “helped” her daughter-in-law to do the yuezi.
However, the country’s modernisation caused huge changes in social arrangements, including the reduction of family size and the advent of small nuclear families, the influences of Western medicine and social organisation based upon individualism and the drastic drop in fertility rates. Accordingly, the practices of yuezi underwent significant changes, both in terms of yuezi-related behaviour and also in the conception of this tradition. The apparition of yuezi centres (月子中心) is doubtlessly one of them.
A Pioneer of Institutionalising the Yuezi Practice
In fact, Taiwan is a pioneer in the institutionalisation of the yuezi practice through yuezi centres. Postnatal care centres first originated in Taiwan at the end of the nineties, where they combined childbirth with postpartum care and were legalised by public health authorities. After that, mainland Chinese companies borrowed the postpartum care centre model and began to appear in Beijing and Shanghai. This model developed throughout China and even in North America to meet Sinophone global citizens’ needs.
The stay in these highly medicalised and specialised institution is costly, particularly in the great Taipei area. The price ranges daily from 7000 NTD (220 Euros) to 20000 NTD (620 Euros). Despite the high price, attending a yuezi centre is common and popular in Taiwan—about 60% of Taiwanese mothers go to one of those centres after giving birth. Some people combine a few weeks in the yuezi centre and the remaining weeks of the month at home with the help of family members or a postnatal doula. Among the participants in my studies, those who chose not to go to a yuezi centre did so because they lacked the means or were abroad when they gave birth and therefore did not have access to a yuezi centre. “Going to the yuezi centre is now the new normal way of doing the month,” one participant underlined.
The increasing importance of these centres could be explained by a strong need to professionalise infant care and child education. It is also influenced by a parental wish to invest in their children, from the beginning, with new technologies and new parenting discourse coming from the West. These perinatal care centres represent an important and pioneer shift in social practices, moving from the private sphere’s management of the perinatal period to institutions’ taking over. Therefore, not surprisingly, there is a huge emphasis on medical expertise by these yuezi centres industry. These centres offer a plethora of experts, including nurses, paediatricians, lactation specialists, nutritionists, physiotherapists, and sometimes Chinese medicine doctors.
The Changing Social Conditions in Taiwan
There is a close link between the importance of the professionalisation of infant care and the changing social conditions of childbirth and childraising in Taiwan. In fact, the declining fertility has not affected the growth of these institutions. On the contrary, postnatal market competition is becoming increasingly fierce. This is because shrinking family sizes have increased the resources available for each child and intensified parents’ investments in both sons and daughters. As families have fewer children, offspring become more “precious” because they are rare.
However, while parents are willing to invest in their children, parents, especially mothers, do not necessarily know how to do so. According to my study, most participants underlined that they chose to go to these centres because they lacked the necessary skill and knowledge to take care of their precious offspring. In other words, since young couples have fewer children and families also become more nuclear-based when new parents welcome their newborn, it is often the first time they are in extended contact with a real baby. This ignorance generates huge anxiety, which is why they need to rely on these yuezi centres. Thus, participants hold that “quality of care provided by the medical team” was the most crucial factor, often followed by the “infant and professional caregiver ratio” with regard to the choice of these postpartum institutions.
Another important reason for choosing to go to a yuezi centre instead of sitting the month (坐月子zuo yuezi) with the help of one’s family elder (usually the mother-in-law) is to avoid interpersonal conflicts. Going to a yuezi centre minimises the daily negotiation of what is the right way to make yuezi. Some participants emphasised their painful postpartum experience with their mothers-in-law and insisted on sitting their month in a yuezi centre since, in most centres, visits are limited to between 30 minutes and one hour once a week. Family members, including parents-in-law and one’s own parents, are then no more participants in sitting the month; they become only “visitors” to the yuezi centres.
Finally, another important difference between the conventional way of sitting the month and the new yuezi centres is the modern promotion of the “yummy mummy” or the “new sexy Mom” by mainstream media slimming advertisements. While there was no such thing as “bouncing back” after childbirth for older mothers, the imperative of “getting your body back” gained popularity and fervency in contemporary Taiwan. Nowadays, becoming a zhengma (正媽) is a normative choice. Modern mothers must invest in and care for their postpartum physical attractiveness.
Following this changing concept of motherhood, these centres offer many courses and resources to help their clients regain their pre-pregnancy figure. Even some centres have commercial alliances with cosmetic surgery clinics. This trend witnesses a rising individualism among women and the young generation. The keyword of “sacrifice” for children in the traditionally gendered expectation is replaced by multidimensional considerations and individual concerns since women need to maintain paid work, and divorce is becoming frequent in present-day Taiwan.
Yuezi: Negotiation between Different Discourses
As yuezi centres provide expertise and professional care to new Taiwanese mother and their families, many family ties and interpersonal relationships are also profoundly changed. At these centres, mothers often receive standardised sets of services. Because of the commercialisation of yuezi, women face a rationalisation and alienation of social space and interpersonal relationships in the yuezi centres.
This system of combined commercialisation and medicalisation renders postpartum care “impersonal,” losing the aspect of interfamilial emotions and care for one another. While some celebrate that an isolated space helps to keep unwanted visits and troublesome family members away from the mother-baby cocoon, some women recall the nostalgia of the privileged postpartum period where mothers received some female family members’ devotedness, full of tenderness and mutual trust.
In sum, meeting multiple competing discourses of yuezi is never easy, and mothers are often confronted with incompatible demands in their everyday lives. It is therefore relevant to examine manifold contexts and consequences of professionalised postpartum care, as well as how mothers try hard to negotiate and compromise different discourses about “sitting the month.”
Amélie Keyser-Verreault is the Postdoctoral Fellow at ERCCT, University of Tübingen.
This article was published as part of a special issue on European Association of Taiwan Studies.
Taiwan Insight 