Postnatal Depression – A Chinese Medicine Perspective

Community of women administering postnatal care to new mother

The treatment of postnatal depression (PND) not only raises a lot of questions, but in our Western society it’s a hot topic that also manages to raise quite a few eyebrows. Despite the fact that mothering is a major transition in any woman’s life – whether she be a first timer or otherwise – and that the process of labour can be, and in our society quite often is traumatic, the stigma attached to PND remains. After all, a mother should be ‘happy’ after the birth of her child, shouldn’t she? Not necessarily, and especially not if the strain of pregnancy and birth has left her body out of whack. It’s of some consolation then that the treatment of postnatal syndromes related to our modern day understanding of PND, have been discussed in the Chinese Medical (CM) literature for half a millennium at least. 

According to an interesting article by Steve Clavey (Melbourne based CM practitioner and writer), the Ji Yin Gang Mu or the Compendium of Benefits to Women (1620), a leading CM text on the subject of gynaecology, there exist three core traditions for treating postpartum emotional disturbances that can be equated to PND.

Depending on the presenting signs and symptoms, these three approaches focus on:

1.      Purging of residual toxic Blood (bai xue) after birth

2.      Replenishment of Blood, which can become deficient due to the trauma of birth (regardless of how much blood is lost)  

3.      Scattering of internal ‘wind’ (an ancient CM descriptor recognised by a discreet set of signs and symptoms) that stirs when the Blood is deficient 

When considering PND then, CM treatment principles always involve some level of intervention to restore the proper functioning of the Blood. I capitalise Blood in this context, because we need to keep in mind that the CM concept of Blood is not exactly synonymous to our Western understanding of what blood is, how it’s manufactured in the body, what its function is, or most importantly, how it relates to consciousness and mental activity. It’s similar, and the CM understanding certainly involves the Western medical concept, and then some.

Of particular interest in the case of PND and other depressive disorders, is the fact that in CM terms, Blood is considered to be the material basis for mental activity. It is said that an ample supply of Blood is needed by the body in order to maintain a sharp consciousness and a robust spirit. A classical understanding supposes: ‘Qi and Blood are the foundation for human mental activities’, and, ‘harmonious circulation of Blood ensures a vigorous spirit’. It is understood, therefore, that an insufficiency of Blood, as brought on by the loss of blood during the birth process, or the deficiency left over from the exertion of labour, can naturally lead to postnatal mental disturbances. Treatment involves a combination of Chinese herbal remedies and acupuncture.

It’s interesting to note that in Asian cultures much emphasis is put on the postnatal resting  period. Due to their traditional understanding of how childbirth depletes the mother’s Blood and Qi, leading to deficiencies, respite and recuperation are encouraged for the first month postpartum. This time is referred to as the ‘sitting or settling month’, a time where new mothers are urged to stay at home as much as possible and avoid exposure to cold, wind and draughts. It is a nurturing time where rest and care of the baby is emphasised, and work, including housework, is discouraged. It is considered a ‘cold’ time for the mother’s body, due to the depletion of Blood. Warming foods are therefore encouraged and cold foods, such as raw food, restrained in order to restore balance to the mother’s recovering body. Hot beverages, soups, ginger concoctions and high protein intake are encouraged to generate warmth and replenish the system. In this way, many postpartum complications, such as PND, are avoided.

Black chicken stock, available at your friendly Asian grocer is the broth of choice for mother’s recuperating after childbirth. It can be purchased as stock cubes and prepared easily at home, and taken as a restorative hot beverage. For the more adventurous, here is a wonderful recipe I found on another interesting blog. It makes for informative reading too, and explains the healing properties of chicken broth and bone broths in general. I hope you will check it out at http://prettyinprimal.blogspot.com.au/2011/01/black-chicken-broth-and-soup.html