The dilemma facing Hong Kong’s expectant mums: follow traditional Chinese beliefs or ways of the West?

While traditional advice about avoiding cold and wet-hot foods, or the idea that dark foods can affect skin colour, stand in stark contrast to what Western doctors say, there is agreement that stress and overexertion can be harmful

PUBLISHED : Monday, 22 May, 2017, 12:31pm
UPDATED : Monday, 12 June, 2017, 11:04pm

“Do not, under any circumstances, raise your hands above your head when you are carrying a child. Understood?” – that advice came from my 94-year-old grandmother, who is well qualified to talk about traditional Chinese pregnancy practices. A mother at the age of 20, she had nine children who produced 14 grandchildren, and she has 14 great-grandchildren.

She says she was taught by her mother to exclude all foods deemed cold or poisonous according to traditional Chinese medicine, and avoid raw or partially cooked meat and seafood.

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While my grandmother’s insistence that raising hands would lead to miscarriage is not supported by anyone I interviewed for this story – Hong Kong-based obstetrician Dr Lucy Lord declares it “complete rubbish, a total fairy story” – the current preference among professionals and expectant mothers is a tailored approach to pregnancy that respects each mother’s cultural beliefs, not pushing mind, body or spirit to extremes in the run-up to childbirth.

Avoid drinking cold beverages and eating ice cream, watermelon, dark chocolate and shellfish while pregnant

Disturbances in qi are believed to cause miscarriage or developmental problems with the fetus. Harmony within the body is maintained by avoiding foods with cold (yin) and wet-hot (poisonous) qualities.

In addition to avoiding refrigerated drinks, ice cream and watermelon, bananas and mung beans are also categorised as cold foods. “Cold foods cause congested veins in the respiratory tract, reduce blood flow and bring down the immunity of the mother”, warns Dr Yu Hsin Tzu, a registered traditional Chinese medicine practitioner at Balance Health in Central.

Wet-hot foods, including mango, lychee, pineapple and shrimp, should also be restricted because it is believed their poisonous energy will cause the baby to suffer from allergies, and eczema and other skin conditions.

Some symbolic foods are also avoided: for example, eating mutton during pregnancy could lead to the baby being born with epilepsy (the Cantonese term for this is faat yeung, which sounds like the word for sheep); rabbit meat causes a cleft lip; snake can lead to a baby’s skin taking on a scaly appearance; and consuming dark-coloured food and drink, including dark chocolate, coffee and cola, are thought to lead to dark complexion.

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While dietary restrictions may seem random and restrictive, many Hong Kong Chinese mothers will follow the traditional Chinese medicine guidelines, choosing to adhere to beliefs passed on from previous generations. “I listened to extended family and friends who were parents themselves, following pretty much all of the dietary restrictions,” says local first-time mother Esther Kwok. While she found her pregnancy diet limiting, she felt better for following yin-yang advice and the beliefs of older family relations.

Asked to comment on the Chinese dietary restrictions from a Western obstetrics and gynaecological perspective, Lord, senior partner at Central Health Medical Practice, remains unconvinced that there is a causal relationship between most of the restricted food and drinks, and problems during or after birth.

While Lord agrees that avoiding shellfish is sensible – “It’s a common cause of severe food poisoning” – she finds little clinical research to support the other restrictions. In fact, she says, chocolate is good in moderation, with studies showing that it is moderately correlated with a lowered risk of pre-eclampsia, a complication characterised by high blood pressure.

“The main difference from a nutrition perspective is that Western thinking is more about what nutrients [the mother needs], and the Chinese will think more about how you nurture your body according to your own body’s constitution,” says Chinese medicine nutritionist Judy Xu of Balance Health.

In addition to balancing qi, Xu advises (from a Western perspective) the consumption of prenatal multivitamins as well as foods that have a low glycaemic index (GI) – including wholegrain rice, bread and pasta – because these help to stabilise blood sugar and cholesterol levels. Whole fruits such as apples, grapes and oranges are also low GI, and are considered neutral (as opposed to hot or cold) in traditional Chinese medicine,and recommended by Yu in moderation.

Weddings, birthdays and funerals are off limits

Attending happy occasions such as weddings and birthdays or sad ones such as funerals could upset the body’s qi, according to traditional Chinese medicine practitioners, and are not advisable for the mother-to-be.

Grief from mourning can adversely impact the heart and liver, says Yu. And pregnancy is not a time for “enforced jollity”, says Lord, as an expectant mother may already be dealing with high anxiety and occasional depression.

History may have more to do with the belief that funerals, tombs and even sick people should be avoided during pregnancy. As immunity is lowered during this time, it would have been of paramount importance in the past for expectant women to stay away from any potential source of infection, says Lord.

From a holistic health perspective, Xu believes that stress negatively impacts the development of the fetus because the mother’s body redirects its efforts away from the baby and into her own vital organs such as the heart and lungs during survival mode. She says keeping calm and balanced in mind and body is important during pregnancy.

Moving home or undertaking major home renovations is not advised during pregnancy

Traditional Chinese medicine scholars suggest that major projects can destabilise the fetus’ developmental qi, potentially causing spontaneous abortion and foetal malformation. My grandmother advises against relocating, renovations or even hammering nails into the wall during pregnancy.

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Yu says expectant mothers should limit exertion if moving home is inevitable. “Carrying heavy objects puts the abdomen under stress, and this will affect the uterus and pelvic floor, leading to an increase in frequency of urine, backache and even groin pain,” she warns.

“Moving home is one of the more stressful things that we do, after death, divorce and birth itself,” says Lord. “Prior to early ultrasounds, foetal well-being was synonymous with the absence of bleeding,” she says.

“All miscarriages eventually presented with bleeding, so anything that caused bleeding was deemed to lead to miscarriage. In fact, lifting heavy things may precipitate bleeding in both healthy and unhealthy pregnancies, and hammering nails could be linked with bleeding, but neither will cause the loss of a healthy baby to a healthy mum.”

While lifting heavy weights while pregnant is not recommended, regular,low-impact exercise is fine for most mothers. “Prenatal exercise should maintain fitness rather than trying to improve it,” says physiotherapist Panda Li of PhysioMotion, who adds that expectant mothers should avoid high impact or new exercises such as kick-boxing and gymnastics due to extra instability in the body’s joints from the hormone relaxin being released during pregnancy.

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As well as housework and normal daily activities, Li suggests working on core stability and pelvic floor retraining with a qualified health professional, while Flex Studio prenatal Pilates instructor Nicole Serje suggests walking, swimming and specialist prenatal Pilates and yoga classes as safe ways to exercise – as long as expectant mums stay hydrated and cool throughout.

Yu recommends a brisk 30-60 minute walk each day, adding that exercising in the morning is better for reducing the dissipation of yang energy at night.

Disclosure of the pregnancy during the first trimester is not allowed

The Chinese cultural context for this is that early disclosure can threaten the stability of the pregnancy, especially during the first three months. It is also recommended from a Western medical perspective.

Lord explains: “Twelve weeks is the crucial time when the ovaries hand over hormonal support to the placenta. If the pregnancy is not viable, or chromosomally abnormal, the placenta will be unable to support the pregnancy.” Joy Flanagan, an Irish expat mother of three living in Hong Kong, says she followed this advice for her pregnancies simply “because more babies are lost in the first trimester, and it can be awkward having to tell people you have lost the baby when they ask”.

There is a lucky time and date to give birth

Hong Kong has one of the world’s highest rates of caesarean section births at more than 41 per cent, compared with the average of 21 per cent in developed countries, and 15 per cent globally.

This high rate is often attributed to many women wanting to give birth on a specific date, at a specific time – nearly always under the advice of a feng shui master.

Private sector hospitals such as the Hong Kong Sanatorium and Hospital charge up to an additional HK$36,000 for operating at an auspicious time. A young mother I spoke to recently chose to give birth via caesarean section on the last working day before the Easter public holiday, as it fell within the lucky period stated by a feng shui consultant, but would incur a slightly lower add-on fee at the hospital.

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The World Health Organisation underscores the importance of focusing on the needs of mother and baby first, and only opting for a caesarean section when a vaginal delivery poses greater medical risk.

Conversations about pregnancy in Hong Kong are sure to change and evolve. My grandmother admits younger generations no longer give traditional Chinese superstitions and beliefs the same weight mothers used to. The key is to remain open-minded to different approaches, and respect variations in cultural beliefs.

Next week we will tackle the maze of traditional Chinese beliefs about confinement for new mothers, and other restrictions after childbirth. Should mothers stay indoors for at least one month after birth? Is having a bath soon after giving birth a bad idea? Experts from Western, Chinese and holistic health backgrounds will share their views.