Postnatal break no longer just a pregnant pause for R&R

New mothers are forsaking traditional care at home to attend 'confinement clubs' that cater to their every need, but are challenging traditional notions of family support, as He Na and Liu Ce report.

Sun Yingying had just thrown a party to celebrate a full month since the birth of her daughter, but instead of glowing with the radiance of new motherhood, the 34-year-old looked exhausted. Despite four weeks of postnatal care, Beijing resident Sun said she hadn't had a decent night's sleep since the baby was born. She described her four-week confinement as "messy", "tearful", and "quarrelsome", and said several other people she'd spoken to felt exactly the same.

By contrast, WangXiao, 29, a new mother from Shenyang, Liaoning province, felt the 28-days she'd spent recuperating after giving birth in June were "happy", "satisfying", "relaxing" and "enjoyable".

Although the young moms and their babies were the centers of attention for all the love and assistance their families could provide, their experiences of the month of inactivity were markedly different - Sun's postnatal care was provided at home by her parents, while Wang spent a month under the supervision of professionals at a "confinement club".

Sun hails from North China, but her husband's family is from Sichuan province in the far south, and the huge differences in eating habits and methods of postnatal care resulted in quarrels and tears. Everyone was tired, busy, and had a lot of grievances to air, she said.

A growing trend

Traditionally, Chinese women stay at home for a month after giving birth, according to Jing Jun, a sociology professor at Tsinghua University in Beijing, who described the practice as "an essential requirement".

However, as people begin to pay greater attention to postnatal care, an increasing number of women are choosing to attend confinement clubs.

"Staying at a confinement club has long been fashionable among new moms in Hong Kong and Taiwan. And in recent years, it's also become popular with well-to-do families on the Chinese mainland," Jing said.

The clubs, which provide professional services to new mothers and infants, charge from 20,000 yuan ($3,200) to 1 million yuan for a 28-day period, with costs rising or falling depending on geographical location, city district, the standard of facilities, services offered and cuisine.

Wang, a newspaper reporter, said her club was in a hotel, and she had a 40-square-meter room that contained double beds. "It was just like a regular hotel room, except for all the baby products," she said.

"My husband and I began looking for a confinement club when I was six months' pregnant. Nowadays, a good confinement nanny costs at least 6,000 yuan a month, and they only take care of the baby, so your relatives have to do everything else. If you stay at a confinement club, once you've paid the fee, 30,000 yuan in my case, you don't need to worry about anything else, including preparing formula powder and cooking meals.

"I didn't have much experience of looking after a baby, and my parents' advice often contradicted what I'd learned, so the confinement club was a good option - it prevented unnecessary tension, and pediatricians, gynecologists and obstetricians were on hand every day," she said.

To help new mothers get back into shape, the club also offered yoga classes with a professional teacher. "Except for feeding times, the babies all stayed in the nursery with their carers. I didn't even need to change diapers, and I slept well at night," she said. "I'd definitely choose the option again if I have another child," she said.

Wang was fortunate to find a club that was not only relatively inexpensive, but also offered a wide range of services. However, not everyone has been as lucky. Recent years have seen a number of well-publicized accidents, such as the confinement club in Shanghai where all the babies contracted pneumonia, or the one in Wuhan, Hebei province, where staff mis-took pure alcohol for saline and used it to wash out the babies' mouths. Moreover, some clubs have been accused of substandard accommodation and failing to provide the promised services.

Broken promises

"My daughter was born in early spring, just as the heating was turned off in our apartment block. It was cold, and we wanted our daughter to be in a warm environment. I also wanted to get back in shape as quickly as possible, so my husband decided to find a confinement club," said Zhao Rui, 28, an art teacher in Beijing. After an online search, com-paring locations and prices, the couple opted for a club not far from their home.

"It claimed to have special techniques to help new mothers regain their shape. It's true that I did lose some weight during my confinement, but I also got rheumatism because the room was so cold and wet," Zhao said. "When I spoke to the man-ager, he blamed me, and said everything was my fault. I asked them to refund the money I'd paid, but they ignored my request," she said. "I'm still young, but every-time the weather changes, my knees hurt like an old person's."

The meals were also a disappointment. "Instead of the varied diet they'd promised, the menu was just the same meals on rotation, and the soup contained just fish heads or tails, or chicken bones. Even more annoying, the staff constantly promoted a range of healthcare products and services," she said.

Problems such as these are common in the burgeoning postnatal care industry, according to experts. "Confinement clubs are not medical institutes, and there are no official requirements for them, such as the standard of facilities, sanitary conditions, and the number of employees," said Xiao Dina, deputy director of the Shanghai Health Industry Development Promotion Association.

The lack of overall supervision means sanitary conditions in the clubs are often a source of concern because babies are vulnerable to mass infections, according to Xiao. Standards vary widely. In high-end chains, the employees are usually trained nurses or paramedics, but in some smaller establishments, it's hard to guarantee that the employees hold the appropriate qualifications, something that has resulted in mothers and children being given the wrong treatment. Even if the staff are described as "trained", questions still remain about their professional skills and experience because some medical staff agencies use connections to ensure people on their books are given the correct accreditation, even if they have no relevant background or education.

Customer is king...or queen

"The rapid growth of the postnatal care industry is the result of rising demand, and the authorities need to act quickly to establish management criteria and regulations for confinement clubs," Xiao said.

According to professor Jing, when people think of confinement clubs, the phrase "astronomical cost" is one of the first things that comes to mind. "The target customers are families with comparatively high incomes, people who have high standards in terms of living environment, professional services for mother and baby, and food. That means the cost will also be high."

Ultimately, though, only the customers can really say if the price is too high, because they make the decision to pay the fee, and most are introduced to the service by satisfied friends or relatives, Jing said. He advised younger couples to choose confinement clubs to smooth the path of family relations, rather than as a status symbol.

"The average age of marriage in the cities has been rising in recent years, and the parents of a lot of young people are too old to help with postnatal care. Confinement clubs can play a part in reducing the burden on families," he said. "More important, the service can effectively avoid intergenerational confrontations caused by different views on postnatal and baby care."

Contact the writers at hena@chinadaily.com.cn and liuce@chinadaily.com.cn

Han Junhong contributed to this story.