4. Results
4.2. Experience of ―Zuo Yuezi‖
This part includes 17 questions, describing clinical and personal experience of Chinese medical Gynecologists in ―Zuo Yuezi‖ practice. The questions‘ subject in this part were the cultural and social background and conditions of ―Zuo Yuezi‖ tradition, it‘s location, time, involvement of third party, ―Zuo Yuezi‖ health outcome and significance, and, finally, the respondents‘ role and manner of involvement in ―Zuo Yuezi‖.
4.2.1 Reason for "Zuo Yuezi"
The respondents were asked what is the reason for ―Zuo Yuezi‖ existence and continuation. As Figure 4.3 shows, 95% of them claimed, that it benefits in terms of reproductive health. 90% -agreed that “Zuo Yuezi” in modern times is a
continuation of tradition. 67% treated this custom as postpartum woman‘s opportunity for rest. Slightly more than one-third of respondents (36 and 38%) considered ―Zuo
46
Yuezi‖ as fashion, commercial phenomenon or treated it as beneficial in social and psychological aspect. (multiple choice question )
Figure 4.3 Reasons for ―Zuo Yuezi‖.
(Multiple choice question- percent does not sum to 100%)
4.2.2 "Zuo Yuezi" Background
Asked about ―Zuo Yuezi‖ background, Taiwanese Chinese medical Gynecologists answered, as shown in Figure 4.4 that it was based on Traditional Chinese Medical theory (71.8%), traditional Taiwanese (66.7%) or Chinese (61.5) culture. Only 5.1% of
respondents considered modern medicine as the background of ―Zuo Yuezi‖. 12.8% of Chinese medical Gynecologists though that it is a kind of folk therapeutic method.
(multiple choice question)
It is a fashion trend and commercial phenomenon
It is beneficial for puerperal women’s social position and psychological
condition
It is justifies postpartum womans rest from work, labor and daily burden It is a continuation of traditional culture It is beneficial in aspect of reproductive
physiology
Frequency
"Zuo Yuezi" is
47 Figure 4.4 The background of ―Zuo Yuezi‖
4.2.3 The Source of "Zuo Yuezi" Information
As Figure 4.5 shows, the belief that modern mothers learn about postpartum care from elders (100%) or experienced relatives and friends (92.3%) prevailed in the sample group. Taiwanese women learned about ―Zuo Yuezi‖ from books (74.4%), press (64.1%), internet (61.5%) and television (43.6%). School education (0.0%) provided no ―Zuo Yuezi‖ information. (multiple choice question)
48 Figure 4.5 Sources of ―Zuo Yuezi‖ information.
4.2.4 Decisive Factors for "Zuo Yuezi" Fashion:
According to respondents, following factors played important role in defining the way of ―Zuo Yuezi‖: As shown in Table 4.17, the most important factor was economy situation (82.1%), followed by the multiparous woman‘s experience of previous puerperium (71.8%) and newborn‘s health condition (35.9%). Woman‘s education, in Chinese medical doctor‘s opinion, might also play some role in decision making (38.5%) as well as her occupation (20.5%) and habitation (20.5%). (multiple choice question)
Table 4.16 Frequencies for the decisive factors for ―Zuo Yuezi‖ fashion (multiple choice question – the sum of percent > 100%)
Frequency Percent
The occupation of puerperal woman 8 20.5
The education of puerperal woman 15 38.5
The family's economy situation 32 82.1
The experience of previous "Zuo Yuezi" 28 71.8 The health condition of the puerperal woman and the
new-born 14 35.9
The dwelling location 8 20.5
Other decisive factors 8 20.5
N= 17
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4.2.5 Who Decides about "Zuo Yuezi" Fashion?
Chinese medicine Practitioners experience resulted in opinion, that ―Zuo Yuezi‖ was woman‘s domain: besides of mother of newborn (94.9%), her mother (89.7%) and mother –in-law (76.9%) were main decisive persons in ―Zuo Yuezi‖ planning. Neither the
postpartum woman‘s spouse (28.2%) nor her doctor (5.1%) had no comparable impact on this matter. Please refer to Figure 4.6. (multiple choice question)
Figure 4.6 Person who decides the ―Zuo Yuezi‖ fashion (multiple choice question – the sum of percent > 100%)
4.2.6 The Frequent Location for “Zuo Yuezi”
In this question, the respondents were asked to rank ―Zuo Yuezi‖ locations from chosen most often, to these less frequently chosen. The index is the mean, which was counted for each location. The lower the number, the more frequently given location was pointed as often choice. The Chinese medical Gynecologists believed, that instead of her own house (82.1%), women during ―Zuo Yuezi‖ most preferably chooses her mother‘s place (100.0%). Postpartum care facility (―Zuo Yuezi Center‖) with percentage of 94.7, won with traditional mother‘s- in –law house, as shown in Table 4.17.
N=1 The doctor who was in charge of
antepartum care and delivery
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Table 4.17 Frequencies for the the preference for ―Zuo Yuezi‖ location
Frequency Percent
Postpartum woman mother's house 39 100.0
Postpartum care center 38 97.4
Postpartum woman mother's-in-law house 31 79.5
Postpartum woman's home 32 82.1
Other place 2 5.1
4.2.7 The best place for “Zuo Yuezi”
The same method was used for indexing the best location for ―Zuo Yuezi‖. The results, as shown in Table 4.18, are similar and show that postpartum women choosed the site correctly: according to responding specialists it was the postpartum women‘s mother house, which was the best place for ―Zuo Yuezi‖. Postpartum care center should be considered as the second option, and then, subsequently, there was the woman‘s own house and her mother‘s-in-law house. Three persons responded that the location is not important.
Table 4.18 Frequencies for the best location for ―Zuo Yuezi‖
Frequency Percent
Mother's place 35 89.7
Postpartum care center 35 89.7
Home 29 74.4
Mother's-in -law place 28 71.8
Other 2 5.1
4.2.8 The Person Who is Taking Care of Woman during “Zuo Yuezi”
The same indexing method was used to find, who cares most often for postpartum woman. As shown in Table 4.19, the results show that it was usually woman‘s mother. If not she, then mother-in-law or the newborn‘s father took care of puerperal woman.
Besides family, the professional nursing personnel as well as servant possibly played the role of caregiver. Other family members were considered as the least often caregiver in
―Zuo Yuezi‖ situation.
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Table 4.19 Frequencies for the woman‘s caregiver preference Frequency Percent
Mother 39 100.0
Mother-in-law 38 97.4
Newborn's father 30 76.9
Professional nursing staff 26 66.7
Servant 21 53.9
Other relaatives 16 41.0
4.2.9 The person who is taking care of the newborn.
As Table 4.21 shows, it was the mother, who took care for her child most frequently, regardless she was resting herself. Besides of her, the family members took care of this duty: Woman‘s mother, mother-in-law, child‘s father. Other relatives as well as
professional nurses and servants were much less often considered a babysitter.
Table 4.20 Frequencies for the the newborn‘s babysitter preference Frequency Percent
Postpartum woman herself 36 92.3
Mother 35 89.7
Mother-in-law 35 89.7
Newborn's father 27 69.2
Servant 20 51.3
Professional nursing staff 18 46.2
Other relatives 19 48.7
4.2.10 The Duration of "Zuo Yuezi"
According to respondents, the ―Zuo Yuezi‖ should last between 20 and 60 days, the mean is 37.7 days. (SD= 8.6 days) The most frequent answer, however, was 40 days.
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4.2.11 "Zuo Yuezi" after Miscarriage
Asked, if ―Zuo Yuezi‖ should be proceeded after miscarriage (without
differentiating the time of gestation), most (69.2%) of respondents answered, that it should, but in different way than postpartum ―Zuo Yuezi‖. Another 23.1% stated that necessity depends on the circumstances. 3 persons thought, that ―Zuo Yuezi‖ after miscarriage should be the same as at postpartum, and none of respondents answered that
―Zuo Yuezi‖ after miscarriage is needless. Please refer to Table 4.21.
Table 4.21 Frequencies for answer concerning ―Zuo Yuezi‖ after miscarriage
Frequency Percent
yes, the same 3 7.7
yes, different 27 69.2
depends 9 23.1
Total 39 100.0
4.2.12 Women’s Complaints Related to Inappropriate “Zuo Yuezi”
During their practice, Chinese medical Gynecologists met with women‘s beliefs that improper ―Zuo Yuezi‖ lead to further health problems. As Figure 4.7 shows, such
problems may include a backache (97.4%), head ache and dizziness (74.4%), general health aggravation (the constitution worsening) (71.8%), cold extremities (51.3%), faster ageing and earlier onset of menopause (35.9%), irregular menses after postpartum (38.5%), uterine prolapse (30.8%), insufficient lactation (30.8%) and worst quality of further offspring (23.1%),
53 Faster ageing
Figure 4.7 Women‘s complaints related to improper ―Zuo Yuezi‖ practice. (Multiple-choice question, the sum of percent <100)
4.2.13 Negative Outcome of Inappropriate "Zuo Yuezi"
When observing ―Zuo Yuezi‖ outcome, Chinese medical Gynecologists had an opportunity to assess its impact on woman‘s health. According to their experience, the consequences of neglecting ―Zuo Yuezi‖ were unnegligible. These observations concured with above opinions of patients themselves. The most common complaint was a back ache (82.1%).The distinct difference between doctors and women was that professionals emphasized the worsening of physical constitution (76.9%) and found the correlation between postpartum care quality and irregular menstruations (51.3%) in the future. Only one person claimed that there was no negative consequences of bad ―Zuo Yuezi‖. Please refer to Figure 4.8. Woman`s complaints related to inappropriate "Zuo Yuezi"
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Figure 4.8 Negative outcome of inappropriate ―Zuo Yuezi‖.
(Multiple question – the sum of percent > 100%)
4.2.14 Time of Negative Outcome Onset.
Asked about the time of above negative consequences onset, as shown in Table 4.22, the respondents‘ opinion was that it happens immediately after ―Zuo Yuezi‖ (38.5%), within few years after postpartum (25.6%). Only one person stated that the onset happens at menopause, and more than one-fourth of practitioners doubted if it surely must happen.
Table 4.22 Frequencies for the time of negative outcome onset.
Frequency Percent
The consequences onset immediately after "Zuo Yuezi" 15 38.5 The consequences onset after a number of years after
"Zuo Yuezi" 10 25.6
The consequences does not necessarily appear 10 25.6
The consequences onset at menopause 1 2.6
N= 1
There is no negative consequences of bad ZY
According to clinical experience, there is another negative consequence of bad…
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4.2.15 The Meaning of Inappropriate "Zuo Yuezi”
When asked to name factors that define the ―Zuo Yuezi‖ as bad or inappropriate, the respondents mentioned: the lack of caregiver (79.5%), excessive labor (71.8%), exposure on wind and cold (74.4%), insufficient nourishment (59.0%), )violation of food taboo (48.7%), premature termination of ―Zuo Yuezi‖ (43.6%), excessive nourishment (30.8%), contact with water and hygiene procedures (25.6%), and confinement (quarantine) cessation (5.1%), please refer to Figure 4.9.
Figure 4.9 The distinguishing elements of inappropriate "Zuo Yuezi‖
(Multiple-choice question – the sum of percent > 100%)
4.2.16 "Zuo Yuezi" as a Therapy
According to Chinese medicine principles, ―Zuo Yuezi‖ is a chance to improve woman‘s physical constitution. Chinese medical Gynecologists were asked, if they ever met a woman, who considered health improvement as one of reasons to become pregnant.
A Table 4.23 shows, 46% of respondents reported, that they met such cases.
N=2 5.1% Contact with water, washing hair or body
indicates
Excessive nourishment indicates Too short time of "Zuo Yuezi" indicates Violation of food taboo indicates
"Zuo Yuezi' was not conducted properly because
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Table 4.23 ―Zuo Yuezi‖ as the method of health improvement
Frequency Percent
No 21 53.9
Yes 18 46.2
Total 39 100.0
4.2.17 The Importance of "Zuo Yuezi”
Asked about importance of ―Zuo Yuezi‖ the overwhelming majority of respondents stated, that it was important (56.4%) or very important (28.2%), as shown in Figure 4.10.
Only few (15.4%) had opinion that some woman did not need to have ―Zuo Yuezi‖.
Figure 4.10 The importance of ―Zuo Yuezi‖