Traditional Birth Attendants
Traditional Birth Attendants are popular, especially among the poor, as their service is cheap and locally available. In fact, at present Traditional Birth Attendants deliver the majority of Cambodia’s babies. Most are older women who learned their trade from a relative or another TBA. However, some taught themselves and others learned their profession under the Pol Pot regime. Currently some NGOs offer training for Traditional Birth Attendants, including instruction about hygiene and the referral of high-risk deliveries to health centers or hospitals, to try to reduce the high mortality rates surrounding birth.
Caring for the Mother after Birth
Cambodians believe that the woman’s body becomes cold after giving birth. They take steps to heat up the body and prevent further cooling or deterioration. A woman is not to take a shower for a few days or a week after delivery, although she can take a sponge bath with warm water. Keeping the body covered from head to toe is important. Cold ice water offered post delivery in the hospital may be seen as unhealthy.
“Tos” is common and there is no direct Western Medicine or US translation to it. Tos may be similar to postpartum depression, but tos is described as more physical and can be benign. It can be a temporary ailment or can be life-long problems. The postpartum rituals are done to prevent tos. If a woman doesn’t (or isn’t able to) follow the rituals, or if she behaves in a manner not in keeping with the proscriptions of the post partum period – like refraining from heavy lifting or from having sexual intercourse – then it is believed that she will experience tos as a result. There are different types of tos, for example “tos sorsai” results from doing heavy lifting and “tos damnek” results from having sexual intercourse.
Often the mother lies on a bed above a file with her baby; this is called ‘roasting’. The roasting starts immediately after delivery and normally takes at least a week to complete. Besides heating up the body, roasting is believed to prevent illnesses after the postpartum period.
A woman is also told to sit on a rock that has been heated in fire every morning, for up to three weeks postpartum. It is believed, as a Traditional Birth Attendant (TBA) told a client, “when a woman sits on the rock it prevents the uterus from coming out.”
It is also a common practice to have a fire-warmed rock on the abdomen. It is said to make the uterus shrink, and to prevent the sagging of the abdomen later.
Steaming is another postpartum practice. Steaming causes the mother to perspire which removes impurities. The steam is made by the boiling a mixture of herbs, usually in a clay pot. During or after the steaming, some women apply a pounded mixture of galangal root and/or turmeric root all over their bodies. (Galangal and turmeric are like ginger, and are ingredients for cooking) These practices prevent illnesses and improve the skin.
In the U.S., some Cambodian women still follow the traditional postpartum practices, such as putting a warmed rock on the abdomen, dieting and/or steaming, in addition to following conventional Western medical practices. The ingredients for steaming are available in the herbal stores in any China Towns.
Postpartum Dietary Practices
During the postpartum period women adhere to special dietary practices. A woman is to eat spicy food, usually including pork or fish and prepared with black pepper or ginger. The food is to be very spicy so that the hotness from the food will heat up the body and strengthen the tendon. Some people want the food very salty, as well as spicy. The salt makes the woman thirsty so that she will to consume more of the medicinal remedy. The remedy is made of herbs boiled with water or combined with rice wine. Women also abstain from eating some foods, including fruits, during Sor Sai Karchey.