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Malaysia as Global Leader in Addressing Postpartum Mood Disorders: A Discussion with Postnatal Care Specialist Valerie Lynn

Valerie Lynn is a Postnatal Care Specialist in modernized traditional healthcare recovery practices from pregnancy, childbirth, miscarriage, and stillborn birth. Her studies are rooted in Malaysia, where rates of postpartum mood and anxiety disorders (PMADs) are among the lowest in the world at just 3%. Valerie is the author of The Mommy Plan and cookbook, Healing Meals: Simple Recipes for New Moms. She serves in several maternal care organizations in the U.S. and Malaysia, and was the first foreigner to earn a certificate in Malay Postnatal Practices and Therapies from University Teknologi Malaysia. Valerie shares her passion for Malaysian healing modalities in her work as a doula and international motivational speaker. 

Nyssa’s Tara Stadnyk chatted with Valerie about Malaysia’s successful methods for the prevention and treatment of postpartum mood and anxiety disorders, and how other countries can benefit from such practices. 

Photo of Valerie Lynn

This transcript has been edited for length and clarity. 

TS: How did you become interested in researching and practicing Malaysian postpartum care? 

VL: In 2006, my ex-husband and I had been living in Kuala Lumpur, Malaysia, for six years when I became pregnant through an intra-uterine insertion (IUI). That October, we departed for the U.S. to live in my home state of New Jersey for one year. I began searching for natural healing products in NJ like those I knew in Malaysia that helped a new mother recover from the inside out, but I only found nipple, bum, and stretch mark products.

Even then, abdominal wrapping garments were not popular. It was an eye-opener to the lack of knowledge, products, services, and support available. It was glaringly obvious that the medical model for pregnancy was baby-centric, with no importance given to the fourth trimester. I gave birth to my son in May 2007 and we returned to Malaysia in August. Soon after, I was offered the position of Executive Director of the American Malaysian Chamber of Commerce. This role was very demanding, and of course, there are always anxieties about a new job. However, I began experiencing high anxiety about my son and his safety, which was only apparent when I was with him. 

In May 2008, while reading Mother’s Day articles out of America on postpartum mood disorders, I recognized I had been experiencing several symptoms of postpartum anxiety and OCD for the past nine months such as feeling on edge or fearful, irritability, racing thoughts, and checking things over and over. I had a recurring fear that I would accidentally hurt or kill my son somehow, whether it was tripping down the stairs while carrying him, a car accident, earthquake, lightning strike, or simply leaving him in the bath and walking away to grab
something and him slipping under the water. It was a level of fear I had never experienced as until then, I had what is considered a “clean” mental health history.

At that moment, I learned about the high rates of postpartum mood and anxiety disorders (PMADs) in the United States, with 25% or over 1,000,000 new cases annually. Then I googled Malaysia, knowing that the 4th trimester was a big part of pregnancy where women followed specific recovery programs and guidelines for the first six weeks. I discovered Malaysia has the lowest rates of PMADs in the world at just 3%. That same day, I invested in my mental and physical health, purchased a postnatal care package at a spa, and rebalanced myself with self-care, meals, herbs, and body care in about four months.

After I recovered, I set out to learn all there was to know about Malaysian postnatal practices and uncover why they were so effective.

Honouring Needs of Mothers and Implementing Change in the West

TS: What can countries like the U.S. learn from the care provided for Malaysian women postpartum, where rates of PMAD are so low? 

VL: Western countries can learn that maternity leave alone is not the solution to a balanced recovery from pregnancy and childbirth. Emphasis must be given to the postpartum ‘Healing Window of Opportunity’ (the first eight weeks following birth) and redefined with specific home self-care activities, remedies, and nutrition that support the healing process from pregnancy and childbirth. In Malaysia, The Healing Window is occupied with nutritious postnatal meals, personal self-care, and lifestyle guidelines intended to protect a new mother’s body and emotions which are in a vulnerable state. A mother’s recovery is viewed as just as important as caring for a newborn.

Malaysia’s national maternity leave policy is only 60 days, but it still has the lowest rate of PMADs globally at just 3%. However, in January 2023, it will be increasing to 98 days (14 weeks) which follows the recommendation of the United Nations. Accordingly, the Malaysian government invests billions into new mothers and families, and places importance on postnatal recovery, particularly the first six weeks. Malaysia’s maternal health care policy entitles each mother to six free 2-hour body treatments, massages, and abdominal wrappings within the first six weeks of the fourth trimester.

There is a biological 6-8 week Healing Window of Opportunity available for every new mother. This time should be planned and filled with home self-care remedies to allow a stronger, more balanced recovery. Currently, in most western countries, this time is devoid of self-care. As statistics indicate, a weakened, prolonged recovery takes place over 1-2 years or longer. You can have a cold for three weeks, or you can have a cold for seven days. It’s a matter of the consistency of home self-care you provide for yourself. It is the same for postpartum recovery. Childbirth is a trauma to the body, but it is a natural trauma, which is why the body can recover so quickly.

TS: What do you think are the steps to take for implementing more postpartum care practices in the U.S., Canada, and other countries where PMAD rates are higher? 

VL: Societal changes we want to see will initially have to be driven by the business community led by companies such as Nyssa, which is already connecting with women and expectant/new mothers. Nyssa is providing what governments aren’t: solutions for women to recover from pregnancy, childbirth, miscarriage, and stillborn birth. The currently offered solutions can easily be expanded with an educational program based on best postpartum recovery global practices, then adapted for a localized mindset, lifestyle, and available resources.

Steps to take for implementing effective postpartum care begin with recognizing the global leaders in this field, which are identified by low rates of PMADs. Then a re-education program should be initiated by existing government programs such as the U.S. Preventative Taskforce or Health & Human Services to disseminate information. Countries with high rates of PMADs like the U.S. and Canada have no choice but to look to other countries, as a compelling body of knowledge does not exist within their borders.

The number one complication of pregnancy is PMAD. In the U.S., suicide and overdose are leading causes of death in the first year postpartum for new moms, with 100% of these deaths deemed preventable (American Journal of Obstetrics and Gynecology). 75% of women experiencing maternal mental health challenges do not receive the care needed for recovery (National Institute of Health). Women of color and those economically disadvantaged are many times more likely to suffer from PMAD and less likely to receive care.

The transition from the third to fourth trimester should be seamless, from medical care to self-care without any gap. There is a growing grassroots movement by expecting mothers and families searching for proven holistic solutions to postpartum recovery and pregnancy-related conditions.

The American College of Obstetricians and Gynecologists (ACOG) references existing cultures that care for and support the healing and recovery after pregnancy and childbirth:

Following birth, many cultures prescribe a 30–40-day period of rest and recovery, with the woman and her newborn surrounded and supported by family and community members. Many agrarian cultures enshrine postpartum rituals, including traditional foods and support for day-to-day household tasks. These traditions have been sustained by some cultural groups, but for many women in the United States, the 6-week postpartum visit punctuates a period devoid of formal or informal maternal support.

ACOG points to the apparent gap in care during the first six weeks postpartum and what should be considered to fill this gap in western self-care measures. Effective, proven, evidenced-based postpartum recovery care and practices backed by science should not be underestimated; they must be understood.

Postpartum Mood Disorders in Fathers & Partners

TS: ¸A study conducted by PRAMS, (Pregnancy Risk Assessment Monitoring System) called “The Pilot Project” showed 1 in 10 fathers in Georgia, USA reported symptoms of depression since the birth of their baby. Have you seen fathers/partners also benefit from Malaysian practices, and if so, how?

VL: The topic of paternal postpartum mood disorders is gaining interest as statistics indicate it is rising. I have been the International Country Coordinator of Malaysia for Postpartum Support International (138 countries) for over a decade. I get contacted by mothers, dads, partners, family members, and friends reaching out when they feel a new mother in their life may be experiencing a PMAD. Just as mothers are not prepared for the postpartum period, fathers are even less prepared.

In Malaysia, it is common to find highly skilled postnatal professionals with in-depth knowledge, skills, and better family support. In western countries, such experienced professionals are difficult to find, which presents both a need and an opportunity for fathers/partners to contribute.

One of the primary ways dads/partners benefit from Malaysian postpartum care is that these practices reduce the risk of a mother experiencing a PMAD, and facilitate in a quicker recovery. Faster recovery allows a mother to reassume financial and family responsibilities, thus reducing the stress of partners carrying the temporary burden, which has been known to cause anxiety and depression. Most men do not reach out for help and therefore exclusively shoulder the responsibilities, which in many cases exacerbates the situation. Another cause of depression in partners/dads is feeling disconnected from the newborn experience, as moms may not always realize they’re excluding their partner from caring for baby. 

I apply the silly, old adage expression, “happy wife, happy life,” to the postpartum period to simplify. A partner must align themselves with the goals of the fourth trimester, then support that with purposeful actions. Having a fourth-trimester plan in place increases the success rate by over 65%.

The first purposeful action for assisting in physical and emotional wellbeing for both the mother and partner is to understand and agree to an uninterrupted, intentional, Malaysian-inspired recovery period of 6-8 weeks. This time is not devoid of activity; on the contrary, it is filled with daily postnatal self-care practices and remedies that facilitate a mother’s recovery in the shortest time possible. Mothers benefit greatly from partners who encourage them to take time for personal care with practices like abdominal wrapping, sitz baths, or yoni steaming. While a mom engages in personal care, a dad/partner can have quality one-on-one time with the newborn, actively establishing a close bond.

Malaysians also place a lot of emphasis on diet during the postpartum recovery period. A fourth-trimester plan includes postnatal meals suitable for the entire family. Postpartum meal services or ‘meal trains’ have become popular. Family and friends volunteer to provide postnatal meals a family selects. If a dad/partner finds themself out of their element in providing care or cooking, the option of hiring a postpartum doula that offers traditional, holistic services may be available.

Understanding that a new mother requires more than just time, but the opportunity to fill that time with postpartum self-care practices, puts a father/partner ahead of most. The last chapter of my book is “The New Daddy/Partner Plan”. This chapter gives insight from dads/partners, providing a new perspective on how to plan, what to expect, and resources in case a PMAD is suspected. Preparation is vital for everyone, but families benefit most when a postpartum recovery plan is in place before the baby arrives.

Malaysian Care for Mothers Everywhere

TS: Tell us about your book, The New Mommy Plan, and how it has been received internationally. 

VL: The title of my book first evolved through my observation of expecting families. Most had a birth plan, and all had a baby plan for when the baby came home, but there was never a plan for a new mother’s recovery, hence the title, The New Mommy Plan.

The New Mommy Plan was researched, written, and first published in Malaysia in 2012. It has been updated twice since then, in 2019 and 2022. I wrote this book with the average, middle-class mother in mind. Malaysian cultural postnatal norms are explained using simple science and adapted for a western audience, so a reader can understand why self-care practices are effective, then be motivated to adopt universal healing guidelines and recommendations in the fourth trimester.
It has been well-received in the birthing community and endorsed by many notable organizations. However, western mothers take convincing on how traditionally aligned, home self-care will help their bodies recover faster. This is because most medical professionals do not discuss postpartum recovery, nor is it covered as an in-depth topic in new parent education classes.

My research for the book was gathered through a self-funded study with the Malaysia Ministry of Health. My advisor was the Director of the Traditional Complementary Medicine Department. For over a year, I conducted interviews with practitioners and parents in hospitals and in the field. I took the core tenants of Malaysian postnatal protocol, backed up the science with centuries of evidence-based proof, and adapted this information for a western lifestyle mindset. 

I am regularly interviewed, asked to speak at conferences, and contribute to journals and publications worldwide. This year a notable invitation was from the country of Barbados, where I was a featured speaker on Midwifery Day, May 2022. My presentation was based on the original research in my book, which has elevated over the years.

Through Amazon, The Mommy Plan is sold in fourteen marketplaces, with consistent sales worldwide. There has also been interest in translating it into Bahasa Melayu and Russian languages.

In 2013, CAPPA (Childbirth and Postpartum Professionals Association) added it to the reading resource list for postpartum doula certification, and in 2019 included new childbirth education certification. I am also listed as a resource for Malaysian bengkung abdominal binding. 

In 2019, DONA (Doulas of North America) approved my 2-day program, "Malaysia Multicultural Postpartum Recovery Practices: An Eco-Friendly Approach”, based on The New Mommy Plan and my cookbook, Healing Meals: Simple Recipes for New Moms. I teach this program at the Malaysian Permanent Mission to the United Nations in New York, NY and the Tourism Malaysia office (under medical education) in Los Angeles.

TS: In 2020, you also published The New Mommy Plan Recipe Book. How does diet play into the recovery process for mothers after giving birth?

VL: In addition to home self-body care, diet plays a significant role in the recovery process after pregnancy and childbirth, including miscarriage, stillborn birth, and abortion. I wrote The New Mommy Plan Recipe Book in response to many requests by new moms for recipes after they read Chapter Six, “Postnatal Diet Dos and Don’ts”, in The New Mommy Plan. So, I took popular western meals and “postpartum-ized” them, and I took traditional meals and westernized them, all explained with postnatal food science based on the postnatal anatomy.

The event of childbirth triggers the body to prioritize postpartum functions of hormonal re-balancing, breastmilk production, and shedding the retained elements of water, fluid, fat, air and blood. This new prioritization by the body compromises, or dramatically slows down, digestion, circulation and metabolism. This is a temporary state during the postpartum ‘Healing Window of Opportunity’, or the first six weeks.

Due to a slower digestion system, difficult-to-digest and cold foods and beverages disrupt the healing process. Even foods considered healthy such as salads, brown rice, and certain vegetables and beans are not suitable for the digestive system at this time. Fecal incontinence, or the inability to control the bowels, affects approximately 7% of all people after childbirth—50% of people experience constipation immediately after delivery, and 24% of people continue to experience constipation at three months postpartum. Therefore, difficult-to-digest and cold foods and beverages are avoided or minimized as they cause the body’s energy to be redirected from new postpartum functions.

Warming-neutral meals such as broths, oats, and stews are recommended as they bring warmth into the body, combat the cold state, and are easy on the digestive system. Traditional postnatal meals align with some components of a macrobiotic diet. The temperament of an ingredient, such as being cool, cold, warm, or hot is considered. For example, watermelon is avoided as it has a cold temperament and brings cold to the body. Honey, ginger, and turmeric have warming properties and thus bring warmth into the body. Knowing which foods and beverages support the healing process rather than disrupt it will significantly contribute to a new mother’s recovery.

The first meal after giving birth is sacred in many cultures. What will be your first meal?

 photo by irsyad ibrahim via pexels 

Sources Cited: 

ACOG, American College of Obstetrics and Gynecologists, Presidential Task Force on Redefining the Postpartum Visit, Committee on Obstetric Practice, Number 736 (Replaces Committee Opinion Number 666, June 2016. Reaffirmed 2021)

Anxiety & Depression Association of America, Perinatal Mood Disorder

Congresswoman Katherine Clark, 5th district of Massachusetts, “Asst Speaker Clark, introduces legislation to provide resources to support moms suffering from mental health issues and substance use disorders.” March 14, 2022.

Chirichella, Caroline, Having a Baby Completely Changed the Way I Poop, Health, July 29, 2021.

Foli, Karen J., South, Susan C., Lim, Eunjung, Jarnecke, Amber M., “Post-adoption depression: Parental classes of depressive symptoms across time.” Journal of Affective Disorders, Vol 200, pp 293-302, ISSN 0165-0327, Aug

Klainin P, Arthur DG. Postpartum Depression in Asian Cultures: A Literature Review. International Journal of Nursing Studies. 2009.

Lallonardo, Marisa, How to lose weight after pregnancy and how long it will take, Insider website, July 8, 2021.

Lynn, Valerie, The New Mommy Plan, Restoring Your Post-Pregnancy Body Naturally, Using Women’s Traditional Wisdom, 2012/2019/2022.

Lynn, Valerie, The New Mommy Plan Recipe Book: Healing Meals: Simple Recipes for New Moms, 2020.

Maven Clinic, “Back-to-Work, The billion-dollar opportunity for companies.” Whitepaper, Online, 2022

The Mayo Clinic website, Cold remedies: What works, what does't, what can't hurt.

The Mayo Clinic website, The Mayo Clinic Diet: A weight-loss program for life.

Nadworny, Katie, Malaysia’s New Maternity and Paternity Leave Provisions Will Soon Take Effect, SHRM, Society for Human Resource Management, October 5, 2022.

Newland, Stephen, The Power of Accountability, Association for Financial Counseling & Planning Education.

Nyssa website, Our Mission.

Paulson, James F., and Bazemore, Sharnail D., “Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression A Meta Analysis.” JAMA, Journal of American Medical Association, Volume 303, Issue 19, pp1961-1969, May 19, 2010.

Read more on preparing for the fourth trimester:
What to Expect AFTER You're Expecting (That No One Talks About)


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