Read Raven's article about the First Trimester.
Read Raven's article about the Second Trimester, Month 4.
Pregnancy Month 5: The Tai Yin of the Foot/the Spleen
From the classics, the 5th Month corresponds to the Tai Yin of the Foot/the Spleen.
“In the 5th month of pregnancy, the fetus begins to receive the essences of fire to form the Qi. The woman should rest and get up late, wash the clothes well, live in the most interior part of the house, put on thick clothes, go out in the morning to breathe in the rays of heaven to avoid the harmful cold. It is appropriate to eat rice and wheat and to make beef and lamb broths, which she mixes with Zanthoxyllum ailanthoides and seasons with the five flavors. It is also called supporting the Qi to stabilize the five zang. It is also said to be appropriate to eat fish and freshwater turtle. It is the tai yin of the foot that supports it. The tai yin of the foot, the circulation of the spleen, governs the four seasons. In the fifth month, the four limbs of the child are completely formed, and this is why the tai yin of the foot supports it.
When one takes the pulse of the pregnant woman, if on strong palpation it is not dispersed, but is lively without being slippery, she is in the fifth month. If the pulse is fast, she is heading for complications/deterioration. If the pulse is tight, there are severe abdominal pains. If the pulse is slow, the abdomen is congested with dyspnoea. If the pulse is floating, the deterioration of the water produces edema.” Footnote 1
These ancient thoughts tell us that this is the month the element of Fire is introduced, which is necessary for Qi, Yang, and for moving forward. This aspect of pregnancy is in addition to the transformational movement of fetal growth. In the earlier months of pregnancy, there is a deep need to sustain a quiet stillness so the blood builds, nourishes, and gently circulates throughout the embryo–fetus. In the 5th month, there is mention of “fire to form Qi”, which for the mother sustains and cultivates her strength for the future tasks of motherhood, and for the fetus, this Fire pattern gets introduced.
Typically, the 5th month is when the mother perceives fetal movement (quickening), receiving the message that the fetus is speaking of itself and expressing its own life force. The mother then begins to perceive the unique Qi of its individuality. Many women having more than one child will speak of how this individual is either gentle or active, or when it prefers to be awake or asleep. No longer is the fetus a silent little seed germinating, growing, and developing in the mystery of the dark feminine; now it has a life force, palpable under one’s own hands.
The element of Fire complements the Water of early gestation. In the 4th month, Water is the first element that is mentioned in the classics. These two Yin/Yang elements are only introduced months after the fragile formation of new life, and they inform us of a wholeness. Prior to this time, the individual fetus has not been described with both Yin and Yang, or we might say, as a whole person. Even though the Pericardium in month 3 and the Triple Warmer in month 4 are each Fire meridians, not until the 5th month is Fire noted “to form Qi". With this presence, the mother will begin to recognize fetal patterns, getting a new and more physical sense of the individual growing inside her.
Spleen as Center add character for earth on the right side
In ancient China, the Spleen was typically seen in the center of the Five Elements. When we look at the shape of a square or even a circle, we see that there are four sides to them. When we look at this character (Spleen), we see that the right upper part of it is written with a square. Within this square is the Chinese character for Earth. That square represents Earth, which to the ancients, is the center of all life. These four equal walls can be interpreted as the number 4 and The Four Directions. The square or circle is itself its own aspect, like a wheel, and as such, can represent something bigger than itself. And Earth, as we can all agree, contains the continuity of life; without Earth, all perishes.
In the illustration of the Five Elements, the Spleen is in the center with movement going out, connecting to the four remaining zang and elements, which connect to each other, and return to the center. Their interconnectedness implies movement: giving, receiving, nourishment, and transformation.
The Spleen (as Earth) when healthy, functions as a nourishing hub, influencing, building and maintaining harmony, balance, and the sustenance of life. The Earth element, seen in the center of these Five Elements, is therefore central to ongoing life.
Speaking of “center”, the 5th month is the middle of pregnancy, where the mother is in the “center” of gestation. During this month the mother’s health, both mental and physical, etches a pattern of Fire and Qi into the fetus.
“The mother’s spleen functions properly in order to give the fetus the right pattern for its own process of distribution”. Footnote 2
The Mawangdui tells the mother
‘to rest and arise late, wash the clothes well, live in the most interior part of the house, put on thick clothes, go out in the morning to breathe in the rays of heaven to avoid the harmful cold.’
There is mention of rest, cleanliness, and caution. The mother is told not to go out in a stressful environment. Instead, she is advised to go out in the morning and breathe in the clear fresh air of the rising Yang. This is a call for Yang/Fire. Morning light is the rising of sun/Yang, and ends the darkness of night, or the sinking of Yin. Seeking this light aids the woman’s internal clock to produce the sleep-inducing hormone, Melatonin. When this internal clock mimics nature, the woman will tire in the evening and automatically awaken in the morning, setting the circadian rhythm into her fetus. These patterns not only affect physical and mental health, but they also affect behavior, contributing to lifelong habits of wellness in mother and child.
As a practitioner, speak about these patterns to women, and encourage them to connect more deeply to the natural rhythms of light and dark. Make sure to point out the influence of electricity, which tempts interactive relationships to the various screens of modern life, causing an out-of-synch rhythm with nature. For women who work night shifts, encourage them to change their schedules to day shifts if possible. Point out that electricity is addictive, bringing us ease and pleasure, but it is an interference with nature’s circadian rhythm. Of course, there are women who do not have the freedom to follow this advice; poverty, political unrest, or individual circumstances may demand otherwise. For them, advise they do their best to weave healthy choices whenever possible, as every little bit of following mother nature is helpful.
In the 5th month, the mother may embrace Fire, but not too much Fire. Caution is given against going out in too much sun, because its excess causes heat and dryness. Balance of Fire and Water is an important concern, in food, environment, and behaviors of night and day. As a result of following these basic balances, the fetus learns to nourish itself as it grows, gathering the Qi needed for survival.
The Spleen and its Ability to Digest, Assimilate, and Transport
The Spleen is responsible to distribute the essences of the “5 flavors” to each of the 5 zang/organs. The woman is advised to season her food with red pepper, which will enhance circulation, adding warmth and Qi. The addition of 5 flavors is not a surprising suggestion, since taste is the influence of the Spleen, and additional foods and spices can increase circulation in the body, where the gathering energy of stillness in early pregnancy is no longer needed. Many women begin to naturally increase their desires for new tastes during this time, adding foods they didn’t enjoy in the early months. The suggestion of fresh-water fish and turtle are given to balance the warming nature of Zanthoxyllum ailanthoides, and broths of meat and lamb. Sun Simiao cautions the mother to eat a balanced diet, “enough but not too much” and cautions her to avoid too much dry or damp food. The mother is also warned not to introduce too much sweet, which would cause heaviness and dampness, and as a result, disturb the ascending movement of the Spleen Qi.
The classics make a point that diet and exercise are of extreme importance for healthy fetal development, recognizing that they have lifelong influences on the fetus. Today we know that pregnant women who have diabetes imprint metabolic imbalances that can lead to obesity in fetuses as well as metabolic problems later in life. Then and now, the dietary choices that women make are as important to the fetus as they are to the mother. Current findings in the study of embryology show us that fetal digestion begins early in the 18th week, or during the 5th month. This example is another recognized bridge between ancient and modern thinking, with each of them recognizing the 5th month as an important role for digestion, or the Spleen.
As well as recommending specific foods, the classics also tell the mother how to dress, where to reside, and when to be outdoors. What this does is remind her that self-care and self-awareness are important, and life as she has lived it previously, needs to be adjusted. For the fetus, these patterns of balance set the stage for lifestyle choices. Eventually, this gathered Qi is an important ingredient that gives the fetus the ability to survive on its own.
Pulses
The healthy pulse of the 5th month is mentioned in detail, describing it as “one that cannot be dispersed with strong palpation, and is lively but not slippery”. The woman is cautioned to keep a healthy pulse by avoiding too much heat, cold, or congestion in all her life choices, as each of these excesses lead to negative influences.
“if the pulse is floating, there are problems in edema; if it is tight, there are pains; if it is slow, there is abdominal congestion and dyspnea; and, if it is fast, there are future complications.” Footnote 3
In conclusion, the 5th month, called “supporting the Qi to stabilize the 5 zang”, expresses the beginning of fetal Qi. This Qi lets us know that the organs of the fetus are developing toward maturation. Clearly, there is not yet enough physiological stability for the fetus to survive on its own, but it is a beautiful recognition of its evolving development. Even today in the 21st century, where modern medicine has life-saving abilities beyond the imagination of the ancients, a fetus born at this time does not survive.
Continue to the Second Trimester of Pregnancy: Month 6 article.
References
- Footnote 1: Mawangdui
- Footnote 2: Rochat de la Vallee, Elisabeth, Pregnancy and Gestation.
- Footnote 3: Ibid
