SAFE MOTHERHOOD AND AYURVEDA

SAFE MOTHERHOOD AND AYURVEDA

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Introduction
Ayurveda places an enormous emphasis on the importance of caring for the mother before during and after pregnancy.
Charak Samhita states:
‘Evam kurvati hi arogya-bala-varna-samvahana-sampadam upetam jnatinam shreshtam apatyam janayati’
If a pregnant woman is taken care of as advised, she will give birth to a child who does not have any diseases – a healthy, physically strong, radiant and well-nourished baby. He will be superior to all in the race.
Ayurveda, the ancient Indian medical science, describes safe motherhood thus, Motherhood is the basis of family life which, in

turn is the backbone of all the orders of society. Hence, family life remains protected if the woman is safe and protected.
This great science compares conception to the germination and sprouting of a seed and its transformation into a sapling. When the male and female seeds unite and the soul enters the union, it becomes an embryo (Garbha). Ayurveda gives importance to the quality of the seed and hence to the development during adolescence, of both the male and female. In addition to the seed, the mother also provides the soil, nutrition and the right season for the seed to grow. Hence, Ayurveda advises

special attention to aid to the nutrition and protection of the woman to keep her (the soil) rich and clean. It further advises that a female less than sixteen years of age and a male less than twenty should not bear a child. The rules of sexual intercourse are also laid down. So also, those of antenatal care; the husband and other family members are advised to take care of the pregnant woman’s diet and encourage activities that are dear to her and beneficial to the fetusor child growing in her body. Thus, the approach towards motherhood, that is pregnancy and childbirth, is a holistic one. Such concepts are excellent, but the question is, are they practiced? In fact, it needs thorough introspection on our part to find out why this approach was abandoned.

Garbhin`eeVyaakaran`a
Ayurveda describes the general management of pregnancy under Garbhin`ee Vyaakaran`a. There are separate chapters for general management, special management, diseases in pregnancy and their treatment and so on. Rules concerning diet, activities, behavior and mental activities; (Aahaara, Vihaara, Aachaara, and Vichaara) respectively are also laid down. The physician is cautioned and advised to be very careful about the management of pregnancy; if a vessel of mud yet to be baked, is filled with oil right up to the brim, is to be carried without spilling even a single drop, every step has to be carefully watched. The same is the case in the management of a pregnant woman. The physician should aim at protecting and nourishing both the fetus and the mother.
From the moment the pregnancy is confirmed, the woman is advised to follow certain rules. The physician steps in and starts
supervision so that the pregnancy can terminate in a normal delivery at the scheduled time. Especially when she approaches full term, critical care is necessary as one of her feet is considered to be in this world and the other in the world of Yama (the god of death). Delivery is not complete unless the placenta is delivered. If the delivery is not normal, says this ancient science; the woman is likely to be affected by one or the other of a list of 64 ailments, which are described in detail in Garbhin`ee Vyaakaran`a.
Sometimes, even an expert, can get baffled by situations arising during the course of pregnancy, delivery, and post-delivery period. Hence, the physician has to have foresight, definite convictions, expertise, experience and compassion while taking on the responsibility of a pregnant woman. He has to think of the welfare of two individuals at the same time, that of the mother and the fetus. Both are to be nourished and protected. The requirements of both are usually identical. But, if they happen to clash, the protection of mother should be the first priority.
If a couple desires to have a good progeny, both the partners should be careful about their diet, activities, behavior and emotional status before as well as after conception. One has to keep this in mind throughout the pregnancy.

General Rules from Inception of Pregnancy to Delivery:
The mother to be should
•    Always try to be in a happy mood
•    Be clean, neat and well dressed
•    Wear simple clothes
•    Sleep under a roof in a clean environment (not infested with insects such as mosquitoes etc)
•    The food she eats should be tasty, more of it should be in a liquid form, moist, nourishing, enriched with all the six (Rasa) tastes and treated by (Deepana) drugs, which are known to increase appetite and digestive power.
She should always avoid
•    Excessive sex, particularly during early and late pregnancy
•    Overeating or fasting
•    Sleeping during the daytime and staying up late at night
•    Tight clothes and tight belts
•    Witnessing or listening to things which give rise to feelings of sorrow, anger, horror, or agony
•    Traveling in a vehicle on rough roads
•    Squatting for a long time or sitting in an uncomfortable position or on a hard surface
•    Lifting heavy things or remaining in a bending position for a long time
•    Oleationby larger doses of fats, massage etc. unless positively indicated
•    Beholding natural urges unless in an emergency
•    Dry, stale, fermented, heavy, very hot or strong food, alcohol, and meat (fish is allowed) smoke
•    Visiting abandoned and remote places
•    Leaning into a deep well
Specific Effects of Poor Habits and Behaviors:
Cause—–Effect
Traveling on horseback—–Premature Birth
Looking into wells or ditches—–Premature Birth
Hearing excessive noise—–Premature Birth
Remaining too often on one´s back—–Umbilical cord twisted Sleeping outdoors or going out at night—–Insanity
Indulging in quarrels and fights—–Epilepsy
Excessive grieving—–Timid and under-developed child
Thinking ill of others—–Envious or lesbian daughter
Stealing—–Wrathful or indolent child
Sleeping constantly—–Unwise child with poor digestion
Excessive pork—–Red eyes, respiratory problems
Excessive fish—–Eye problems

Garbhin`eeParicharyaa(specific care)
The development of the fetus in the uterus is described under Garbhaavakraanti, and special regimes and prescribed for each month under Garbhin`ee Paricharyaa. The general rule is to take greater care during the first three months of pregnancy and after the completion of the seventh month.
The garbling perikarya are broadly discussed under three topics:
•    Maasaanumasika pathya : months dietary regimen and prescriptions
•    Garbhasthaapaka dravyaas: Substances which are beneficial to pregnancy and
•    Garbhopaghaathakara bhaavas : Activities and substances that are harmful
During the first trimester, stress is laid on stabilizing the pregnancy and nurturing the uterine bed through Rasa and Rakta Dhaatu_s. The embryo gets nourishment directly by percolation (Upsnehana). Hence more (Jaleeya) liquid substances such as juicy fruits, coconut water, milk, and so on are advocated.
In the first month, sipping cold milk and maintaining a light diet, and during the next two months, the intake of milk medicated with herbs like Vidaaree, Shataavaree, Yasht`imadhu, Braahmee and so on, which are (Jeevaneeya) life-building and (Garbhasthaapaka) helping Nidation, are advocated. Honey and ghee are also recommended.
By the end of the third month, the body parts of the fetus become differentiated, sensory perceptions and motor reactions start developing, the heart starts beating, and it is said to express its desires through the mother. This is the period when the woman craves for certain foods/flavors. The needs of both the fetus and the mother are identical. Hence, Ayurveda recommends that her cravings be fulfilled as far as possible, if not contraindicated. Braahmee helps in calming the nerves and is also a good (Prajaasthaapana) sustainer of pregnancy.
From the fourth to the seventh month, drugs, which give strength to the uterine muscles and

nourishment to the embryo, are advised e.g. Ashvagandhaa, Krauncha Beeja, and Gud`oochi. They help to prevent intrauterine growth retardation (IUGR). Nourishment starts through the umbilical cord by the (Kedaara Kulyaa) channels in the field for the reach of moistening, method. The diet should be one of rice, milk, butter and ghee. Fruits, which are orange or yellow in color, are advocated such as mangoes, apples, and carrots, Aamalakee etc. Leafy vegetables are also advised during the seventh month. The abdominal skin gets stretched giving rise to itching and striations, called Kikkvisa. This should be treated by taking sips of the infusion of berries or butter medicated with Manjist`haa, the application of the pulp of sandalwood and lotus or of a paste made of neem, basil, and Manjist`haa, or oil medicated with Karaveera leaves or jasmine.
From the seventh month onwards, there should be less fat, less salt and less water in the diet. Rice and kaanji with a little ghee are advocated. After the completion of the seventh month, herbs, which are mild diuretics and urinary antiseptics such as Gokshura and Saarivaa, are advocated. Basil in small quantities is advised; it is also anti-spasmodic.
As soon as the pregnant woman enters the ninth month, she is supposed to move to the Sootikaagaara (delivery area), which is specially prepared for delivery. After an Asthaapana Basti (simple enema), she should undergo Anuvaasana Basti (retention enema of medicated oil with some herbs), which may be repeated. Tampons soaked in the same oil are kept in the vagina to make the pelvis soft and elastic and enhance the excretory functions of Apaana Vaayu (urination, defecation), which facilitates the expulsion of the fetus. The skin and nails become soft, and her strength and complexion are rejuvenated.
Garbhasthaapaka aushadhi – Substances beneficial for the maintenance of pregnancy.
Garbha sthaapaka dravyas counteract the effect of thegarbhopaghathakara bhaavas and help in the proper maintenance of thegarbha. They can also be used in the treatment and prevention of abortion. These are to be used as a routine as they are beneficial for the maintenance of proper health, growth, and development of the mother and fetus.
Some of the garbhasthaapaka aushadhis are aindri, Brahmi (Bacopa monnieri), shathaavari (Asparagus racemosus), doorva (Cynodon dactylon), etc. These should be taken orally as preparations in milk and ghee. A bath with a cold decoction of these drugs should be given during pushya nakshatra. These should be kept in close contact with the mother and can be used as amulets around the right arm and on the head. Drugs of the jeevaneeya gana can also be used in a similar way.
Garbhopghaatha kara bhaavas – Activities harmful to the fetus
Garbhopghaatha kara bhaavas are the aahaara and vihaara which are harmful to thegarbha (fetus). These may cause some congenital defects in the child and are not conducive to the birth of a healthy child, with all the good qualities.The pregnant woman should avoid the use of intoxicating substances like wine, meat (in excess), ushna (hot),teekshna (sharp)katu (pungent), guru and vishtambhi (hard and heavy to digest) foods.The pregnant woman should avoid strenuous exercise and coitus (both excessive) harsh or violent activities, travel in vehicles

Sootikaagaara:
The Sootikaagaara should be such as to meet seasonal needs. The type of land, the timber used for building, the architectural layout of the area (the bathroom, toilet, kitchen, fireplace, delivery room) the type of firewood used, the water supply and so on are described in detail. Materials such as linen needles and instruments essential drugs and furniture are also specified. The house should be fumigated to make it free from insects. Porous bags containing Rakshoghna drugs should be suspended all around at the entrance and at the corners to ward off insect, bacteria and unseen evil elements (Rakshoghna drugs are supposed to kill or repel them). These drugs are Calamusasafetida, garlic, Guggulu, and Sarshapa.
The nurse or birth attendant recommended by Ayurveda should be experienced, friendly, alert, an expert, affectionate by nature, concerned and caring. The attending physician should be an expert also.

Treatment of Diseases during Pregnancy:
Any diseases occurring for in a pregnant woman should be treated with drugs that are mild in action compatible and safe for the fetus.Panchakarma (detoxifying procedures) should not be advocated, except Basti (enema) and Pichu (tampon) in the eighth and ninth months of pregnancy.
Ayurveda also describes nine diseases, which are caused because of the pregnant status of the woman. These diseases are peculiar to pregnancy and are called Garbhopadrava_s. They are nausea, anorexia, and vomiting dryness of mouth, fever, Edema, Anemia, diarrhea and retention of urine. Their specific treatments are also elaborately described.
As far as possible, medication should be avoided during the first three months of pregnancy. Only symptomatic treatment with very mild herbs and a suitable diet should be offered. The physician is advised to take into account the severity of the disease, the resistance power of the mother and the duration of the pregnancy, and choose the middle path so that the disease or the treatments do not result in sequelae in the mother or the fetus. For example, the use of Das`hamoolarisht`an in vaataja fever, cold infusion of Glycerrizalotus and Saarivaa in Paittika fever and Gud`oochi, Vaasaa quash in Kapha fever to bring down the temperature. Similar special treatments are advised for other diseases. Drugs such as Vachaa, Kumaaree, are contraindicated in pregnancy and substances like garlic and asafetida are to be used cautiously.
Even three thousand years ago, thus Ayurveda has stressed the importance of safe motherhood. It aims at excellence in the formation of the fetus, its development without anomalies, a comfortable full term delivery, and maintenance of the health of the mother. Ayurvedic methods or practices, if followed during pregnancy, will lead to a complication-free delivery.
Ayurveda starts working from selection of life partner and preparation before conception to postpartum period.

By
Dr. Timsi Sharma
Dr. Vikas Sharma

 

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