AYURVEDA has a well-documented description of caring for pregnant women, called Garbhini

Paricharya. The regimen prescribes practices for each month and stage of pregnancy. These

systems are, in fact, diligently followed as traditional practices in innumerable households even

today.

Garbhini Paricharya prescribes ahara (diet), vihara (lifestyle) andvichara (thought process) to

be followed during pregnancy as these have a direct effect on the mother and the child. Of

these, wholesome diet is given great importance as it aids foetal growth, maternal health and

lactation after childbirth. Great care is also recommended during the first three months and

after the completion of the seventh month of pregnancy.

During the first three months of pregnancy, the foetus is in a formative stage. During this stage,

the embryo is nourished directly by upsnehan (percolation). Therefore, more liquid diets such

as fruits with juice content, coconut water, milk are recommended.

While milk and a light diet is recommended during the first month; in the second and third

months, milk medicated with life-building herbs such as Vidari,

Shatavari (Asparagus), Yashtimadhu (Licorice) andBrahmi are prescribed along with honey and

ghee. Brahmi helps in calming the nerves and is also a good prajasthapan (sustainer of

pregnancy).

Garbhini Paricharya considers milk an ideal constituent of diet for pregnant women as it is a

source of calcium, lactose and butter fat. Milk also has moderate amounts of protein with

anabolic properties that give strength. Ayurveda is particular that pregnant women should not

get constipation. While mild laxatives and enema is recommended if there is a tendency to

constipation, it is found that usually, milk alone is sufficient to cope with the constipation.

Towards the end of the third month, the foetus starts showing distinct development and

sensory perceptions. Motor reactions start developing and heartbeat can also be heard.

The fourth month sees the formation of dhatus (tissues) in the foetus. In the fifth month, blood

and muscles are formed. In the sixth month, fatty tissue is formed. In the seventh month, foetal

growth is complete. Foetal organs are well formed and acquire strength by the sixth and

seventh months. Skin, hair and nails are also noticed at this stage. Medicated ghee is

recommended as a nutritional supplement to the diet.

The embryo gets its nourishment through the umbilical cord. Rice, milk, butter and ghee along

with fruits and leafy vegetables are recommended. This is useful for foetal growth, for maternal

health and for further lactation. As per Ayurveda, pregnancy is the time to consume nutritional

food substances like urad dal and amla.

From the fourth to the seventh month, medicinal supplements such asAshwagandha, Kraunch

beej and Guduchi (Shindilkodi in Tamil,Gulancha in Bengali). Aswagandha and guduchi are given

to strengthen the uterine muscles and also to nourish the embryo. These also help in the

prevention of intrauterine growth retardation.

Fat, salt and water should be reduced in the diet from the seventh month onwards.

Rice kanji with ghee is a recommended diet. Small amounts of basil can be taken as anti-

spasmodic. Herbs such asGokshura and Sariba, which are mild diuretics and urinary antiseptics,

can also be taken.

Ayurveda advises certain concoctions (available in Ayurvedic pharmacies) during pregnancy, for

the growth of the foetus and for the health of the mother.

Ghrita preparations (medicated ghee) like Phala Sarpis can be taken from the first month of

pregnancy. Dadimadi Ghritham improves the growth of the foetus while Kalyanaka

Ghritham improves mental growth.

These concotions can be taken from the seventh month of pregnancy. In

addition, Sukhaprasava Ghritham helps in easy delivery of the baby. These Ghrita preparations

can be included as an integral part of the diet, during pregnancy.

Interestingly, the suggested Ayurvedic diet correlates to modern nutrition recommended for

pregnant women such as high protein, vitamins and minerals.

MOTHER AND CHILD CARE IN TRADITIONAL MEDICINE

Diagnosis Of Pregnancy

The topic of Prasoothi Tantra itself it divided into three areas viz.

1. The ante-natal phase - which includes - diagnosis of pregnancy and care during

pregnancy - garbhini-paricharya.

2. Natal phase - namely the process of delivery - from the onset of the labour pains upto

delivery of the placenta -prasava kaala paricharya.

3. Post-natal phase - namely the post-partal period or looking after the new-born baby,

care of t h e mother during lactation -soothika paricharya.

The first phase ofgarbhini-paricharya starts off with the diagnosis of pregnancy. Diagnosis of

pregnancy can be based on:

i. Presumptive signs and symptoms

ii. Probable signs

iii. Positive signs

Our Aachaaryas have classified them assadyogruheeta -garbha lakshanas andvyaktha-garbha-

lakshanas. Sadyogruheeta- garbha-lakshanas (including presumptive and probable signs) are

the set of signs and symptoms which help in the detection of pregnancy within a week of

conception or even just after coition.Vyaktha-garbha-lakshanas (positive sings) are generally

observed after amenorrhea i.e. these symptoms are observed after her first missed period and

are symptoms which help in confirming the pregnancy.

1. Sadyogruheeta garbha lakshanas

The signs and symptoms that can be seen immediately after conception are follows:

Charaka lists them as "Nishteevika gowravamangasaadas-tandra apaharshow hrudaye

vyatha cha trupthischa beejagrahanam cha yonyaam garbhasya sadhyonamgathesya lingam"

i.e. repeated spitting, heaviness, malaise, drowsiness, horripilation, uneasiness, pain in the

chest, a feeling of satisfaction, retention of the ejaculated semen in theyoni (Cha. Sam., Sha.

2/23).

Sushrutha lists them as "Shramoglaanihi pipaasaa sakthisadanam

shukrashonithayoravabandhahasphuranam cha yonehe" i.e.fatigue, langour, excessive thirst,

lassitude of the thighs, retention ofshukraandshonitha (absence of menstrual and coital

discharges) and quivering in the vagina (Sus. Sam., Sha. 3/10).

Vaagbhatta II states "...angagrahaha, trupthirgurutwam,

sphuranam shukraasraananubandanam, hrudaya spandanam thandra trudglaanihi

lomaharshanam" i.e. body pain, satisfaction, heaviness, quivering, retention and combination

of shukra and aarthava, palpitation, dizziness, excessive thirst, langour, horipulation are the

immediate sings of pregnancy (Ash. Hru., Sha. 1/37-38).Vaagbhatta I includes nausea and

excessive salivation also in the list of symptoms.

There are various interpretation of the term "sadyogruheetha". According to

some Aachaaryas these are the signs and symptoms which are seen and felt by the pregnant

woman immediately after conception i.e. the moment the shukra andaarthava unite, or even

just after maithuna (copulation) which results in conception. According to others they are the

signs and symptoms which appear within seven days of conception. Some others say that they

are the signs and symptoms before the cessation of menstruation. It is also explained as signs

and symptoms of women having become recently pregnant (5).

2. Vyaktha garbhalakshana / dowhrudya lakshana

These are the signs and symptoms observed after the growth of the embryo becomes

conspicuous.Charakaexplains these signs and symptoms as that of dowhrudyam or that of

having twohrudayas and states that their knowledge is essential to facilitate their management.

These signs and symptoms are seen during the third month of gestation. They are described

byCharaka as : "Aarthavaadarshanamasya samsravanam anannaabhilasha chardihi

arochakomlakaamatha cha visheshena shraddha pranayanamucchaavacheshu bhaveshu

gurugaatratwam chakshusho glaanihi sthanayoho, sthanyamoshtayoho, stanamandalayoshcha

kaarshynyamatyartham, shwayathuhu paadayoreeshallomaraajyudgamo yonyaaschataala

twamithi garbhe paryaagate roopani bhavanthi". Thevyakthagarbha lakshanas are

amenorrhea, excessive salivation, dislike for food, vomiting, anorexia, craving for sour

substances, alternate desires for article which are of high or low quality (beneficial/non-

beneficial), heaviness of body, langour of eyes, milk secretion in breasts, blackening of lips and

areola, slight odema of feet, development of romaraji (the vertical streak of hair line extending

to the umblicus) and dilation of vagina (Cha. Sam., Sha. 4/16).

In addition to these, Sushrutha and Bhaavamisra mention - repeated drooping of eyes, vomiting

without apparent cause, aversion to good smells and excessive salivation and tiredness as

symptoms (Sus. Sam., Sha. 3/11) and Bha. Pra. Poo. Gar. 3/42).Vruddha

Vaagbhatta inAshtaanga Sangraham along with the other signs and symptoms also mentions -

"yatha yatha cha garbho vruddhimaapnothi tatha bharahara - rasaapchaaraatcha sthriyaa

balakshaya" - i.e. the increase in the weight of the embryo causes diversion for her nuterients

and thus her energy also decreases (Ash. San. Sha. 2/9 and 59). Vaagbhatta in Ashtaanga

Hrudaya -adds the symptoms emaciation, indigestion, burning sensation of the whole body and

expression of various desires.

In Charaka Samhitha and Kaashyapa Samhitha, the signs and symptoms for each

month maasaanumaasika-lakshana have also been described from the fourth upto seventh

month which are as follows:

1. Fourth month - Chathurthi maasi sthiratwam apadyathe garbhaha thasamaat tada

garbhini guru gaathrathwam adhikam aapadyathe visheshna" i.e. due to stability in the

foetus the woman feels more weariness in the body (Cha. Sam., Sha. 4/20).

2. Fifth month - Charaka states : "Panchame maasi garbhasya, maamsa

shonitopachayo bhavathi, adhikam anyebhyo maasebhyaha tasmaat tada garbhini

kaar-shyamaapadyathe visheshena. During the fifth month, there is an excessive

increase of flesh and blood of the foetus in comparison to the other months; due to this

the pregnant woman grows excessively thin (Cha. Sam., Sha 4/21). Kaashyapa has also

mentioned a similar symptom namely "Garbhinee panchemaasi tasmaat kaarshyen

yujyate" i.e. in the fifth month the pregnant woman is associated with leanness. (Kaa.

Sam., Sha. Asa.).Chakrapani Dattas commentary on Charaka slines are "Yatho garbha

maamsaadi poshanenaiva ksheena ahaara rasona maathur maamsaadi samyak

poshayathi" i.e The nutrition of the mother is utilised for the growth of the child during

this month, hence the mother grows thin.

3. Sixth month - Charaka states thatShashte maasi garbhasya bala

varnopachayo bhavatyadhikamanyebhyo, maasebhyaha, thasmattada garbhini

balavarnahaanim, aapadyathe visheshena i.e. there is a comparitive increase in the

strength and complexion of the foetus during the sixth month of gestation. Therefore

the lady loses her strength and complexion considerably (Cha. Sam., Sha. 4/22).

4. Seven month - Sapthame maasi garbha sarvairbhaavaihi aapyaayyathe, thasmaat tada

garbhini sarvaakaaraihi klaanthathama. There is an all round development of the foetus

during the seventh month of gestation. Therefore, a pregnant women becomes

exceedingly deficient in all aspects of her health (Cha. Sam., Sha. 4/23). Though there

has been reduction in the physical state of the mother, in the seventh month all the

factors viz., flesh, blood, etc. Get reduced simultaneously (Chakrapani

Dattas commentary onCha. Sam., Sha.4/23)

5. Eighth month - During the eighth month of gestation there is cross movement of

theojas through the channels carrying nourishment from the mother to the foetus,

because of the immaturity of the foetus. It is advised that one should not even mention

about the eighth month to the pregnant woman because the knowledge of the danger

involved in this month, would only increase her fear, which in turn will

aggravate vaatha in her body and may lead on to dangerous consequences like pre-

mature delivery or even death of the foetus. During the eight month theojas is not

stable. If theojas has moved to the mother the foetus will die and if it is still with the

foetus then the mother’s life will be in danger. Hence our aacharyas do not consider this

month fit for labour (Cha. Sam., Sha.4/24).

Ojas is defined as ojastejo dhaathunaam i.e. the essence of all the dhaathus is called

the ojas. The ojas is responsibe for the life to be sustained and is also the source for the

internal strength and resistance power.

Garbhini Paricharya : Care Of The Pregnant Woman

Garbhini paricharya or antenatal care is the most important aspect in the whole area

of Prasuthi Tantra. This is so because all other aspects depend on this phase. The

proper garbhini charya would result in the proper development of the foetus, its delivery, the

health of the mother and thus her ability to withstand the strain of labour and have an

eventless post-partal phase. The care of the pregnant woman reflects on the quality and health

of the offspring For these reasons our aachaaryaas has given a detailed and systematic and

monthwise regimen plus a list of do's and dont's to be followed in the antenatal phase.

The garbhini paricharya is broadly discussed under three topics:

a. Maasaanumasika pathya : monthwise dietary regimen and prescriptions

b. Garbhasthaapaka dravyaas : Substances which are beneficial to pregnancy and

c. Garbhopaghaathakara bhaavas : Activities and substances that are harmful

This can also be listed as the various foods and activities that are prescribed and proscribed,

according to their effects on the garbha.

Maasaanumaasika pathya : Monthwise dietary regimen

As there is a constant development of the embryo there would also be difference in its

requirements of food and nutrition. Thus the requirements of the mother also change. Having

understood this change in requirements, theAayurvedic Aachaaryaas have given in detail the

monthwise dietetic regimen.

By following these dietetic regimens prescribed, the pregnant woman, having normal

development of foetus, remains healthy and delivers a child possessing good health, energy,

strength, complexion and voice. The child would also be sturdy. They are recommended for the

pregnant woman right from the first month upto the ninth month of pregnancy.

The maasaanumaasika pathya help in:

1. Softening of placenta (apara), pelvis, waist, sides of the chest and back

2. Downward movement of vaatha(vathaanulomana) - this is needed for the normal

expulsion of foetus during delivery.

3. Normalisation of the urine and stool and their elimination with ease

4. Softening of her skin and nails

5. Promotion of strength and complexion

6. Delivery with ease of a healthy child endowed with excellent qualities in proper time.

Recommended diet and regimen for various months

First Month

As soon as pregnancy is suspected, the mother should take non-medicated cold milk separately

in desired quantity (considering her digestive power and strength) Congenial food should be

taken in the morning and evening. Massage with oils should be given but rubbing of unguents

should be avoided (as they would liquify the doshas) (Cha. Sam., Sha. 8/32) and (Ash. San.,

Sha 3/3)

Second month

In the second month, the woman should be given milk medicated with madhura drugs and

liquid foods which are sweet and cold (Cha. Sam., Sha. 8/32 and Sus. Sam., Sha. 10/3).

Third month

In the third month she should take milk with honey and ghee (Cha. Sam. Sha. 8/32) and shasti

(a variety of rice) cooked in milk. In the first three months of pregnancy the product of

fertilization is in a fluid/jelly state and thus the woman should be given more of liquids or fluids.

Also during these three months the major part of mass is formed - for thismadhura andsheetha

veerya substances should be given which help in the formation of the cellular mass and

promote growth.

Fourth Month

Butter extracted from milk (not from curds) in the quantity of one aksha (approximately 10

grams) or milk with the same amount of better should be given (Cha. Sam., Sha. 5/32).

Cooked shasti (a variety of rice) with curds, pleasant food, mixed with milk and butter and meat

of wild animals (Sus. Sam., Sha. 10/3) should be given to the pregnant women during the fourth

month. During the fourth month there is solidification and the development of the limbs. So

there is more need of solids, and more of solid food is advised.

Fifth Month

Ghee prepared with butter extracted from milk (Ksheera sarpis) and food similar to that of the

fourth month should be given except that, ghee is given (mixed with milk) instead of butter.

Sixth Month

Ksheera sarpis medicated with the drugs of madhura gana - ghrutha or rice gruel medicated

with gokshura (Tribulus terrestris) should be given in the sixth month. As it is quite common to

notice retention of urine, in this phase of pregnancy, madhura gana drugs andgokshura would

help as diuretics.

Seventh Month

The diet given in the seventh month should be the same as in the sixth month, along with ghee

medicated with pruthak parnyaadi (Vidaarigandhaadhi) group of drugs. This would help in the

proper development of the foetus.

Eight Month

Before we list out the diet and regimen for the eighth month it would not be out of place to

mention the role of vaatha in the process of delivery and how important it is to maintain it. We

see that the regimen and diet prescribed are of the nature of controlling vaatha especially

the apaana Vaayu. The functions of apaana Vaayu are "Vaathavinmoothra shukraartava

garbha nishkramanaadikriyaaha" i.e. the expulsion of gas, faeces,

urine,shukra (semen),aartava(menstrual discharge) and the delivery of the foetus (Ash. San.

Sut. 20/4). Hence to have normal delivery it is very important that we maintain thevaatha and

due to this reason we find that towards the last few months of delivery, all efforts are taken to

keep thevaatha in an unvitiated state.

As has been said earliervaatha plays an important role in the delivery of the garbha - thus care

is taken to maintain it. For this reason,basthi i.e. medicated enema, is administered during the

eighth month. It forms one of thepanchakarmas which are the five types of eliminative

therapies. Basthi is broadly of two types -anuvaasana basthi(unctuous enema) and aasthapana

basthi (corrective enema). Basthi in general is the therapy of choice to eliminatevitiated vaatha.

Anuvaasana basthi or sneha basthi differs from aasthaapana basthi ornirooha basthi by the

proportion of thekashaayas (decoctions) and snehas (oils) used in preparing the enema.

While anuvaasana has a lesser proportion ofKashaayas, theaasthapana has lesser quantity

ofsneha.

Sushrutha has advisedaasthaapana basthi (a medicated enema with non unctuous substances

like kashaaya) with decoction of badari (Zizyphus jujube) mixed withbala (Sida

cardifolia), athibala (Abutilon indicum),shatapushpa(Foeniculum vulgare), palaala (pasted

sesamum seeds), milk, curds, masthu (sour buttermilk), oil, salt,madanaphala(Raundia

dumentorum) honey and ghrutha and followed byanuvaasana basthi (a medicated - unctuous

enema) with oils medicated with milk and decoction of drugs of madhura group. These would

help in clearing the retained faeces and invaathaanulomana (regulation of vaatha by its

downward movement).

Ninth Month

The pregnant woman should be given anuvaasana basthi with oil prepared with the drugs

of madhura group, and also vaginal tampons (pichu) with the same oil for lubrication

of garbhaashaya (uterus) and prasava maarga (birth canal). Daily bath with cold decoctions

of vaathahara drugs are also advised. Meat soups with cooked rice and fat or rice gruel mixed

with good quantity of fat should be given as diet.

Garbhasthaapaka aushadhi - Substances beneficial for maintenance of pregnancy

Garbha sthaapaka dravyas counter act 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 foetus.

Some of the garbhasthaapaka aushadhis are aindri, braahmi (Bacopa monnieri), shathaavari

(Asparagus racemosus), doorva (Cynodon dactylon), etc. These should be taken orally as

preparations in milk and ghee. A bath with 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 foetus

Garbhopghaatha kara bhaavas are the aahaara and vihaara which are harmful to

thegarbha (foetus). 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 These can be grouped under

two different headings namelyaahaara and vihaara.

Aaahaara (food) to be avoided during pregnancy

The pregnant woman should avoid use of intoxicating substances like wine, meat (in

excess), ushna (hot),teekshna(sharp)katu (pungent), guru and vishtambhi (hard and heavy to

digest) foods (Cha. Sam., Sha. 4/18), (Sus. Sam., Sha. 3.12), (Ash. Hru., Sha 1/44-47).

Vihaaras (activities and behaviour) to be avoided during pregnancy

The pregnant woman should avoid strenuous exercise and coitus (both excessive) harsh or

violent activities, travel in vehicles (on uneven road) (Cha. Sam., Sha. 4/18).Sushrutha has said

that - the pregnant woman should totally give up coitus, exercise santarpana (satiation or

anabolic foods and regimen), swapna viparyaya (sleeping in the day and keeping awake at

night), utkataasana (squatting or the posture of sitting on the hams with the soles of feet

touching the ground). She should not suppress her natural urges and she should not

undergosnehana (oleation therapy) andrakthamokshana (blood letting). Her mind should be

always in a pleasant state and she should neither touch nor see unpleasant things of disfigured

persons (with some physical defects) scary objects, nor listen to exciting and scary stories. It is

said that the mental state of the mother can influence the outcome of pregnancy as well as the

child to be born. Hence one is advised to listen to scriptures - in some families the recitation

(paaraayana) of suitable texts such as the Sundara Kandam (from the Ramaayana) or the

tenth skanda ofBhaagavatha is performed routinely. She should not talk in high pitch and avoid

thoughts which would promote her anger or fear - all these physical and mental activities would

harm the foetus (Sus. Sam., Sha. 10/2).

Vaagbhatta has said that she should also avoid prolonged stay in the hot sun and peeping into

pits and wells (Ash,San, Sha, 3/3). Haaritha advices, avoidance of foods which are vidaahi and

constipative and vegetables like yam, garlic and onions, (Haa.Sam. 3/49). The author

of Yogaratnakara has contra indicated the use of sudation, emesis,kshaara (alkalies) foods

along with polluted food andviruddhaahara. (Yog. Rat. ksheera dosha chikitsa).

The effects of the variousgarbhopagathakarabhaavas have been mentioned as follows:

squatting or sitting in abnormal postures, control of natural urges, use of pungent hot foods and

exertion would cause intra uterine death of foetus death of foetus or premature delivery or

abortion. Sleeping in supine position with stretched extremeties would cause the encircling of

the umbilical cord around the neck. Indulgence (excessive)in sex would cause deformed

impudent or lazy child. Over sleeping during pregnancy could result in a child who is sleepy,

ignorant and has a weak agni (power of digestion). Regular use of wine or other intoxicants

would result in a child with a poor memory and an unstable mind. The excessive use of any of

the six rasas would cause - urinary disorder, skin and eye disorders, premature aging, infertility

emaciation, weakness and disorders like flatulence and eructation respectively. (Cha, Sam., Sha.

2/61).

For a detailed description ofVirudhddhaahaara, the reader is referred of Section I of

Chapter VIII, of Ayurvedic Principles of Food and Nutrition- LSPSS Monograph II.

Dowhrudya

One often comes across, varying and erratic likes and dislikes, in a pregnant woman irrespective

of the culture or the part of the World she belongs to. These likes and dislikes are peculiar to

the state of pregnancy and they vary in vary in each woman. Some of these desires are very

strong. The speciality or peculiarity of these likes and dislikes are that they are very often in

contrast to the usual desires of the same woman when she is not pregnant. Though these

symptoms have been mentioned and described, there seems to be no understanding of its

actual cause.

Aayurveda has a definite understanding of these varied desires and terms the condition

as dowhrudyam. The reason for the manifestation of dowhrudyam is the presence of a

second hrudaya in the foetus. As such she has two hrudayasone of her own and the other of

the foetus. She is called a dowhrudini. As the foetus reaches the fifth month the chetna (i.e.

consciousness) enters it and starts having its own individual desires, these along with those of

the mother are manifested as a contrasting combination of likes and dislikes. This is a unique

concept that explains the sudden and abnormal likes and dislikes, that pregnant women may

manifest. It is said that these special desires can also help in the assessment of the sex of the

child, as they are peculiar to the sex of the unborn baby.

According to our Aachaaryaas the foetus grows upto a period of four months the "chetna" or

the life gets associated with the foetus and this causes the longings of the mother. These

longings and desires are to be satisfied. Not doing so may cause abnormalities of the foetus like

dwarfism. These desires are not always beneficial, and may prove harmful to the foetus (even

when fulfilled). In such cases one should use one's "yukthi" of power of reasoning, so as to fulfill

her desire and at the same time render it harmless.

Some suggestions in this regard are as follows:

1. If there is an execessive desire for salt and raw (sour) mango the same can be

substituted by rock salt (saindhava lavana) and aamalaki (Phyllanthus emblica)

2. Desires for ushna theekshna hot/pungent foods like pickles can be fulfilled by intake of

lime juice and ginger.

3. Desire for charcoal and ash can be fulfilled by taking burnt aamalaki alone or in

combination with harithaki(Terminalia chebula) and vibhithaki (Terminalia bellerica).

4. Desire for clay, mud and brick can be replaced by gairika (red ochre) fried in ghee.

Desires of the mother are said to have some relationship with the character of the child. For

e.g. It is said that if a women desires to see a king, she will have a son who becomes prosperous

etc. Indriyaarthaasthu yaan yaan saa bhokthum icchathi garbhinee, garbhaabaadha bhayaat

thaamsthaan bhishagaahrutya dopayet, saa praaptadowhruda puthram janayet gunaan

vitham, alabhdha dowhrudaa garbhe labhetaamani vaa bhayam yeshu yeshu indriyaartheshu

dowhrude vai vimaananaa, prajaayet suthasyaarthisthasminsthathendriye. The physician (who

wishes for the well being of the mother and the foetus) should satisfy all the desires of the

mother related to all the five sense organs. This is so because, the lady

whose dowhrudam (special desires) is fulfilled will beget a healthy child and if it is not fulfilled

either she or the child would be affected . The sense organs which are not satisfied during

pregnancy would result in some defect or abnormality (physical or functional) or the

corresponding organ in the child (Sus. Sam., Sha. 3/16-18)

Hrudayam does not literally mean the organ heat (which is defined as a hollow muscular

cone shaped organ). It is described as the seat of the mind, the objects of mind, sense

faculties, five objects of senses, consciousness and the soul together with its qualities

like happiness etc. (Cha. Sam., Sut. 30/3-4). Thus the presence of the garbha

hrudaya does not merely mean the formation of the organ-heart, but the individual

consciousness, its likes and dislikes which are manifested after

the chetna (consciousness/life) enters it in the fourth month.

Local Practices

There are various practices followed in the rural areas (including tribal areas), which have a

rationale in Aayurveda. Some of the practices that are followed during pregnancy have a great

significance. A few of them which are still in practice are listed below.

It has been observed in Bangladesh that sexual intercourse is discouraged in the last few

months of pregnancy - the reason given is that it may harm the foetus. A similar practice is

observed in other areas also. Sometimes, it is reported that the sexual intercourse in late

pregnancy is prohibited since "it would amount to incest, since the body of the child is already

formed. As we have mentioned earlier this practice is sound and aachaaryaas have proscribed

sex during pregnancy.

Woman is allowed to do her normal daily household chores and some specify that she should

not exert herself too much by carrying heavy loads or by running (8). Execessive hard work is

prohibitted for pregnant woman, because over exertion may lead to abortions or other

complications. Not doing any work is also not advisable as it would make the child dull and

sleepy. So it is best to resort to mild house work, which would not be so strenuous and would

also keep her active.

Lying on the back (supine position), carrying water from the well or peeping into pits and wells

are also prohibited. These are healthy practices and have a rationale. Lying on the back or in

supine position may cause the twisting of the umblical cord around the neck of the foetus,

carrying water can be tiresome work and also involves risk of slipping and falling down, which

are not good both for the woman and the foetus. The same reason can be given to the next

practice of "not-peeping into wells and pits" the risk is more in pregnant woman as their body is

a little more delicate also they may feel guiddy more easily than normal people, and so may fall

into pits or wells by accident.

Food restrictions are also followed meticulously and to many a modern investigator these do's

and dont's appear in-comprehensible. Among the advice on various prescriptions and

proscriptions, some are listed here. One basic advice is to avoid food in large quantities or even

over nourishing foods, the reason being "to avoid a large foetus resulting in a difficult delivery".

Excess of santarpana is not advised during pregnancy, hence this is a good practice.

There are also a number of foods that are to be avoided during pregnancy. Some of them are

pumpkin, banana, brinjal, gongura, guava and papaya. These foods were considered

too "ushna" (which may cause abortion) or very heavy to digest (straining her agni). Yet another

study in Andhra Pradesh (10) found that eggs were to be avoided. This again is "guru" and

in "aama" from, which may cause indigestion and formation of aama. These in turn may lead

on to aamaja garbha sravam (abortion due to aama). Some are of the opinion that eggs can be

given if the digestive power of the pregnant woman is good as per the dictum "Garbham

aamagarbhena" which means that the foetus can be nourished by other substances having the

same quality. By and large these practices are sound and are supported Aayurveda.

Therapeutics During Pregnancy

The physical and psychological disorders of a pregnant woman are no different from any other

individual as the doshasand dooshyas of the body remain the same. However, the principles of

management differ as teekshna, katu and strong medicines would harm the foetus. Thus the

choice of drugs for the disorders occuring during pregnancy should be restricted - they must

be mrudu (mild), sheetha (cold) madhura (sweet) and hrudya (pleasing). But when mother's life

is in danger then she should be saved by the use, if necessary of drastic measures and pungent

drugs, even if it may be harmful to the foetus (Ash. San. Sha. 2/62-63). If the disease is acute

and/or serious emetics can be given followed by the use of sweet and sour substances mixed

with anulomaka drugs (carminatives). All the pacifying drugs should be mrudu, (i.e.) mild and be

given along with food or drinks. In short, in the words of Charaka, the pregnant woman should

be treated with all the care as when carrying a pot filled with oil. Just as the slightest oscillation

of the pot causes spilling of oil, the slightest excitement to the pregnant woman can initiate

complications like abortion etc. (Cha. Sam., Sha. 8/22).

The treatment in a pregnant woman depends on the month of gestation as well as the severity

of the disease.

Conditions during Pregnancy and their treatment

1. Body pain and joint pain

2. Dizziness

3. Weakness (Paandu roga/anemia)

4. Nausea, vomiting, morning sickness

5. Swelling / oedema

6. Night blindness

7. Blurred vision

8. Worms

9. Piles

10. Constipation

11. Diarrhoea

12. Fever

13. Jaundice

14. Measles

15. Itching in the vulva

16. Excessive vaginal discharge (white/red)

17. Burning sensation while urinating

18. Convulsions

19. Pain in the abdomen

20. Head ache

21. Insomnia

22. Kikkisa (Striae gravidarum)

We have made an attempt to outline some of the most common conditions and diseases that

are encountered during various stages of pregnancy. We have also tried to give the causes,

treatments and preventive measures for the various conditions.

Some of the medications* which can be administered in the common ailments of pregnant

women

1. Body pain/Joint pain

External application of Dhanvantra thaila, Sahacharadi thaila, Visha garbha thaila, and

other Vaatha hara thailas is recommended.

2. Dizziness

The suggested medicine is the swarasa of shathaavari (Asparagus racemosa). However

it is essential that the root cause of dizziness should be detected and treatment given,

as it may have various causes, like paandu,general weakness or toxaemia.

The medications given here are based on the suggestions made by Aayurvedic

Vaidyas in a meeting held atAalandi (see Appendix II). The reader is advised to consult

an Aayurvedic Vaidyas, for any ailment. This is NOT meant to be used as a "manual" for

treatment.

3. Paandu rogaOne of major disturbing conditions during pregnancy is paandu, or anemia

during pregnancy.Aayurvedic aachaaryaas have recognised this condition and

prescribed adequate medication, also taking care not to cause any side effects which are

often seen during the administration of iron supplement in the form of ferrous sulphate

and folic acid. This iron supplement does not find a good compliance with the pregnant

woman as it increases the vomiting sensation and nausea and also causes constipation

in many women. To avoid such reactions it is advised to take the necessary iron

supplement in a form that is most suitable for her body and also in combination with

other drugs which help in controlling such reactions.

Some of the combinations in practice are:

a. Lohasavam with Draksharishtam (Draksharishtam acts as a mild laxative)

b. Dhaatri loha - In this preparation, there is lot of aamalaki (Phyllanthus emblica) which

controls the nausea and constipation. There is also some yashtimadhu (Glycyrrihiza

glabra) and guduchi (Tinospora cordifolia) which also help in alleviating the side effects

c. Punarnava mandooram - Punarnava (Boheavia diffusa) acts as diuretic and hence helps

to prevent any retention of urine or oedema which if often seen in pregnant woman

especially at the end of the second trimester and in the third trimester

4. Nausea and vomiting

All the classics have mentioned excessive salivation and nausea etc. morning sickness) as

symptoms of normal pregnancy. Sushrutha has included pregnancy also while describing

the nidaana of chardiroga (i.e). Vommiting. Madhukosha commentary says that vaayu being

pushed upward by foetus gets provoked and causes vomiting.

There are three specific causes for this garbhaja chardiroga

a. Vaatha Vaigunya

b. Dauhrida - avamaanana or non fulfillment of dauhrudya

c. Garbha nimittha or due to the foetus

Power of laaja (puffed rice) with honey can be given, as it is the best among anti-emitics.

However the cause for vomiting is to be checked, since vomiting may be a symptom for some

other disease.

5. Sopha (Oedema/Swelling)

This is another common condition. The treatment here is two fold - oral medication :

Decoction of roots ofvarshabhoo (Boheavia diffusa) mixed with paste

of devadaaru (Cedrus deodara) and moorva (Mardensia tenacissima) or only devadaaru with

honey can be given.

External application - Sudation/fomentation with hot water should be done. A paste

of chandana (Santalum album), madhuka (Glycyrrhiza glabra), usheeram (Vetiveria zizanioides),

naaga puspha, tila (Sesamum indicum), ajasringa, manjishta (Rubia cordifolia), root

of ravi and Punarnava (Boehavia diffusa), is beneficial

6. Night blindness

Flowers of agasthi (Agathi grandiflora) can be given. Nutritive food also should be given.

7. Blurred vision

This generally occurs as a secondary symptom in conditions of paandu, so it can be cured by

treating paandu.Some "Loha" preparation should be given.

8. Worms

Vidanga (Emblica ribes) in the dose of 3 grams with honey is suggested Pregnant women are

prone to have worm infestation because they have dowhrudya which often results in the desire

for mud, ash etc.

9. Piles

Untreated constipation may also be one of the causes for piles in pregnant

woman. Preparation likeAbhayarishtam and Dantyaarishtam are advised. If constipation is the

cause then it should be rectified. Siddha vaidyas advise Nathai odu bhasma or Nathai kari

lehyam (The preparations of snail shell and snail flesh)

10. Constipation:

Constipation is another common condition during pregnancy. If the constipation is

mild, draaksha (Vites vinifera) and dry rose buds can be given. If the constipation occurs due

to Udavartha during the eighth month of pregnancy and is not relieved either by use

of anuvaasana basthi(oils medicated with the drugs ofmadhurangana) or by intake of

substances which are unctuous and vaathahara, then it should be considered as

incurable. Nirooha basthi is given as a next step of treatment.

Constipation may be caused due to the iron supplement. So while administering any loha

preparation, we have to augment it with drugs or preparations which would prevent

constipation.

Udavartha is a variety of vaatha raga where in the vaayu (flatus), faeces and urine have

an upward movement (unlike the normal movement which is downwards0, this is due

to downwards), this is due to prathiloma (moving in the opposite direction) of vaatha.

This is generally caused due to vegadhaarana (control of urges)

11. Diarrhoea:

Diarrhoea or athisaara can be due to a number of reasons. This can be due to the use of

incompatible foods, eating before the digestion of the previous meal, over eating, indigestion,

vega dhaarana (control of urges), consumption of hard or solid substances (eg. seeds, uncooked

pulses and grains), excessives tharpana(satiation) and langhana(emaciation), eating uncooked

roots and tubers, polluted water, water, heavy andabhishyandhi dravyas, and also hunger, grief

or fear. In conditions of aama, paachana drugs (like Ashta choornam) should be given (Kas.

Sam., Khi 10). A decoction of bilwa (Aegle marmalos), mustha (Cyperus

rotundus), dhaanyaka (Corriandum sativum)and jeeraka (Cuminum cinimum)can be used.

12. Fever

This is the most troublesome diseases in a pregnant woman. The foetus is also affected due to

transfer of heat of fever from the mother to the foetus. Fever may be due to - excessive

hunger, exertions, abhyanga, massage, dryness, heat, retention of normal faeces, improper use

of snehana, swedana and agni karma psychological strain, climbing on mountains and smell of

grass and flowers (pollen).

Before the fourth month, the lady is advised a fast for one day (fasting is contraindicated in

pregnancy as a general rule, but during jwara (fever) it can be advised for a day), followed by

liquid diet (rice gruel) free from fat and salt. After the doshas have subsided, cereals with soups

should be prescribed. advised meat soups and milk. Pungent diet and drinks, exercise and

sudation should be avoided. No medicine need be given.

During and after the fourth month medicines should be given only after considering the month

of pregnancy and the doshas involved and their degree of vitiation. Lekhana karma and other

such measures which make the body light should be done after considering properly - the

complications of the disease, stamina and toleranceof the woman and the month of gestation.

A decoction of mustha (Cyperus rotundus), parpataka (Mollungo

pentaphylla), chandana (Santalum album) andsunti (Zingiber Officinallis) can be given.

For details on Aama please refer section on aama Chapters III, Aayurvedic Principles of

Food and Nutrition Part I, LSPSS Monograph II

14. Jaundice:

For treating jaundice the juice of bhooaamalaki (Phyllanthus nirun) with honey and sugar can

be given orguduchi (Tinosposa cordifolia), katuki (Pipcorrhiza kurrpa), chirata

(Swertia chirata) and daaruharidra (Berberis aristata) are given in the form of decoction.

15. Measles

A decoction of nimba(Melia azadirachta), dhaanyaka (corriandrum sativum), guduchi(Tinosposa

cordifolia) andpatola (Trichosanthus dioica) should be given.

16. Itching in the Vulva :

A paste of haridra (Curcuma longa), nimba (Azadirachta Indica) and chandanam can be applied

twice daily.

17. Excessive vaginal discharge

Some amount of discharge (Both as mucous and bleeding)is normal during pregnancy but when

it is recurrent and excessive, medical advice is to be taken immediately. The case for the

discharge should be properly investigated and required treatment should be given. The flowers

of silk cotton tree (Bombax malabaricum) should be fried in ghee and taken with sugar early in

the morning.

18. Burning sensation during micturition

Gokshuradi choornam with warm water, or just the decoction ofgokshura be should given.

19. Convulsion (aakshepa)

Convulsions may occur as a complication of garbhajanya vishamayatha. She should be given

internally, a mixture of lime juice, bida lavana (rock salk) and saindhava lavana or a decoction

of agnimantha (Premna latifolia) and varuna (Crataeva nurvala). It can also be treated

according to the doshic predominance In the later stages of pregnancy ghrutha seka (sprinkling

with ghee) is advised. The seka can be hot or cold according to the condition of the disease.

20. Pain in the abdomen

Pain in the abdomen may be to various reasons, the actual cause should be detected and

treatment given. The decoction of yashtimadhu (Glycyrrhiza glabra), shunti (Zingiber

officinale) and devadaaru (Cedrum deodara) can be given to give relief. If the pain is due to

accumulation of gas, then she is given garlic boiled in milk orHingwashtaka choornam orLavana

Bhaskaram. She can also use more of asafoetida in her diet to avoid accumulation of gas.

21. Headache

A paste of dhaanyaka (Corriandrum sativum) in milk is applied externally Here also the

causative factors should be detected and avoided.

22. Insomnia

Buffalo's milk can be given and externally abhyanga over the head can be done.

23. Kikkisa (Striae gravidarum)

Stiriae gravidarum is defined as the lines which appear on the abdominal skin, especially

around the umblicus due to the stretching of the skin caused by the growing foetus.

The Aayurvedic view is that the growing foetus displaces all the doshas upwards and reaching

the chest region produces burning and itching sensations. The result of this itching are the

linear lines on the abdomen. Internally she can be frequently given butter treated with

themadhura gana drugs, in the dose of 10 ml (approximately). Externally, the paste

of chandana (Santallum album) andusheera (Vetiveria zizanioides) or the paste of kutaja

bark (Holarrhena antidysentrica), seeds of arjaka (Orthosiplion pallidus), mushta (Cyprus

rotundus) andharidra (Curcuma longa) can be applied. Irrigation of the abdomen and breasts

should be done with decoction of patola (Trichosanthes dioica), nimba (Azadirachta indica),

manjishta(Rubia cordifolia) andsurasa (Occmim sanctum).

One should avoid scratching to avoid disfigurement of the stretching skin. If the itching

becomes irresistable then the powders ofkutaja, arjaka mustha, haridra, patola, nimba

manjishta, surasa etc. should be rubbed or paste of chandana should applied will suppress

itching sensation due to its coolness.

Local Traditions

It is interesting to note that rural and tribal people are not only competent enough in diagnosis

and care during pregnancy but are equally good in the management of diseases and conditions

during pregnancy. A comprehensive list of conditions encountered during the various stages of

pregnancy and their treatment have been given earlier. All the conditions (barring a few) are

managed by them with locally available drugs. While most of their practices are healthy and

should be encouraged, some are irrational and risky and should be discouraged. Some others

are interesting and need further study.

Oil massage and hot water bath is advised for body pain in Tamil Nadu, Kerala and Karnataka.

The report from Uttar Pradesh advises fomentation with hot water boiled with ajamoda (Apium

graveolens). In Gujarat it is reported that warm water with leaves of shigru (Moringa olifera) is

more useful. Dizziness and nausea are managed by oral administration of powder of dhanyaka

Corriandrum sativum) with sugar in Uttar Pradesh and Tamil Nadu. Similarly juice

of tulasi(Ocimum Sanctum) is also used with sugar. Lemon juice is widely used in Tamil Nadu

and Karnataka. Some people in Tamil Nadu also take ginger in the form of chutney.

Weakness and anemic conditions are managed by intake of powder of badam (almonds) with

milk. Ghee, milk, fruits and nourishing food is also advised. Decoction of cardomom seeds

andaniseeds, chutneys and pickles made of gigner, mint leaf and leaves ofthiruvatchi (Bauhinia

Tomentosa) were also given. Siddha Vaidyas prescribed the chutney made of thiruvatchi leaves

in conditions where the pittham is vitiated and also when there is nausea and anorexia (9).

Barley water and tender leaves of taadphal tree (Borassus flabelifer) with palm jaggery is

advised for oedema in Tamil Nadu. Both of them are mutrala (diuretics) and help to reduce the

fluid retention. For conditions like night blindness and blurred vision there were no significant

responses. In conditions of worm infestation the woman is given a decoction

of jyothismathi (Cordiospermum lelicacabum), in Tamil Nadu and Karnataka.

Piles was treated by intake of flesh of snails in Tamil Nadu. Siddha vaidyas widely used

preparations of the flesh of snail and the shell of snails. The general advise for relief from

constipation is to include green and leafy vegetables and fruits like plantains (8). While in parts

of Kerala and Tamil Nadu oral dehydration is resorted to in diarrhoea, in Tamil Nadu it was also

reported that milk boiled with garlic (in the form of lasuna ksheera paakam) is given. Also

butter milk rice is given and chillies and greens are avoided. Lasuna ksheera paaka acts as a

good aama paachana/ and agni deepana drug. The practice of avoiding chillies and leafy

vegetables is good.

Decoctions of Trikatu (Gingiber offcinale, Piper longum and Piper nigrum) and Tulsi are given in

Kerala and Tamil Nadu for fever.Jaundice seems to be very common and field groups were well

experienced in treating it.Bhooamalaki (Phyllanthus niruri) used in Tamil Nadu and Karnataka.

Also ghruthakumari (Aloe vera) and bringaraja (Eclipta alba) are used in Orissa and Tamil Nadu

Washing with salt water, decoction of haritaki (Terminalia chebula) or plain hot water is advised

for itching in the vulva in Kerala and Tamil Nadu. In Orissa it is advised to apply ghee locally. For

excessive vaginal discharge a decoction of ani seeds and tender coconut was advised in Tamil

Nadu. The woman was advised to drink barley water and decoction ofgokshura

(Tribulus terrestris), in conditions of burning sensation while

micturition. Gokshura being mutrala (diuretic) relieves the burning sensation.

Pain in the abdomen is teated by giving decoctions of dhanyaka or decoction of fresh ginger

with palm jaggery. Externally castor oil or coconut oil is applied over the abdomen. In cases of

head ache, a paste of tender coconut and breast milk is applied on the forehead in Kerala and

Tamil Nadu. The woman is advised to take more milk (preferably buffalo's milk) at night, apply

lime juices or oil on the head, in Tamil Nadu to get relief from insomnia. Buffalo's milk

being "guru" induces sleep. Applying lime juice and oil cools then system and induces sleep.

Abortion and Miscarriage

Every pregnancy does not complete the full term and result in the birth of a baby. The

pregnancy may be terminated in between due to various reasons. Termination of pregnancy

within the first three months after conception is called as abortion. In next three months it is

termed as miscarriage. After the sixth month it is called as premature delivery. The first signs

and symptoms for an abortion or miscarriage is bleeding and severe back pain. Thus a woman

should take medical advise, as soon as she has any of these symptoms.

When the pregnancy gets terminated and there is bleeding, it is called as abortion. This can be

caused due to a number of reasons, including the use of unwholesome food or improper

regimen. If the bleeding occurs during the second or third month of pregnancy, then the

pregnancy can not be stable because during this period the embryo lacks maturity. After the

fourth month this may not be very critical and one can maintain the pregnancy, despite

bleeding.

Garbha sraava/ Garbha paatha

The expulsion of foetus upto fourth month of pregnancy is termed as garbha sraava, because

the product of conception is in a fluid form. After the fifth and sixth months it is termed

asgarbhapaatha as by this period the foetal parts have attained some stability of have become

solid. The causes for these could be many, such as excess of-anger, grief, envy, jealousy, fear,

terror, cohabitation, exercise, jerk, suppression of vegas (manifested urges), improper food,

sleep and posture, hunger, thirst and intake of unwholesome food.

When this happens the following symptoms are manifested : pain in the uterus, sacral and

groin region and over the urinary bladder along with bleeding. The cause of the pain is the

vitiation of vaayu and the bleeding is due to expulsion of aama-garbha and opening of orifices

of aarthavavaha sroehases.

Treatment

As the Garbhopaghathakara bhaavas are ushna teekshna and saaraka in guna, the general

principles for treating abortion is similar to garbha sthaapaka aahaara, vihaara andaushadas.

Thus the treatment given is alwayssheetha, mrudu and sthambaka in nature.

1. Immediately after bleeding is noticed the mother should be advised to lie down in

slanting position so that her head is at a lower level and the leg at a higher level, on a

bed which is soft, cooling, comfortable and cooling

2. The entire body below the navel should be smeared with shathadowtha

ghrutha and sahasra dowtha ghruthaand sprinkled with cold (chilled) cow's milk,

decoctions of yashti madhu (Glycyrrhiza glabra) or nyagrodha (Ficua bengalensis).

3. Cotton swab dipped in milk or ghee boiled with the sunga (bud) of nyagrodha (Ficus

bengalensis).

4. A cotton swab dipped in ghee mixed with the powder of yashtimadhu (Glycyrrhiza

glabra).

Internally she can be given milk or ghee boiled with buds of nyagrodha (Ficus bengalensis) in a

dose of one aksha (12 ml) or even plain milk ghee.

Psycologically she should refrain from anger and sorrow. She should be entertained with talks

which are gentle and pleasing to her mind. She should further avoid exertion exercise and

cohabitation (Cha. Sam., Sha. 8/24).

Conditions when the abortion should be left untreated, to proceed

a. When the bleeding has been very severe and would have caused irrepairable damage. In

such cases even if the abortion is treated and stopped, there could be some

damage/deformity in the foetus, caused due to the acute blood loss.

b. If the bleeding is due to the factor which also causes the formation of "aama",

c. ** They are pippali (Piper longum), pippalimoola, cavya (Piperchaba), chitraka

(Plumbago zeylanica), shunti (Zingiber officinale)

Habitual Abortion

Some women have a tendency for abortion and the slightest of exertion and even normal

movements tend to cause abortion. In such cases, preventive medicines, aimed at treating the

cases of habitual or repeated abortion can be attempted.

The powder or paste of the following drugs should be used with milk in the particular months,

which would help the foetus to grow properly.

1. First month :

Madhuka (Glycyrrhiza glabra), shaakabeeja, payasya (Ipomoea paniculata) and

suradaaru (Cedrus deodara)

2. Second month :

Ashmantaka (Banuhimia malabarica),blacktila, taamra valli andshataawari

(Asparagousracemosa).

3. Third month :

Vrukshaadini, payasya, lata, utpala, andsaarivaa (Hemidesmus indicus)

4. Fourth month :

Ananta (Gardenia floribunda), saarivaa (Hemidesmus indicus), raasna (Pluchea

lanceolata), padma, madhuka (Glycyrrhiza glabra).

5. Fifth month :

Bruhatidwayam, kaashmari (Gmelina arborea), stem bark and leaf buds of latex

yielding trees and ghruta.

6. Sixth month :

Prishniparni (Uraria picta), bala (Sida cardifolia), or vacha (Acorus calamus),

shigru ( Moringa olifera)swadamshtraandmadhuparnika. (This relieves even very

severe pain).

Disorders Of The Foetus And Concluding Remarks

There are conditions in which, the improper diet and regimen of the mother, does not lead to

garbhapaatha or garbhasraava, but becomes a chronic disorder and causes some deformity or

intra uterine death at later stages of pregnancy. These are not very easily detected. Today we

come across, various conditions like uterine moles, tubal pregnancies, vesicular moles and

abdominal pregnancies Aayurvedic Aachaaryaas have described some conditions which have

very similar signs and symptoms, though there may be variance in the causes and pathogenisis

that have been described.

Signs and symptoms of abdominal pregnancy

Here is an exerpt from a obstetric book to show this point:

If the foetus dies after reaching a size too large to be absorbed it may undergo suppuration,

calcification, mummification or adipocere formation. When the gestation sac adheres to the

intestines, infection to the gestation sac and suppuration may occur. Eventually the abscess

ruptures and if the patient does not die from septicaemia foetal parts may be extruded through

the abdominal wall or more commonly through the bladder or rectum. In some, gestation may

go on to term when a spurious labour ensures and the foetus dies, the liquor gets absorbed and

the abdominal enlargement decreases. Mummification and formation of a lithopeodian

occasionally ensue and the calcified products of conception may be carried for years without

producing symptoms (6).

A few of such conditions are described below :

1. Garbha Shosha

Either due to non-availability of proper diet (nourishment to the foetus) or vaginal

discharges (bleeding) after conception the foetus may suffer from sosha (emaciation or

dryness). Such a foetus attains its proper growth or maturity after a long time and the

woman delivers it after prolonged delay.

According to Sushrutha, this is due to the affliction by vaayu - the foetus gets dried up,

does not fill the mother's abodomen properly and quivers very slowly. The symptoms of

this condition are as follows:-

1. The size of the foetus is small and underdeveloped

2. The quivering of the foetus is very mild.

3. The fetal heart sounds are also very mild.

Treatment

iv. The use of rooksha (dry) articles and those vitiating vaatha are to be avoided

v. Bruhmaneeya (anabolic) drugs, milk and meat soup should be used.

vi. Milk treated with madhuyashti (Glycyrrhiza glabra), fruit of kaashmari (Gmelina

arborea) with or without saareeva (Hemindesmus indicus) and mixed with sugar

should be taken.

Upavishtakam

After the fourth month of pregnancy (i.e after the attainment of saara by the foetus. If

due to the intake of pungent and hot (ushna and teekshna) aahaaras, the mother has

bleeding or any other type of yonisraavam (vaginal discharge), it may lead to the

improper growth of the foetus and the delay in delivery. This condition is termed as

Upavishtaka

Treatment

Ghruthas which are generally given to treat afflictions of bhutas (semi divine beings) are

prescribed o treat upavishtaka e.g. Vacha-ghrutha, guggulvaadi- ghrutha,

mahapaishachika ghrutha. Also ghrutha medicated with jeevaneeya, bruhmaaneeya,

madhura and vaathahara drugs can be given. Milk and meat soups medicated with the

above groups of drugs or just milk and meat soups can be given without medication.

Naagodara/Upashushka

If the woman observes fasts, eats stale food, does not take fatty or oily substances and

uses other vaatha vitiating articles, the foetus gets dessicated and does not grow. This

foetus remains in the uterus for a very long time and does not quiver. This entity is

termed as naagodara.

Treatment

The treatment for naagodaram is same as that of Upavishtakam.

Leena garbha

Due to obstruction in the srothases and due to vaatha the foetus becomes "leena"(clung

or adhered). This foetus remains in the uterus for very long duration and gives rise to

various complications.

Treatment

i. She should be treated with mild and predominantly unctuous sudation, emesis

and purgatives, because strong emetics etc. Are likely to harm the foetus.

ii. Bruhmana gruels should be given

iii. The women should be kept happy.

Concluding Remarks *

As we had already outlined in the earlier chapters the local communities appear to have a very

sound knowledge in the area of diagnosis of pregnancy. In other areas like the care of the

pregnant woman and management of diseases during pregnancy there is a wealth of

knowledge and several healthy traditions. However, knowledge is incomplete in some areas

and it can be supplemented by inputs from ISMs. Certain practices have been identified which

deserve to be investigated in greater detail.

However, it is most important that we need to examine and understand Lok Swaasthya

Paramparaas free of any biased ideas. There are still a large number of "educational" pamphlets

and material prepared by various government agencies that are now in circulation which reflect

a Western ethno-centric bias. Some of them label several of our peoples practices are

superstition, because of such a biased view point - namely the failure to look at the practices

also from the point of view of our own scientific traditions. For example a point of view of our

own scientific traditions. For example a pamphlet on Nutrition published by one of our

prestigeous research institution has devoted a chapter to "Care of the pregnant woman". It says

that - "There are other pregnant woman who believe that foods like egg, meat, pappaya etc.

are "hot" foods and causes abortion..... All these beliefs have no scientific basis"(13).

Such short sighted attitudes prevail not only among academicians and researchers but they also

seem to prevail among community health workers who presumably have a much more

thorough and intimate knowledge of local practices and customs etc. For example a well known

book that is meant to educate health workers states that "a lot of people believe that there are

many kinds of foods that will hurt them or that they should not eat when they are sick. They

may think of some kind of foods for "hot" sicknesses and "cold" foods for cold sicknesses. They

may also avoid some foods which they have "pittham" or they may believe that many foods are

for a mother with a new-born child. These beliefs may do more harm than good" (14).

The above examples have been good to illustrate the fact that all these evaluations and

educational material have been produced with a high degree of ethno-centric bias. It would be

necessary to rid ourselves of this limitation and understand these practices also from the point

of view of our own scientific traditions, if we are to build on the strengths of these practices.

Since the material is continued in Part II a detailed overall conclusion will be given later; only

some remarks are now presented.

Glossary of Technical Terms

Aarthava Menstrual fluid, also means the ovum

Aarthava vaha srothas The channels carrying aarthava

Aasthaapana Basthi Corrective or unctuous enema

Agni Karma Cauterization

Aksha A measurement of weight approximately

10 gms.

Anuvaasana Bashti Unctuous enema

Apaana Vaayu One of the five verieties of Vaatha

Apara Placenta

Basthi Enema

Basthi-sheersha Neck of the bladder

Beeja Ovum

Chardi Roga Vomiting

Chetna Life

Dowhrudya A state of having two hrudayaas

Garbha Foetus

Garbha paatha Abortion

Garbha sraava Substances and regimen which are

conducive to the growth of the foetus

Garbhaashaya Uterus

Garbhini Paricharya Care of the pregnant woman

Gothra Clan

Gyaanendriya Sense organs of perception

Jeeva Life

Karmendriya Organs of action

Kshaara Alkali

Kshetra Location (here means garbhashaya)

Kukshi Pelvic region

Kusha A variety of grass

Laaja Puffed rice

Langhana Fasting

Lekhana Karma Emaciation

Loha Iron

Maasaanumaasika Pathya Monthwise dietary regimen

Maithuna Sexual intercourse

Masthu The clear supernatant part of curds or

sour buttermilk

Nathai Snail

Ojas The final essence of dhaathus

Paachana Digestive

Pichu Tampon/douche

Prasava maarga Birth canal

Prasoothi Tantra Obstetrics

Pushya nakshathra The pushya constellation

Raktha mokshana Blood letting

Rasa Product of digestion

Rithu Menses

Rithu kaala Period of menstruation

Romaraaji The linear pigmented area stretching from

the umbilicus to the sumphisis pubis,

known as linear nigra

Saaraka Inducing flow or excretion

Sadyogruheetha

Garbha lakshanas

Immediate signs and symptoms of

pregnancy

Samprapthi Anabolic

Seka Sprinkling

Shaali A variety of rice

Shasti A variety of rice which grows in 60 days

Shonitha Blood or menstrual blood

Shukra Semen

Snehana Unction

Soothika Paricharya Care of the parturent

Swapna viparyaya Reversed sleeping habits

Swedana Sudation/fomentation

Tharpana Anabolics

Utkataasana Squatting posture

Vega Natural urge

Vidaahi Inducing burning sensation

Vyaktha Garbha lakshanas Positive signs and symptoms of pregnancy

Yukthi Reasoning