Prenatal Care in Ayurveda
Women Health Series IV
The management of physiology, psychology with medicinal and non medicinal ways to achieve healthy mother and fetus is called as Antenatal or prenatal care. The management of pregnant lady and pregnancy according to modern science is based on the supervision of the physiology of the pregnancy.
According to WHO, it consists of proper intrapartum fetal surveillance, examination of the vital parameters of the woman like weight, cardiac activity and the systemic examination. Fetal surveillance is performed by clinical examination like fetal heart sound, investigations like Utrasonography, Colour Doppler etc. The medicines given are mainly iron, calcium and multivitamin supplements for the prophylaxis of anemia and for proper fetal growth.
Ayurveda places an enormous emphasis on the importance of caring for the mother before, during and after pregnancy. Yoga and Ayurveda being the ancient scientific medicinal systems of the world , have a significant contribution in the field of human reproduction. Aim of prenatal care by Ayurveda aims to achieve proper growth of the fetus, uncomplicated pregnancy, normal healthy delivery of fetus and wellbeing of both mother and child.
In one of its most famous teaching analogies, Ayurveda compares human 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, an embryo (garbha) is created. Ayurveda gives great importance to the quality of the seed (ovum). In addition to the female seed, the mother also provides the ‘ideal terrain’ (i.e. the uterus) into which the seed is to be planted. Young women less than sixteen years of age and boys under twenty should not bear children.
Ancient Indian medicine has recognized the need for the mental, spiritual and physical preparation of the women expecting to conceive. Ayurveda suggests procedures and medicines for the preparation of the couple planning pregnancy, three months prior to conception.
Procedures and herbs for the purification of the gametes (sperm and ovum) is the first step. This includes methods for achieving a healthy state of mind. If the couple is not in a state of mental stability and calmness, even if they are physically fit, they cannot give birth to a healthy child.
Ayurveda prescribe a particular daily practice for the pregnant woman. Along with the prescription for diet, Yoga and routine body care, instructions are also given for reading material, subjects of discussion, and music to be listened to etc. Thoughts and feelings of the parents affect the baby. According to Indian philosophies, even before the thought is expressed, it remains in an unexpressed form in the deeper levels of consciousness. From this moment onwards thoughts of mother can reach fetus.
Prenatal care by Ayurveda
This is achieved through three stages
- Treatment procedures
- Herbs for purifying male and female gametes
- Providing mental calmness for achieving conception.
In this stage general and specific medical advice is given to correct any conditions which may affect production of healthy sperm and ovum. Proper advice is given to the couple and relatives to provide and sustain a healthy and calm environment.
Procedures and advices for keeping mother and foetus healthy.
During pregnancy, mother may have different health problems. Ayurveda describes nine diseases, which are caused because of the pregnant status of the woman. These diseases are peculiar to pregnancy and are called garbhopadravas. They are nausea, anorexia, vomiting, and dryness of mouth, fever, edema, anemia, diarrhea and retention of urine. Their specific treatments are also elaborately described.
Any disease occurring in a pregnant woman should be treated with drugs that are mild in action, compatible and safe to the fetus. Pancha karma (detoxifying procedures) should not be advocated, except vasthi (enema) in the eighth and ninth months of pregnancy.
Each of such situations should be carefully managed with safe medicines suggested by a qualified Ayurvedic doctor.
General advices for pregnant
It is advisable for the pregnant woman not to watch films depicting scenes of horror, murder, and violence. It can produce negative effect on the child’s character in future. During pregnancy she should keep company only with people who have a favorable influence over her. She should read fine literature, look at the beautiful works of art, listen to soft music, contemplate pleasant landscapes and have only positive and constructive thoughts.
Visiting lonely places, going to riverbanks alone, thoughts and disputes which provoke anger can harm both mother and the fetus and should always be avoided. Looking at the setting sun, stars, solar and lunar eclipses are contraindicated during pregnancy
Eat food that is mild, easy to digest and maintain regular meal timings. It is better to avoid spicy foods, sexual intercourse, heavy exercises, fall or trauma, weight loss programmes, negative feelings, difficult postures like balancing on one leg or squatting and exposure to unhappy or violent events.
A pregnant woman should take natural supplements like grapes, dates and sweet herbs with milk.
Have milk mixed with the above-mentioned natural supplements.
Have the same sweet natural supplements, but now mix them with milk, honey and ghee.
Continue taking the same sweet supplements with milk. This time replace ghee with butter [12 – 15g]made from milk.
Continue the supplement regime of the fourth month. Oil application and gentle massage followed by a bath with lukewarm water is recommended. Continue this till delivery.
Continue the supplement regime of the fifth month.
Mothers-to-be may feel an itchy sensation on the breast and abdomen or a burning sensation in chest or throat due to increased size of fetus.
Eat food in smaller quantities, frequently, and a bite of sweet something with a little ghee or oil that is easy to digest. Ensure that your salt intake during this period is reduced to a minimum. Also, avoid drinking water immediately after a meal.
Eat rice prepared with milk in semi-solid or liquid form with ghee.
Follow the same diet as in the eighth month. Meat soup with cooked rice gruel with ghee.
Concept of Twin heart state or Dauhrida during pregnancy
Dauhrida is a unique concept of Ayurveda .Dau means two and hrida means the heart. Due to the presence of the fetus there are two hearts in the body of the lady. The fetus expresses its desires of the food through mother. Hence sometimes woman expresses desires which are not indicated to be consumed in the pregnant stage. But Ayurveda advocates that such desires if expressed by the woman are to be fulfilled by the attending relatives. As this desire is indicative of deficiency of that property of the material inside the body of the fetus .Hence fulfillment of the daurida is helpful for the proper growth of the foetus.
Caring to provide a normal delivery.
Apply oil on the abdomen and genital areas.Take an oil enema in small quantities to help ease false labour pains. You can even insert cotton ball dipped in oil into the vagina to lubricate the passage. Be particular about maintaining hygiene to avoid infection, which cause itchiness or swelling of the genital area.
Yoga, Pranaayama and meditation techniques
Yoga postures commonly called as ASANA lead to strengthening of the muscles and ligaments and help to maintain their elasticity. This is very important for proper fetal blood circulation. Moreover the strength of the pelvic floor is very important for the bearing down effort of the mother during delivery.
Pranayama is the breathing technique. It is helpful in making the use of total tidal volume of the lungs as it is reduced in pregnancy due to the pressure of the diaphragm from below due fetus. This increases the flow of oxygen reaching to the fetus and thus helps in the fetal growth. Pranayama techniques also lead to increase in the breath holding capacity of the lady during delivery.
Diet recommendations :
Ayurveda strongly advice that strict follow of the dietary regimen leads to the excellent nourishment of the foetus, good balance of the physiology of pregnancy and hence uncomplicated pregnancy and delivery.
Mental calmness and stability need to be preserved throughout the pregnancy period. These qualities are the manifestation of “Sathwa Guna” of mind. It is closely related to ones food habits and many other factors. Abstinence from spicy foods and addictive substances is advised to keep this guna up.
General guidelines for diet in pregnancy according to Ayurveda
- Diet should be wholesome, congenial and freshly cooked.
- Pregnant lady should eat the food with full concentration and with affection towards the fetus.
- She should always use ghee, butter and milk in her diet.
- She should take the diet according to her digestive capacity and season, the place of living.
Role of Panchakarma in Pregnancy
Panchakarma is unique treatment modality of Ayurveda. Ayurveda have advocated indications and contraindications of these procedures Every procedures of this modality is useful prior to conception. But during child bearing phase it is contra indicated except 8th and 9th months. In the antenatal period very few such procedures are indicated. Pregancy being a stage holding two lives strong panchkarma procedures are not advised in this stage. The suggested treatment procedures in the Antenatal period are as follows:-
It is a procedure in which liquid or powders of the dravya (herbs) are administered through nasal route. It is utilized for the maintenance of pregnancy. It is called as Pumsavana sanskara. Here suitable kwatha (decoction), swararasa (juice) or Ghrita (medicated ghee) is administered through nasal route. It is absorbed through the nasal mucosa and acts on the endocrines to release the hormones which maintain the pregnancy.
2.External application of medicated oil:-
It is helpful for the proper circulation of blood especially stagnated blood in the extremities. It improves the tone of the muscles. The joints especially the knee joint, hip joint, sacroiliac joint are very much painful in this stage. Hence abhyanga is very helpful in properly lubricating the joints and maintain their health.
Vasti is contraindicated in pregnancy. The simple reason is as it removes the dosha through anal route, it can trigger the contractions. But Aacharya Sushruta has advised to administer the Matravasthi (using oil of very less quantity-60 ml) in the last trimester precisely in the 8th month of pregnancy.
Ayurvedic classics suggests that in the stage of pregnancy the large area of the abdomen is occupied with the gravid uterus and large intestines are practically collapsed. This affect functioning or normal physiological movements of Apana Vayu. Therefore the large intestines harbor dry stools which can generate toxins in this area. . The matravasthi lubricates the area, softens the stools. The evacuation of the intestines can play very important role in the expansion of the gravid uterus which is very helpful for the growth of the fetus. Moreover the lubrication of the area is helpful for the smooth generation of the contractions and favorable outcome of the pregnancy i.e. healthy mother and fetus.
4.Yoni Pichu :-
Sterilized cotton soaked in either kwatha (decoction),taila (oil) or ghrita (ghee).It is advised to keep such pichu in the vaginal tract of the pregnant woman so as there is local vatha samana(pacification of vatha),which felicitates normal healthy labour.