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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