Antenatal n Postnatal Care in Ayurveda

Antenatal Care

Pregnancy and Motherhood in Ayurveda
Ayurveda places an enormous emphasis on the importance of caring for the mother before during and after pregnancy.

Dharma artha strishu laxmischa strishu lokha: prathishtitha: (CS, Cs 2/3)

“It is the woman who procreates children and propagates the human species. Dharma (righteousness), artha (wealth), lakshmi (auspiciousness), and loka (the entire universe) are represented in every woman.” (CS, Cs 2/3) Ayurveda regards the woman and her ability to produce and care for children as the basis of family life which, in turn, is the very foundation of society. Therefore, only if the women of a society are safe, protected, and content can these qualities manifest in that society.

Bijatama karma mahabhutow:sukshamai:satwanugaischa sa:

Ayurveda prescribes specific nutritional measures for the growth and protection of the woman to keep her vital and pure. 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. Guidelines for correct sexual intercourse are also generally outlined. Young women less than sixteen years of age and boys under twenty should not bear children. Nature does not support pregnancy nor family life begun during the brahmacharya period (student years, ages birth to 20).The general rules of pre-natal care are also given and are perhaps the most provocative of all. The husband, parents, siblings, and other family members are advised to oversee the pregnant woman's diet and encourage activities that are healthy and enjoyable to her and beneficial for the child developing in her body. Similar to its strategy to promote longevity, the Ayurvedic approach towards motherhood, that is pregnancy and childbirth, is indeed a holistic one. Ayurvedic recommendations touch upon the diet, behavior, activities, and even the spiritual actions of not only the mother but the

Antenatal Care According to Modern Science:

Antenatal care is the systemic medical supervision of women during pregnancy. Its aim is to preserve the physiological aspect of pregnancy and labour and to prevent or detect, as early as possible, all that is pathological. Early diagnosis during pregnancy can prevent maternal ill-health, injury, maternal mortality, foetal death, infant mortality and morbidity. Hence, the earlier in pregnancy a woman comes under the supervision of an obstetrician, the better.

Antenatal care begins with 'history-taking' and is followed by a complete examination of the patient. Thereafter, the mother-to-be receives advice and instructions about her mode of life, diet and regular antenatal check-ups till labour sets in. The obstetric history begins with the age of the mother and includes information about the number of years since marriage, number of pregnancies, previous deliveries, abortions, pre-term labour, complications during previous pregnancies or labour, etc. Difficulties in previous deliveries, application of forceps, caesarean births and the birth weight of former children is also important.

The date of the last menstrual period and the duration and frequency of normal menstrual cycles as also the calculation of the expected date of delivery is done at this stage. The due date is calculated by adding nine months and seven days to the first day of the last menstrual period.

A general history is necessary and asked for regarding the occurrence of any illness in the past - German measles, rheumatic fever, tuberculosis, and psychological disorders. A family history of diabetes mellitus or hypertension is also enquired into.

The wisdom regarding the general management of pregnancy is found in both the Charaka and Sushruta Samhitas under the subject of “Garbhini Vyakarana”. There are separate chapters for general management, specific management, diseases in pregnancy and their treatment and many other practical pieces of advice . Guidelines regarding diet, activities, behavior and mental activity (ahar, vihar, achar and vichar, respectively) are also detailed.

The physician is cautioned to be very vigilant during the management of pregnancy. “If a cup filled with oil right up to the brim is to be carried without spilling even a single drop, every step has to betaken with care”. (CS Cs 8/22) Ayurveda advises the same degree of care and attention in the management of a pregnant woman.

The goal is the protection and nourishment of both the growing fetus and the mother.
The concept that improper decisions and lifestyle are responsible for the genesis of disease is a well-known Ayurvedic idea. Crowded urban living in particular has been cited in the Charaka Samhita as causing disease and shortening lifespan. (CS Cs1/1) From the moment the pregnancy is confirmed, the woman is counseled to follow certain guidelines of living. The Ayurvedic physician gently offers supervision from the very beginning, even before the actual conception of the child, so that the pregnancy can terminate in a normal delivery after a normal period of gestation. Especially when she approaches full term, critical care is necessary as “one foot is considered to be in this world and the other in the world of Yama” (the god of death). Complete and healthy delivery includes delivery of the placenta. If the delivery is not complete and normal, the woman is likely to be affected by one or the other of a list of 64 maladies, which are describes in detail in Garbhini

Vyakarana.
For a couple to produce healthy offspring, both the partners should be careful about their diet, activities, behavior and emotional status before as well as after conception. One has to keep this in mind throughout the pregnancy.
which are described in detail in Garbhini Vyakarana

Garbhini Pratham diwasatprabutha nityam Praharsha…..(Su.Sha.10./2)

In Astanga hrudaya Garbhini paricharya is described in detailed manner….Acharya explains, Garbhini from the first day after the conformation of pregnancy should be happy,clean ,With out makeup, She should wear white clothings,she should be calm and every day she she do pooja and read some good books.Shoud not touch any dirty things and should not see any obscene things.

She should not talk at very high peech and laugh loudly and should not sleep uneven places .should take proper diet which includes snigdha, drava, hrudya Ahara.

Diet during 1^st, 2nd and 3^rd month of Pregnancy:

Visesha astu garbhini Prathama dwithya tritiya masesu madhura Drava ahara samupucharayet,…………(Su.Sha.10/3sh)

1^st & 2^nd month…..Should have Drava, shitha, Madhura ahara.

3^rd month……. sastikha odana payasa bojayeth

4^th month……..dadhana

5^th month…….payasa

6^th month……..sarpisha….

From 4^th month to 7^th month Diet And regimen to be followed :

Chthurte pyonavneeth sansrustha……..(su.sha 10c/3s)

5^th month….dugdha +Sarpi+Anna

6^th month….shawa danstra +anna or yavagu pana

7^th month…..pruthak parnayadi yuktha gritha pana

Asteme badarodakena balatibala.shata puspa payo dadhimastu taila madana phala Gritha mishrena asthapyeth…….Su. Sha 10c/5ths.

Thatha:payo madhura kashaya siddhyena anuvasayeth……Anulomahi vayu sukham prasruyeth niraupdrava cha bhavathi…….. Su. Sha 10c/5ths

About antenatal care

Once you know or suspect that you are pregnant, you should make an appointment with your GP to discuss your antenatal care. Your GP may test a sample of your urine to confirm that you are pregnant. However, you may not need to have another pregnancy test if you have a positive result from a home test.

Your GP will refer you for your first appointment, or "booking" appointment. This could be at a hospital, at your GP surgery, in a clinic or at home.

Arrangements for antenatal care vary but the National Institute for Health and Clinical Excellence (NICE) recommends that healthy women have up to 10 check-ups for a first pregnancy, including the booking visit. You will probably need about seven appointments if you have already had a healthy pregnancy.

First antenatal appointment

The first antenatal appointment is sometimes called the "booking appointment".

This should be as early as possible and before 12 weeks of pregnancy.

You may see a midwife, a doctor, or both. They will talk to you about your health and previous pregnancies, to find out about your needs.

You will be advised to take a daily supplement containing 400 micrograms (0.4mg) of folic acid. This reduces the risk of your baby being born with a neural tube defect, such as spina bifida. You may need a higher dose if you have a family history of spina bifida, or if you take medicine for epilepsy.

Your midwife or doctor will also take some blood samples for testing. This is to check whether you have any conditions that may affect you or your baby's health. These tests include:

• your blood group
• your rhesus (RhD) type - your blood is either rhesus positive or rhesus negative - women with RhD-negative blood are usually offered injections at 28 and 34 weeks to help prevent problems with the baby in future pregnancies, such as anaemia, jaundice or stillbirth
• a test for anaemia
• routine tests for infections that can affect you or your baby, such as hepatitis B, syphilis, HIV and bacterial infections
• your immunity to rubella (german measles)

Your midwife or doctor will measure your height and weight, and work out your BMI (body mass index) once - usually on your first antenatal appointment. If your BMI is under 18 or over 35, you may need extra care.

Your blood pressure and urine will also be tested. Most women don't need to have a vaginal or breast examination.

Dating scan

You will be offered an ultrasound scan called the dating scan between 10 and 13 weeks to estimate when your baby is due. This is known as your estimated due date (EDD). The scan also tells you whether you are expecting more than one baby.

Additional antenatal appointments

At each antenatal appointment after your booking visit, your midwife or GP will measure your blood pressure, and test your urine for infection and the presence of protein. Protein in the urine and raised blood pressure are signs of pre-eclampsia, which can be harmful to both mother and baby. You will be offered another blood test for anaemia at 28 weeks.

As your baby grows, your womb (uterus) rises out of your pelvis and becomes the "bump". The top of this is called the fundus. Your GP or midwife will measure the height of the fundus to check how your baby is growing.

Your midwife or GP will ask about your baby's movements and try to find out the position of your baby by feeling your abdomen. Towards the end of your pregnancy, the baby's head usually drops down in the pelvis into a position ready for delivery (when the head is said to be engaged). The head may not engage until labour starts if you have had a baby before.

Your baby's heartbeat won't be routinely checked but some women ask to listen to it. Your midwife or doctor may put an ultrasound listening device on your abdomen to make the heartbeat sound louder.

Postnatal care

This phase is called the Sutika period - a term derived from the word prasuta or the mother after delivery. There are different opinions about the duration of this period, which ranges from six weeks to six months and some believe that it lasts until the restoration of menstrual cycle.

A special diet plan for the prasuta is recommended for this period to make good the loss of the reproductive fluids, dhatus and blood during the pregnancy and delivery. The prasuta should consume light yet nourishing food during the sutika kaal.

In the first week of the Sutika Kaal special care should be taken for Lochia- (accumulation of abnormal blood in the uterus). The vagina should be cleaned twice daily with medicated lukewarm water. Use of medicated jaggery water is also recommended for three to four days.

The body of the sutika especially pelvic region and thighs and the parturient canal should be massaged regularly with warm mustard oil, at least for of thirty days. After the body massage the stomach should be wrapped tightly with large piece of clean cloth. The wrapping helps in compression of the abdomen and it avoids the presence of hollow space in the abdominal region thereby obviating the possibility of vata vitiation. The massage should be followed by a bath with sufficient amount of lukewarm water.

In the sutika period the head of the prasuta should be properly covered and care taken to avoid her contacting the cold air. Light physical exercise is suggested in this period, however care should be taken to avoid physical stress and fatigue. She should not indulge in sexual activity during this period.

Proper adherence to this regimen results in faster recuperation and restoration of the health of the mother. Adequate care and precautions along with the prescribed regimen ensures that the mother regains her physical charm and maintains a beautiful figure and retains health just akin to that of her pre pregnancy days.

Ayurveda says that After Delivery mothers Agni will be low and vata is viciated immediately after delivery.

Aims of Postnatal care:

1.To restore the agni.

2.Normalize the vata.

3.Optimize the quality of Breast milk.

4.to avoid exerction

5.Diet should be very light.

Thus here to calm the vata which is viciated oil massages are recommended.