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Microsoft word - management of antenatal care with yoga and ayurveda.docxMANAGEMENT OF ANTENATAL CARE WITH YOGA AND AYURVEDA
Every human being on the planet is concerned with the process of birth. It is a sign of new beginning and growth and perception of soul (atma) or god. But the process is painful and consists of Tapa sadhana (patience and perseverance) for almost a year and nursing and upbringing for couple of years ahead. Hence every science, tradition, therapy has tried to make the process safe, less painful, and successful. The management of physiology, psychology with medicinal and non medicinal ways to achieve healthy mother and foetus is called as Antenatal or prenatal care. Yoga and Ayurveda being the ancient scientific medicinal systems of the world have a significant contribution in the field of Human reproduction. And after thousands of years the principles are constant and still can be utilized to find solutions to the increasing problems connected with the future The foeus is called as Garbha and it consists of anga-prtyanga(organs and systems) mana(mind) and Soul(atma).The woman carrying the garbha is garbhini (pregnant lady) and the care taken by the relatives,herself,doctors and paramedics is called as Garbhiniparicharya(antenatal care)in ayurveda. 1.Aims and Objects of garbhini Paricharya(antenatal care)
The expectant woman needs proper care and management of her body, mind and soul, her diet, habits, exersice. Pari is surrounding and charya is the guidelines to be followed or management to be done.Ayurveda advocates the dietary regimen, exercises, psychological counseling, dos and don’ts in the In ayurvedic manuscripts the aims and objectives of the Antenatal care is explained as 1. Paripoornatva (proper growth of the foetus and mother) 3. Sukhaprasava (for normal healthy delivery of foetus and wellbeing of both mother and foetus) Development of Garbha according to Ayurveda
In the ancient manuscripts of ayurveda, in the Vedic scripts like garbhopanishada, complete development of garbha i.e. foetus is explained. When this particular medicinal system was prevalent on the earth the modern gadgets like stethoscope, ultrasonography were unavailable. Explanation of how different organs developed, mind and intelligence was created inside the body was based on The events in the foetal development according to Ayurved is summarized as follows- GHANA,PINDA,PESHI(SOLID MASS WITH SHAPE) SARVA INDRIYA AND SARVANGA AVAYA(MINIATURE FORM OF FOETUS) CHETANA,MANA,MANSA SHONITA UPACHAYA(DEVELOPMENT OF MIND,MUSCLE ,BONE DEVELOPMENT) SARVANGA POORNA(COMPLETE ANATOMICAL DEVELOPMENT) OJA SANCHARA(INSTABILITY DUE TO OJA MOVEMENT FROM MOTHER TO FOETUS) POORNA NIRMANA(COMPLETE MATURITY AND READY TO DELIVER) Integration of Yoga and Ayurved and Antenatal care by modern medicine
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 foetal surveillance, examination of the vital parameters of the woman like weight, cardiac activity, systemic examination.Foetal surveillance is performed by clinical examination like foetal heart sound, investigations like ultrasonography,color Doppler etc.The medicines given are mainly iron calcium and multivitamin supplements for the prophylaxis of anaemia and for proper foetal growth. The diet and exercise are also advocated in the modern day antenatal care. Besides there is a big emphasis on the management of the pathologies evolving in the pregnant woman and the foetus in the utero. Now looking at the incidence of congenital anomalies, teratogenic complications, and unexplained feotal deaths, rising rate of pregnancy induced hypertension and related complications it can be concluded that a proper support of alternative systems of medicine is needed in the management of such unsolved questions. According to sushruta samhita one cannot completely cure a patient or treat a disease by using one pathy;on the contrary on must be well versed about different systems of medicine and use them prudently for the benefit of the patient. This is the very fundamental principle behind the integrated management of the pregnant woman and pregnancy. 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 lady 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. This increases the flow of oxygen reaching to the foetus and thus helps in the foetal growth.Pranayama techniques also lead to increase in the breath holding capacity of the lady during delivery. Diet recommendations according to Ayurveda. Milk with honey and ghee, olio prepared with rice and pulses Medicated cooked rice, milk with butter. Rice gruel, sweet rice, cooked rice with meat Ghritakanda,ghee with vidarigandha group Rice gruel with milk an ghrita,meat soup Meat soup with cooked rice gruel with ghee. General guidelines for diet in pregnancy according to Ayurveda 1. Diet should be wholesome, congenial and freshly cooked. 2. Pregnant lady should eat the food with full concentration and with affection towards the 3. She should always use ghee, butter and milk in her diet. 4. She should take the diet according to her digestive capacity and season, the place of living. 5. Dauhrida is a unique concept of Ayurveda.Dau means two and hrida means the heart. Due to the presence of the foetus there are two hearts in the body of the lady. The foetus 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 foetus.hence fulfillment of the daurida is helpful for the proper The stalwarts in the ayurveda mention that following the dietary regimen properly leads to the excellent nourishment of the foetus, good balance of the physiology of pregnancy and hence Dos and Don’ts in the lifestyle of the Pregnancy
Dos and Don’ts in the lifestyle of the Pregnant Lady are as follows- She should remain in high spirit of mind. She should make an attempt to cope up with She should wear clean garments and decorated ornaments She should perform religious and auspicious deeds and worships. She should donate either money or some goods. This generates proper energy to the foetus. Her sleeping and sitting place should be covered by soft cushion., not to high, Sanskara is the Sanskrit word meaning transformation.Garbha is the foetus.According to Yoga and Ayurveda it is said to be the combination of shukra (male gamet), artava (female gamet) and Jeeva i.e.soul.There are many factors responsible for the development of the garbha like Matruja (maternal), pitruja (paternal), satmyaja (acquired) etc.They are dependent on the lifestyle, food taken by the parents in the life time. But there are certain aspects of garbha which come along the Jeeva like mana, anhakara, Swabhava etc.which are beyond control of the human beings. They are related with the metaphysical aspects of the life. They are mostly concerned with the things performed by that particular Garbhasanskra aims at transformation of physical and metaphysical aspects of the garbha.It will definitely make a child of the required nature; mentality and intelligence. The Yadnya (holy fire with chanting of mantras) performed in the Sanskara remove the bad energies and bring the positive force in Pranayama, Omkara, Mantras, Upanishadas, various classical ragas, any good pleasant music, and stories told to the garbha, talking to the garbha; all these things will definitely minimize the untoward effects of the pollutants, bad energies, lifestyle effects etc.Moreover it will develop a bond of affection between the parents and the baby. The Sanskara explained in the manuscripts use certain herbs which are potent Garbhasthpaka (maintain pregnancy).There is good social gathering which maintains the mood of the pregnant lady. This elevated attitude helps for secretion of proper enzymes and hormones required for the foetal growth. Moreover Foetus will also get a positive social environment since its intrauterine life. Ayurvedic Medicines to be utilized in the stage of pregnancy
Ayurved manuscripts have indicated use of certain herbs having medicinal properties in the diet as well as in the form of regular medications. Certain group of herbs is indicated to be potent in checking the bleeding in the concerned month of pregnancy (antihaemorragic activity).The list is given below in the tabular form. Moreover many herbs are indicated to be utilized in the form of medicines against certain diseases in the pregnancy stage like hyperemesis gravidarum, anemia, edema etc.The TAPYADI LOHA,MANDOORA BHASMA,NAVAYASA CHOORNA, Preferably in the first trimester of pregnancy, use of drugs containing metals should be avoided. It can lead to teratogenic effects on the foetus.The daily requirement of iron, calcium, and essential minerals can be fulfilled by utilizing ayurvedic medicine. In my practice as obstetrician for last 10 yrs and data of more than 500 patients, we are successfully performing antenatal management only on the basis of ayurvedic medicines. We are sometimes utilizing antibiotics or tocolytic drugs in the acute stages. The chart of routine regimen of drugs used in the pregnancy is as follows- TAPYADI LOHA,MADHUMALINI VASANT,,SHATAVARI KALPA TAPYADI LOHA,MADHUMALINI VASANT,SHATAVARI KALPA Role of Panchakarma in Pregnancy
Panchakarma is unique treatment modality of Ayurveda.In this therapy the disease producing ailments of the body are removed outside the body through nearest route (shodhana).Manuscripts of Ayurved have advocated indications and contraindications of these procedures. 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 panchakarma suggested in the Antenatal period are as 1. Nasya-It is a procedure in which liquid or powders of the dravya (herbs) are administered
through nasal route. It is utilized for the garbhasthapaka (maintenance of pregnancy).It is called as Poosanvahana sanskara.The 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. Abhyanga-sanvahana-It is the poorva karma (to be performed before any panchakama).It is
nothing but the application of oil to all over the body and specific points. It is potent vatashamaka (pacifier of vata).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 3. Basti-Basti is nothing but medicated enema. It is either of oil (sneha) or decoction (kwath) in
type. Bye and large Basti is contraindicated in pregnancy. The simple reason is as it removes the dosha through anal route, it can trigger the contractions. But Sushrita has advised to administer the Matrabasti (using oil of very less quantity-60 ml) in the last trimester precisely in the 8th month of pregnancy. It is written in the texts that this basti pacifies the vitiated Apana Vayu.In this stage of pregnancy the large area of the abdomen is occupied with the gravid uterus and large intestines are practically collapsed. Therefore the large intestines harbor dry stools which can generate toxins in this area. The matrabasti 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 foetus.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 foetus. 4.Yoni Pichu-It is cotton tampon 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 vatashamana(pacification of vata),lubrication which felicitates for the normal healthy labour. Hence it can be well concluded from the cusory study of the antenatlcare explained in the 1. Ayurveda and Yoga have a significant role to play in the management of pregnancy and care 2. Paricharya is an unique concept of ayurveda. 3. Panchakarma and garbhasankara are helpful in prevention of congental anomalies and metabolic disorders,and life threatening complications related to pregnancy.
COMMONWEALTH OF PENNSYVLANIA DEPARTMENT OF PUBLIC WELFARE XXXXXXXXXX W05-2989/922 6/29/2005 7/27/2005 AND NOW , after careful review and consideration of the Recommendation of the Administrative Law Judge, it is hereby ORDERED that the Recommendation be adopted in its entirety. Either party to this proceeding has fifteen (15) calendar days from the date of this dec