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Some
common diseases found in women
Pregnancy
& Motherhood
Ayurveda
describes "safe motherhood" Thus, "Motherhood
is the basis of family life which, in turn, is the backbone
of all the orders of society. Hence, family life remains protected
if the woman is safe and protected."
This
great science compares 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,
it becomes an embryo (garbha). Ayurved gives importance to
the quality of the seed and hence, to the development during
adolescence, of both the male and the female. In addition
to the female seed, the mother also provides the 'soil, nutrition
and the right season' for the seed to grow. Hence, Ayurved
advises special attention to be paid to the nutrition and
protection of the woman to keep her (the soil) rich and clean.
It further advises that a female under sixteen years of age
and a male under twenty should not bear a child. The rules
of sexual intercourse are also laid down. So also, those of
antenatal care: the husband and other family members are advised
to take care of the pregnant woman's diet and encourage activities
that are dear to her and beneficial to the foetus or child
growing in her body. Thus, the approach towards motherhood,
that is pregnancy and childbirth, is a holistic one. Such
concepts are excellent, but the question is are they practiced?
In fact, it needs thorough introspection on our part to find
out why this approach was abandoned.
Garbhini
Vyakaran
Ayurved
describes the general management of pregnancy under Garbhini
Vyakaran. There are separate chapters for general management,
special management, diseases in pregnancy and their treatment
and so on. Rules concerning diet, activities, behavior and
mental activity (ahar, vihar, achar and vichar respectively)
are also laid down. The physician is cautioned and advised
to be very careful about the management of pregnancy: if a
vessel filled with oil right up to the brim is to be carried
without spilling even a single drop, every step has to be
carefully watched. The same is the case in the management
of a pregnant woman. The physician should aim at protecting
and nourishing both the foetus and the mother.
From
the moment the pregnancy is confirmed, the woman is advised
to follow certain rules. The physician steps in and starts
supervision so that the pregnancy can terminate in a normal
delivery at the scheduled time. Especially when she approaches
full term, critical care is necessary as one of her feet is
considered to be in this world and the other in the world
of Yama (the god of death). Delivery is not complete unless
the placenta is delivered. If the delivery is not normal,
says this ancient science; the woman is likely to be affected
by one or the other of a list of 64 ailments, which are described
in detail in Garbhini Vyakaran.
Sometimes,
even an expert can get baffled by situations arising during
the course of pregnancy and the post-delivery period. Hence,
the physician has to have foresight, definite convictions,
expertise, experience and compassion while taking on the responsibility
of a pregnant woman. He has to think of the welfare of two
individuals at the same time - that of the mother and the
foetus. Both are to be nourished and protected. The requirements
of both are usually identical. But, if they happen to clash,
the protection of the mother should be the priority.
If
a couple desires to have a good progeny, 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.
General
Rules from Inception of Pregnancyto Delivery
The
mother-to-be should -
Always try to be in a happy mood
Be clean, neat and well dressed
Wear simple clothes
Sleep under a roof in a clean environment
The food she eats should be tasty, more of it should be in
a liquid form, moist, nourishing, enriched with all the six
rasas (tastes) and treated by deepan drugs which are known
to increase appetite and digestive power.
She
should always avoid -
Excessive
sex particularly during early and late pregnancy
Overeating or fasting
Sleeping during the day time and staying up late at night
Tight clothes and tight belts
Witnessing or listening to things which give rise to feelings
of sorrow, anger, horror or agony
Travelling in a vehicle on rough roads
Squatting for a long time or sitting in an uncomfortable position
or on a hard surface
Lifting heavy things or remaining in a bending position for
a long time
Oleation massage etc. unless positively indicated
Beholding natural urges unless in an emergency
Dry, stale, fermented, heavy, hot or strong food, alcohol
and meat (fish is allowed)
Visiting abandoned and remote places
Leaning into a deep well.
Garbhini Parichaya
The
development of the foetus in the uterus is described under
Garbhavakranti, and special regimens are prescribed for each
month under Garbhini Paricharya. The general rule is to take
greater care during the first three months of pregnancy and
after the completion of the seventh month.
During
the first trimester, stress is laid on stabilizing the pregnancy
and nurturing the uterine bed through rasa and rakta dhatus.
The embryo gets nourishment directly by percolation (upsnehan).
Hence more jaleeya (liquid) substances such as juicy fruits,
coconut water, milk, and so on are advocated.
In
the first month, sipping cold milk and maintaining a light
diet, and during the next two months, the intake of milk medicated
with herbs like Vidari, Shatavari, Yasthimadhu, Brahmi and
so on, which are jeevaneeya (life-building) and garbhasthapak
(helping nidation) are advocated. Honey and ghee are also
recommended.
By
the end of the third month, the body parts of the foetus become
differentiated, sensory perceptions and motor reactions start
developing, the heart starts beating, and is said to express
its desires through the mother's blood. This is the period
when the woman craves for certain foods/flavours. The needs
of both the foetus and the mother are identical. Hence, Ayurved
recommends that her cravings be fulfilled as far as possible,
if not contraindicated. Brahmi helps in calming the nerves
and is also a good prajasthapan (sustainer of pregnancy).
From
the fourth to the seventh month, drugs, which give strength
to the uterine muscles and nourishment to the embryo, are
advised e.g. Ashwagandha, Kraunch beej and Guduchi. They help
to prevent intrauterine growth retardation (IUGR). Nourishment
starts through the umbilical. cord by the kedar kulya method.
The diet should be one of rice, milk, butter and gee. Fruits
which are orange or yellow in color are advocated such as
mangoes, apples, carrots, amalaki etc. Leafy vegetables are
also advised. During the seventh month, the abdominal skin
gets stretched giving rise to itching and striations, which
are, called kikkis. This should be treated by taking sips
of the infusion of berries or butter medicated with Manjistha,
the application of the pulp of sandalwood and lotus or of
a paste made of Neem, basil and Manjistha, or oil medicated
with Karveer leaves or jasmine.
From
the seventh month onwards, there should be less fat, less
salt and less water in the diet rice kanji with a little ghee
is advocated. After the completion of the seventh month, herbs,
which are mild diuretics and urinary antiseptics such as Gokshuru
and Sariva, are advocated. Basil in small quantities is advised;
it is also anti-spasmodic.
As
soon as the pregnant woman enters the ninth month, she is
supposed to move to the Sootikagar (delivery area) which is
specially prepared for delivery. After an asthapan basti (simple
enema), she should undergo anuvasan basti (retention enema
of oil boiled with some herbs) which may be repeated. Tampons
soaked in the same oil are kept in the vagina to make the
pelvis soft and elastic, and enhance the excretory functions
of apan, vayu (urination, defecation) and expulsion of the
foetus. The skin and nails become soft, and her strength and
complexion are rejuvenated.
Spotting
of blood during any month of pregnancy is considered to be
serious and should be dealt with as advocated under Masanumasik
Chikitsa, which describes the treatment month wise.
Sootikagar
The
Sootikagar should be such as to meet seasonal needs. The type
of land, the timber used for the building, the architectural
layout of the area (the bath room, toilet, kitchen, fire place,
delivery room), the type of fire wood used, the water supply
and so on are described in detail. Materials such as linen,
needles and instruments, essential drugs and furniture are
also specified. The house should be fumigated to make it free
from insects. Porous bags containing rakshoghna drugs should
be suspended all around - at the entrance and at the corners
- to ward off insects, bacteria and unseen evil elements (rakshoghna
drugs are supposed to kill or repel them). These drugs are
calamus asafoetida, garlic, Guggulu and Sarshap.
The
nurse or birth attendant recommended by Ayurved, should be
experienced, friendly, alert, expert, affectionate by nature,
concerned and caring. The attending physician should be an
expert.
Treatment
Of Diseases During Pregnancy
Any
disease occurring in a pregnant woman should be treated with
drugs that are mild in action, compatible and safe to the
foetus. Panchakarma (detoxifying procedures) should not be
advocated, except basti (enema) and pichu (tampon) in the
eighth and ninth months of pregnancy.
Ayurved
also 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, dryness of mouth, fever, oedema, anaemia,
diarrhoea and retention of urine. Their specific treatments
are also elaborately described.
As
far as possible, medication should be avoided during the first
three months of pregnancy. Only symptomatic treatment with
very mild herbs and a suitable diet should be offered. The
physician is advised to take into account the severity of
the disease, the resistance power of the mother and the duration
of the pregnancy, and choose the middle path so that the disease
or the treatments do not result in sequelae in the mother
or the foetus. For example, the use of Dashamularisht in vatic
fever, cold infusion of Glycerriza lotus and Sariva in paittic
fever and Guduchi vasa quash in kapha fever to bring down
temperature. Similar special treatments are advised for other
diseases. Drugs such as Vacha, Kumari, myrrh, are contraindicated
in pregnancy and substances like garlic and asafoetida are
to be used cautiously.
Different
types of obstructed labor and their management with maneuvers,
especially internal rotation, are also described in this section.
If the physician notices that the disease is going to be dangerous
to the mother, especially in the garbhopadravas, no time should
be lost in terminating the pregnancy.
Even
three thousand years ago, thus, Ayurved had stressed the importance
of safe motherhood. It aims at excellence in the formation
of the foetus, its development without anomalies, a comfortable
full term delivery, and maintenance of the health of the mother.
Today, with a better understanding of the physio-pathological
processes and the advancement of allied sciences, we have
put together a safe motherhood program for women in the form
of a package namely, combating anemia, immunization of the
mother, regular antenatal check up to detect any pathology
in the foetus or the mother, to predict the course of delivery
and, take appropriate interventions if necessary, and finally,
the delivery by a trained person.
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