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=== Introduction ===

=== Introduction ===

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The [[Sharira Sthana]] and [[Chikitsa Sthana]] provide valuable insights into obstretics, midwifery and gynaecology in the Vedic ages. Since Ayurveda is holistic in its treatment of various aspects of life sciences, these sections go beyond in their treatment of these branches of medicine, prescribing ground rules for effective neonatology and improved parental health. This chapter starts with certain guidelines for purification of the parents, including spiritual practices and appropriate rules for coitus, to improve the odds of giving birth to a healthy and desired offspring. For purification, therapies such as [[Panchakarma]] are advocated. A very specific - and contentious - spiritual procedure called ''putreshti yajna'' is also explained here, with an aim towards giving birth to a son (or a child of desired gender) with all excellent qualities.  

The [[Sharira Sthana]] and [[Chikitsa Sthana]] provide valuable insights into obstretics, midwifery and gynaecology in the Vedic ages. Since [[Ayurveda]] is holistic in its treatment of various aspects of life sciences, these sections go beyond in their treatment of these branches of medicine, prescribing ground rules for effective neonatology and improved parental health. This chapter starts with certain guidelines for purification of the parents, including spiritual practices and appropriate rules for coitus, to improve the odds of giving birth to a healthy and desired offspring. For purification, therapies such as [[Panchakarma]] are advocated. A very specific - and contentious - spiritual procedure called ''putreshti yajna'' is also explained here, with an aim towards giving birth to a son (or a child of desired gender) with all excellent qualities.  

Next, the chapter talks of fertilization and its features, and confirmation of conception. At this stage, sound parental health is also important. Couples are advised to follow various dietary measures as well as rules to engage in physical and mental activities, etc.  

Next, the chapter talks of fertilization and its features, and confirmation of conception. At this stage, sound parental health is also important. Couples are advised to follow various dietary measures as well as rules to engage in physical and mental activities, etc.  

==== Selection of Suitable partner for conception ====

==== Selection of Suitable partner for conception ====

In Ayurveda classics, the preparation of procuring healthy progeny begins with the selection of a partner. For a healthy progeny with longevity and desired traits, both partners should be of reproductive age without any physical or mental disease or chronic illness. Conception in older age is associated with genetic abnormalities like Down’s syndrome and rare chromosomal abnormalities like Patau's syndrome and Edward's syndrome in the offspring. Increased maternal age may also lead to the poor outcome of pregnancy. Conception during illness may result in congenital anomalies or growth retarded fetus.  Research has shown risks of low birth weight, premature labor, anemia, and pre-eclampsia are related to the biological age<ref> CM Gibbs et al, The Impact of Early Age at First Childbirth on Maternal and Infant Health, 2012, PMID:22742615 </ref>.  

In [[Ayurveda]] classics, the preparation of procuring healthy progeny begins with the selection of a partner. For a healthy progeny with longevity and desired traits, both partners should be of reproductive age without any physical or mental disease or chronic illness. Conception in older age is associated with genetic abnormalities like Down’s syndrome and rare chromosomal abnormalities like Patau's syndrome and Edward's syndrome in the offspring. Increased maternal age may also lead to the poor outcome of pregnancy. Conception during illness may result in congenital anomalies or growth retarded fetus.  Research has shown risks of low birth weight, premature labor, anemia, and pre-eclampsia are related to the biological age<ref> CM Gibbs et al, The Impact of Early Age at First Childbirth on Maternal and Infant Health, 2012, PMID:22742615 </ref>.  

Ideal position for coitus and factors affecting conception:  

Ideal position for coitus and factors affecting conception:  

Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis<ref> Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing </ref>. Hence chanting or reciting mantras or shlokas is recommended for maintenance of a psychosomatic balance of the body. In Vedic rituals, shloka (sacred hymns) to be chanted are said to invoke Lord Brahma, the creator of the universe and the progenitor of all the activities of the universe, Lord Brihaspati, the power behind every activity, Lord Vishnu, the preserver of the universe, Soma and Agni, the prime principles in all living beings, Ashvinau, the symbol of health and well-being in every creature, and Mitra and Varuna, the forces necessary to sustain life in the universe. Therefore, vedic scriptures, including Ayurvedic texts, emphasize on paying one’s obeisance to deities and forces of the universe, in the form of Gods, if one desires a healthy offspring.

Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis<ref> Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing </ref>. Hence chanting or reciting mantras or shlokas is recommended for maintenance of a psychosomatic balance of the body. In Vedic rituals, shloka (sacred hymns) to be chanted are said to invoke Lord Brahma, the creator of the universe and the progenitor of all the activities of the universe, Lord Brihaspati, the power behind every activity, Lord Vishnu, the preserver of the universe, Soma and Agni, the prime principles in all living beings, Ashvinau, the symbol of health and well-being in every creature, and Mitra and Varuna, the forces necessary to sustain life in the universe. Therefore, vedic scriptures, including Ayurvedic texts, emphasize on paying one’s obeisance to deities and forces of the universe, in the form of Gods, if one desires a healthy offspring.

Chanting of mantras is known to have physical, mental and spiritual benefits. Mantra chanting form the basis of yogic meditation practices to help calm one’s mind and ease anxieties, which could have adverse effects on one’s progeny. Ayurveda science also mentions the role of the atma, along with the union of sperm and ovum, as a prerequisite, in the formation of the garbha. For the atma (of the newborn) to be of best satva and good prior karma, the ambiance and environment of the area should be spiritual, and chanting helps in creating such an environment.

Chanting of mantras is known to have physical, mental and spiritual benefits. Mantra chanting form the basis of yogic meditation practices to help calm one’s mind and ease anxieties, which could have adverse effects on one’s progeny. [[Ayurveda]] science also mentions the role of the atma, along with the union of sperm and ovum, as a prerequisite, in the formation of the garbha. For the atma (of the newborn) to be of best satva and good prior karma, the ambiance and environment of the area should be spiritual, and chanting helps in creating such an environment.

==== Do’s and Dont’s before coitus ====

==== Do’s and Dont’s before coitus ====

As explained by Charaka, a pregnant woman is like a vessel full of oil and should be treated with care, meaning that all doshas, dhatu, mala and ojas of the pregnant woman are at such a critical physiological stage that if one does not attend to her in a timely and proper way it may lead to damage to the foetus or the mother or both. Hence the disorders which may occur during pregnancy are to be treated with special care. For the antenatal mother, the diet or medications which should be used for curing any ailment should be mild and effective. Panchakarma treatment, because of its use of invasive and strong medicines, is to be avoided. Basti and abhyanga to kati are advocated in the eighth month of pregnancy, and these are comparatively safer procedures and may also help in a normal labor. During the eighth month, the fetus is sufficiently developed and viable, and even if the mother gets labor pain while undergoing treatment (mild to aggressive courses, as the need may be), the fetus can be preserved, and there are fewer chances of compromising fetal life.  

As explained by Charaka, a pregnant woman is like a vessel full of oil and should be treated with care, meaning that all doshas, dhatu, mala and ojas of the pregnant woman are at such a critical physiological stage that if one does not attend to her in a timely and proper way it may lead to damage to the foetus or the mother or both. Hence the disorders which may occur during pregnancy are to be treated with special care. For the antenatal mother, the diet or medications which should be used for curing any ailment should be mild and effective. Panchakarma treatment, because of its use of invasive and strong medicines, is to be avoided. Basti and abhyanga to kati are advocated in the eighth month of pregnancy, and these are comparatively safer procedures and may also help in a normal labor. During the eighth month, the fetus is sufficiently developed and viable, and even if the mother gets labor pain while undergoing treatment (mild to aggressive courses, as the need may be), the fetus can be preserved, and there are fewer chances of compromising fetal life.  

The effects of drug use during pregnancy on the fetus has been researched and documented. The mother as well the fetus, if subjected to certain drugs /treatment, can lead to side-effects on either or both.  FDA has specified a certain list of drugs (X category) which are contraindicated during pregnancy <ref> https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/labeling/ucm093307.htm

The effects of drug use during pregnancy on the fetus has been researched and documented. The mother as well the fetus, if subjected to certain drugs /treatment, can lead to side-effects on either or both.  FDA has specified a certain list of drugs (X category) which are contraindicated during pregnancy <ref> https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/labeling/ucm093307.htm

Ix Gawade T, Ghorpade M, Effect of bala siddha taila anuvasana basti on labour pains; Ayurlog: National journal of Research in Ayurveda science’ Vol 3, Feb 2015

Ix Gawade T, Ghorpade M, Effect of bala siddha taila anuvasana basti on labour pains; Ayurlog: National journal of Research in [[Ayurveda]] science’ Vol 3, Feb 2015

  </ref>. In Ayurveda, the principles of antenatal treatment are given for shamana as well as shodhana, other drugs and treatment are contraindicated. In practice, for any ailments occurring during pregnancy, herbal medicines are preferred over herbo mineral medicines.

  </ref>. In [[Ayurveda]], the principles of antenatal treatment are given for shamana as well as shodhana, other drugs and treatment are contraindicated. In practice, for any ailments occurring during pregnancy, herbal medicines are preferred over herbo mineral medicines.

==== Disorders of the fetus and its treatment ====

==== Disorders of the fetus and its treatment ====

==== Samskara After birth ====

==== Samskara After birth ====

   

   

Ayurveda Acharyas follow some medicinal practices in combination with ritualistic customs. The very first feed to the baby should be applied in a ritualistic and hygienic way. Therefore, in jatakarmasamskara, the father has to take a bath before holding the baby, followed by reciting mantras softly in the ear of the baby, followed by making the baby lick gold with honey and ghee. Licking initiates swallowing movement in the newly born baby, and once such sucking and swallowing movements start, it is safe to initiate breastfeeding. Breastfeeding is recommended immediately after birth since breastmilk provides colostrum (stanya piyusha) which gives the baby ample amount of protein, cholesterol, and immunoglobins. Colostrum is said to be essential for the growth of brain and memory of the baby. Cholesterols in the colostrum have essential linoleic fatty acids and various species-specific properties that are essential for nervine and enhancement of immunity. According to the recent practice of neonatal care, breastfeeding should be initiated within 15 minutes after birth, in the case of normal labor, and within 2 hours of birth in case of cesarean section. Precautions should be taken to prevent neonatal sepsis. Are ther any special ayurvedic ways being used now?

[[Ayurveda]] Acharyas follow some medicinal practices in combination with ritualistic customs. The very first feed to the baby should be applied in a ritualistic and hygienic way. Therefore, in jatakarmasamskara, the father has to take a bath before holding the baby, followed by reciting mantras softly in the ear of the baby, followed by making the baby lick gold with honey and ghee. Licking initiates swallowing movement in the newly born baby, and once such sucking and swallowing movements start, it is safe to initiate breastfeeding. Breastfeeding is recommended immediately after birth since breastmilk provides colostrum (stanya piyusha) which gives the baby ample amount of protein, cholesterol, and immunoglobins. Colostrum is said to be essential for the growth of brain and memory of the baby. Cholesterols in the colostrum have essential linoleic fatty acids and various species-specific properties that are essential for nervine and enhancement of immunity. According to the recent practice of neonatal care, breastfeeding should be initiated within 15 minutes after birth, in the case of normal labor, and within 2 hours of birth in case of cesarean section. Precautions should be taken to prevent neonatal sepsis. Are ther any special ayurvedic ways being used now?

==== Prescribed post-partum measures for women ====

==== Prescribed post-partum measures for women ====

Within ten days of childbirth, the uterus returns to its normal size and shape, the lochia (serous and water discharge from uterine bed through the vagina) becomes minimum or nil, and the physiology of the woman is restored to her normal stage. The mother also lactates in this phase. However, since she is still weak and vulnerable to diseases, while her body (and life) returns to a state of normalcy, she should be kept under strict vigil and care.

Within ten days of childbirth, the uterus returns to its normal size and shape, the lochia (serous and water discharge from uterine bed through the vagina) becomes minimum or nil, and the physiology of the woman is restored to her normal stage. The mother also lactates in this phase. However, since she is still weak and vulnerable to diseases, while her body (and life) returns to a state of normalcy, she should be kept under strict vigil and care.

Orally decoction of dashmoola for garbhashaya shodhana as well as relieving backache is given, trikatu churna, vasa churna, bharangi churna, pippali churna, parsik yavani churna  in combination with honey or warm water is administered for sufficient uterine contractions ensuring proper drainage of lochia, for agnideepana  and for relieving pain. Shatavari churna with milk (Kshirpaka) for proper lactation, tablet triphala guggulu as the antiseptic measure is also given to the mother. At many Ayurveda hospitals, the mother is massaged with bala oil followed by steam; yonidhupana is done by sitting on a chair with herbs for fumigation kept below. (fig) A blanket is wrapped around the body covering legs after mother sits on it.  The abdomen is wrapped with a big cloth to prevent distention and ensure proper involution.

Orally decoction of dashmoola for garbhashaya shodhana as well as relieving backache is given, trikatu churna, vasa churna, bharangi churna, pippali churna, parsik yavani churna  in combination with honey or warm water is administered for sufficient uterine contractions ensuring proper drainage of lochia, for agnideepana  and for relieving pain. Shatavari churna with milk (Kshirpaka) for proper lactation, tablet triphala guggulu as the antiseptic measure is also given to the mother. At many [[Ayurveda]] hospitals, the mother is massaged with bala oil followed by steam; yonidhupana is done by sitting on a chair with herbs for fumigation kept below. (fig) A blanket is wrapped around the body covering legs after mother sits on it.  The abdomen is wrapped with a big cloth to prevent distention and ensure proper involution.

[[File:Chair_for_yonidhupana.png|thumb|center|upright=1.35|alt=A Chair for yoni dhupana.]]

[[File:Chair_for_yonidhupana.png|thumb|center|upright=1.35|alt=A Chair for yoni dhupana.]]

Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..  

Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..  

Characteristics of Breast milk, the effect of a mother's diet on breast milk and its management: Shuddha stanya (pure breast milk) is necessary for the newborn. According to Ayurveda whenever the pakva ahara rasa enters the stana (breast), its madhura rasa get converted into stanya (breast milk). Therefore, whatever the mother eats converts into stanya. If the mother takes a diet that causes dosha prakopa, then such a vitiated dosha vitiates the stanya and the vitiated stanya causes disease in the newborn baby. Therefore, the mother should take balanced and healthy diet which does not vitiate doshas.

Characteristics of Breast milk, the effect of a mother's diet on breast milk and its management: Shuddha stanya (pure breast milk) is necessary for the newborn. According to [[Ayurveda]] whenever the pakva ahara rasa enters the stana (breast), its madhura rasa get converted into stanya (breast milk). Therefore, whatever the mother eats converts into stanya. If the mother takes a diet that causes dosha prakopa, then such a vitiated dosha vitiates the stanya and the vitiated stanya causes disease in the newborn baby. Therefore, the mother should take balanced and healthy diet which does not vitiate doshas.

Some of the properties of stanya afflicted with vitiated doshas are as follows: vitiated vata dosha has tikta, kashya rasa and therefore, the stanya afflicted with vitiated vata dosha becomes tikata and kashya (bitter). Similar samprapti (etiology) is applicable in cases of pitta and kapha dosha prakopa as well.  

Some of the properties of stanya afflicted with vitiated doshas are as follows: vitiated vata dosha has tikta, kashya rasa and therefore, the stanya afflicted with vitiated vata dosha becomes tikata and kashya (bitter). Similar samprapti (etiology) is applicable in cases of pitta and kapha dosha prakopa as well.