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To expel the dead fetus, the treatments to be administered are to initiate uterine contractions and induce labor. If necessary surgical treatment for removal of a dead fetus is also believed to save the mother from serious complications like DIC (disseminated intravascular coagulopathy) may occur if fetal fibrin is absorbed in maternal circulation.  After the removal of the dead fetus, the physician should administer sura varga (alcoholic preparations) for the relief of pain and purification of the gut and genito-urinary system and also for the sense of exhilaration. Loss of fetus in such a later stage can be very stressful for mother and anxiety, depression and other psychotic complications may arise if proper care is not taken. Once there is complete shuddhi of koshtha and garbhashaya, one should give brimhana treatment to promote tissue bulk and nutrition. As there is the removal of the kleda from all dhatus during the management and shuddhi, santarpana is very essential.
 
To expel the dead fetus, the treatments to be administered are to initiate uterine contractions and induce labor. If necessary surgical treatment for removal of a dead fetus is also believed to save the mother from serious complications like DIC (disseminated intravascular coagulopathy) may occur if fetal fibrin is absorbed in maternal circulation.  After the removal of the dead fetus, the physician should administer sura varga (alcoholic preparations) for the relief of pain and purification of the gut and genito-urinary system and also for the sense of exhilaration. Loss of fetus in such a later stage can be very stressful for mother and anxiety, depression and other psychotic complications may arise if proper care is not taken. Once there is complete shuddhi of koshtha and garbhashaya, one should give brimhana treatment to promote tissue bulk and nutrition. As there is the removal of the kleda from all dhatus during the management and shuddhi, santarpana is very essential.
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Monthly regimen during pregnancy:
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==== Monthly regimen during pregnancy ====
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Regular intake of recommended diet and daily routine is essential for fetal growth as well as maternal well-being. Daily use of milk and milk products is an important aspect of garbhini paricharya. Milk can nourish all body tissues and is considered a wholesome diet, fulfilling the requirement of fetal as well as maternal growth. Milk is sheeta, snigdha, and madhura and increases the ojas in the body. Ojas is said to be the essence of all body tissues and revitalizes to produce new body elements. The regimen is rich in proteins as well as carbohydrates which are essential for fetal growth and development. Due care is taken while prescribing the regimen to prevent vata prakopa.  Disturbance in vata balance may cause many diseases of the fetus as well as the mother.  From the eighth month onwards, the preparation of birth canal for pariturition begins and also there is the descent of fetal presenting part in the pelvis. To relieve the symptoms of this pressure on pelvis and augment the formation of lower segment, to prepare cervix to become ripe and easily dilatable, basti and pichu (vaginal tampon) of oil are advised. ix Basti keeps vata dosha balanced & its gati in anulom (downward) direction, preventing the obstruction in the path of vata dosha to help the process of labor, natural and in ease.
 
Regular intake of recommended diet and daily routine is essential for fetal growth as well as maternal well-being. Daily use of milk and milk products is an important aspect of garbhini paricharya. Milk can nourish all body tissues and is considered a wholesome diet, fulfilling the requirement of fetal as well as maternal growth. Milk is sheeta, snigdha, and madhura and increases the ojas in the body. Ojas is said to be the essence of all body tissues and revitalizes to produce new body elements. The regimen is rich in proteins as well as carbohydrates which are essential for fetal growth and development. Due care is taken while prescribing the regimen to prevent vata prakopa.  Disturbance in vata balance may cause many diseases of the fetus as well as the mother.  From the eighth month onwards, the preparation of birth canal for pariturition begins and also there is the descent of fetal presenting part in the pelvis. To relieve the symptoms of this pressure on pelvis and augment the formation of lower segment, to prepare cervix to become ripe and easily dilatable, basti and pichu (vaginal tampon) of oil are advised. ix Basti keeps vata dosha balanced & its gati in anulom (downward) direction, preventing the obstruction in the path of vata dosha to help the process of labor, natural and in ease.
    
Antenatal patients are prescribed Ayurvedic regimen throughout pregnancy with proper diet advice. The medicines given are shatavari, phalghrita especially during the first trimester.
 
Antenatal patients are prescribed Ayurvedic regimen throughout pregnancy with proper diet advice. The medicines given are shatavari, phalghrita especially during the first trimester.
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Use of a herbomineral preparation Garbhapala rasa because of its lead content is under controversy. Appropriate preparation of this herbominearal compound following Ayurvedic Formulary of India ensures proper development of the fetus and prevents bleeding and threatened abortion during the first trimester. Along with the physical development of the fetus, the spiritual and psychological development is also taken care of. Given this, the do's and don't's includes visiting scenic and places of interest, associating with likable people, eating prescribed diet, reading and listening to interesting stories are advised.  
 
Use of a herbomineral preparation Garbhapala rasa because of its lead content is under controversy. Appropriate preparation of this herbominearal compound following Ayurvedic Formulary of India ensures proper development of the fetus and prevents bleeding and threatened abortion during the first trimester. Along with the physical development of the fetus, the spiritual and psychological development is also taken care of. Given this, the do's and don't's includes visiting scenic and places of interest, associating with likable people, eating prescribed diet, reading and listening to interesting stories are advised.  
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The lifestyle, diet, exercise, synthetic drugs, food additives like artificial colors, preservatives, the onslaught of electromagnetic radiations have become an integral part of the day today life (ref:https://infoayushdarpan.wordpress.com/2017/01/18/the-role-of-masanumasik-formulations/). This affects the growth and development of the fetus. Decoctions made in the form of Ghana vati as mentioned by Ashtanga and Sushruta are used as a monthly treatment for all antenatal patients which facilitate proper nourishment and hence the growth of fetus preventing any illness. Research has shown that application of matra basti and yoni pichu of Bala tssail given from the first day of 9th month results in normal labor without prolongation with spontaneous onset Ref. Also, it reduces postpartum complications like a backache, lower abdominal pain, and abdominal distention.
 
The lifestyle, diet, exercise, synthetic drugs, food additives like artificial colors, preservatives, the onslaught of electromagnetic radiations have become an integral part of the day today life (ref:https://infoayushdarpan.wordpress.com/2017/01/18/the-role-of-masanumasik-formulations/). This affects the growth and development of the fetus. Decoctions made in the form of Ghana vati as mentioned by Ashtanga and Sushruta are used as a monthly treatment for all antenatal patients which facilitate proper nourishment and hence the growth of fetus preventing any illness. Research has shown that application of matra basti and yoni pichu of Bala tssail given from the first day of 9th month results in normal labor without prolongation with spontaneous onset Ref. Also, it reduces postpartum complications like a backache, lower abdominal pain, and abdominal distention.
    
Kikkisa (striae gravidarum) which occurs on abdominal and breast area due to itching is to be treated with local application of drugs which relieves itching and burning sensation. Also, certain herbs are varnya in nature i.e. to improve color and complexion of skin. Ointments, oil, and lepa are prepared from these formulations and prescribed to mother to apply on abdominal area, thighs, and breast from the second month itself to prevent kikkisa.  
 
Kikkisa (striae gravidarum) which occurs on abdominal and breast area due to itching is to be treated with local application of drugs which relieves itching and burning sensation. Also, certain herbs are varnya in nature i.e. to improve color and complexion of skin. Ointments, oil, and lepa are prepared from these formulations and prescribed to mother to apply on abdominal area, thighs, and breast from the second month itself to prevent kikkisa.  
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Care during 9th month of pregnancy: Instead of suitiikagara, what special care of pregnant lady is advised by Ayurvedic obstretian at home before she goes into labor should be described. What instructions are given when labor pain starts?
 
Care during 9th month of pregnancy: Instead of suitiikagara, what special care of pregnant lady is advised by Ayurvedic obstretian at home before she goes into labor should be described. What instructions are given when labor pain starts?
 
   
 
   
Management of Labor:
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==== Management of Labor ====
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Instead of moving the mother after the labor pain starts, she is shifted to the delivery abode (sutikagara) at the onset of the ninth month. The entry is a ritual and done on auspicious day and timing to ensure the successful and uneventful outcome of pregnancy and parturition without any untoward complications. Symptoms and signs which signify formation of the lower segment with uterine contractions and cervical dilation indicate the onset of labor. As soon as the onset of labor is determined, the counseling and observation of mother are to be with while she is lying down.  
 
Instead of moving the mother after the labor pain starts, she is shifted to the delivery abode (sutikagara) at the onset of the ninth month. The entry is a ritual and done on auspicious day and timing to ensure the successful and uneventful outcome of pregnancy and parturition without any untoward complications. Symptoms and signs which signify formation of the lower segment with uterine contractions and cervical dilation indicate the onset of labor. As soon as the onset of labor is determined, the counseling and observation of mother are to be with while she is lying down.  
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After the birth of a baby, in the case of retained placenta, the therapies administered are to increase uterine contractions and increase intra-abdominal pressure for placental detachment and descent in the vagina. All these measures, along with basti, are vatahara and are vata shamaka measures for the restoration of prakrita gati of vata dosha to expel out the placenta along with stool and urine.
 
After the birth of a baby, in the case of retained placenta, the therapies administered are to increase uterine contractions and increase intra-abdominal pressure for placental detachment and descent in the vagina. All these measures, along with basti, are vatahara and are vata shamaka measures for the restoration of prakrita gati of vata dosha to expel out the placenta along with stool and urine.
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Care of the Newborn:
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==== Care of the Newborn ====
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Resuscitation of a newborn is the initial step and is called Pranapratyagaman Vidhi. There is a prescribed sequence for the clearing of mucous secretions from the oral cavity. First the palate, then the inner aspect of lips, kantha (pharynx), and the Jivha (tongue) should be cleaned. Once the secretion is cleared from the palate, it facilitates the air entry in the pharynx easily. Clearing of pharynx clears the air passage and finally clearing of tongue removes the amniotic fluid and mucous which sticks to the tongue. Nowadays, a neonatal care practice is to clear up the secretion with a suction apparatus first from the mouth and then through the nose. The reason for removing secretions from the mouth first is to prevent the aspiration of more copious oral secretions than nasal secretions. Emesis with ghee and rock salt prescribed in the past is not done. Modern practice is to do gastric suction.  
 
Resuscitation of a newborn is the initial step and is called Pranapratyagaman Vidhi. There is a prescribed sequence for the clearing of mucous secretions from the oral cavity. First the palate, then the inner aspect of lips, kantha (pharynx), and the Jivha (tongue) should be cleaned. Once the secretion is cleared from the palate, it facilitates the air entry in the pharynx easily. Clearing of pharynx clears the air passage and finally clearing of tongue removes the amniotic fluid and mucous which sticks to the tongue. Nowadays, a neonatal care practice is to clear up the secretion with a suction apparatus first from the mouth and then through the nose. The reason for removing secretions from the mouth first is to prevent the aspiration of more copious oral secretions than nasal secretions. Emesis with ghee and rock salt prescribed in the past is not done. Modern practice is to do gastric suction.  
 
Once the baby is breathing well next step is to cut the umbilical cord under aseptic conditions to prevent serious complication of stump infection. This is followed by application of oil and dry powders with antiseptic and drying property. All these measures are to prevent infection in the umbilical stump, early fall of the umbilical cord, healthy healing of the wound after the fall of the cord stump and for prevention of complications like omphalocele, etc. Lodhra, madhuka, priyamgu, suradaru, and Haridra, etc. are drugs that have kashaya and astringent properties to remove excessive moisture and prevent infection, since dry conditions favor the early separation of stump. Oil made up of the same drugs has antimicrobial and wound healing properties and prevents moisture and microbes. The wrong method of cutting of cord and improper care of the cord leads to complications.
 
Once the baby is breathing well next step is to cut the umbilical cord under aseptic conditions to prevent serious complication of stump infection. This is followed by application of oil and dry powders with antiseptic and drying property. All these measures are to prevent infection in the umbilical stump, early fall of the umbilical cord, healthy healing of the wound after the fall of the cord stump and for prevention of complications like omphalocele, etc. Lodhra, madhuka, priyamgu, suradaru, and Haridra, etc. are drugs that have kashaya and astringent properties to remove excessive moisture and prevent infection, since dry conditions favor the early separation of stump. Oil made up of the same drugs has antimicrobial and wound healing properties and prevents moisture and microbes. The wrong method of cutting of cord and improper care of the cord leads to complications.
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Samskara After birth:  
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==== Samskara After birth ====
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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?
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Prescribed post-partum measures for women:
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==== Prescribed post-partum measures for women ====
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Parturition and postpartum phase cause significant changes physiologically, psychologically and anatomically especially, in her hormones and the neuro-endocrinal axis. All dhatus of the mother are at a low ebb (kshaya) during labor, and therefore there is vata prakopa and agnimandya. Therefore, in the postpartum phase, a physician should administer vatahara, deepana, and brimhana upakrama and should help restore the woman’s body tissues in a systematic manner, taking care of her digestive capacity. To regain homeostasis, the regimen of diet for first ten days postpartum are prescribed.   
 
Parturition and postpartum phase cause significant changes physiologically, psychologically and anatomically especially, in her hormones and the neuro-endocrinal axis. All dhatus of the mother are at a low ebb (kshaya) during labor, and therefore there is vata prakopa and agnimandya. Therefore, in the postpartum phase, a physician should administer vatahara, deepana, and brimhana upakrama and should help restore the woman’s body tissues in a systematic manner, taking care of her digestive capacity. To regain homeostasis, the regimen of diet for first ten days postpartum are prescribed.   
 
The measures prescribed in these texts are for the woman after delivery to transition from the effects of labor into a state of normalcy and good health smoothly. These measures help in the involution of the uterus and pelvic cavity, contraction of the distended abdomen, and help in restoring digestion. Immediate care will help in easing the fatigue of labor too. Experienced practitioners endorse these measures clinically.
 
The measures prescribed in these texts are for the woman after delivery to transition from the effects of labor into a state of normalcy and good health smoothly. These measures help in the involution of the uterus and pelvic cavity, contraction of the distended abdomen, and help in restoring digestion. Immediate care will help in easing the fatigue of labor too. Experienced practitioners endorse these measures clinically.
    
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.
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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.
 
   
 
   
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Source: http://www.jennsutkowski.com/blog-du-moment/steam-that-yonisteam-that-yoni-for-me-or-i-mean-you
 
Source: http://www.jennsutkowski.com/blog-du-moment/steam-that-yonisteam-that-yoni-for-me-or-i-mean-you
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Naming Ceremony:
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==== Naming Ceremony ====
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The naming ceremony is also advised to be done on the tenth day of childbirth. Although the family is free to keep a name of their choosing, guidelines for selection of the name are given here - one that is auspicious and derived through rituals, and the other for social identity.   
 
The naming ceremony is also advised to be done on the tenth day of childbirth. Although the family is free to keep a name of their choosing, guidelines for selection of the name are given here - one that is auspicious and derived through rituals, and the other for social identity.   
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Naming the baby is a very important event. A person’s name always leaves a very deep impact on his/her personality and behavior. Psychologically, what one hears and reacts is very important for the mental wellbeing of the person. Therefore, one should be given a good name having an auspicious meaning and that which instills confidence in the individual. Vedic cultures have formal naming ceremonies, as do some other cultures around the world. [50]
 
Naming the baby is a very important event. A person’s name always leaves a very deep impact on his/her personality and behavior. Psychologically, what one hears and reacts is very important for the mental wellbeing of the person. Therefore, one should be given a good name having an auspicious meaning and that which instills confidence in the individual. Vedic cultures have formal naming ceremonies, as do some other cultures around the world. [50]
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Examination of Newborn
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==== Examination of Newborn ====
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All the morphological features of the newborn should be examined thoroughly to rule out any features of congenital anomalies and life-threatening conditions as early as possible. With the help of such findings, one can prevent further complications and consequences of these congenital issues. Therefore, on the tenth day of the child’s delivery, the physician should examine the baby thoroughly. The newborn is grossly examined at birth, but thorough examination is recommended on the tenth day because many minute observations might get missed just after birth and will become obvious by the tenth day.  
 
All the morphological features of the newborn should be examined thoroughly to rule out any features of congenital anomalies and life-threatening conditions as early as possible. With the help of such findings, one can prevent further complications and consequences of these congenital issues. Therefore, on the tenth day of the child’s delivery, the physician should examine the baby thoroughly. The newborn is grossly examined at birth, but thorough examination is recommended on the tenth day because many minute observations might get missed just after birth and will become obvious by the tenth day.  
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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.  
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As explained earlier, stanya produced from the adya ahara rasa dhatu (from the first dhatu..) is afflicted with vitiated kapha/shleshma dosha. Shodhana treatment is key for treating stanya dushti vikara (i.e. breastmilk infections). Shodhana should be followed by the administration of tikta, katu, and kashaya rasa drugs like vachaharidradi gana or charakokta patha mahaushadi suradarvadi stanya shodhana mahakashya (Cha. Sutra Sthana).
 
As explained earlier, stanya produced from the adya ahara rasa dhatu (from the first dhatu..) is afflicted with vitiated kapha/shleshma dosha. Shodhana treatment is key for treating stanya dushti vikara (i.e. breastmilk infections). Shodhana should be followed by the administration of tikta, katu, and kashaya rasa drugs like vachaharidradi gana or charakokta patha mahaushadi suradarvadi stanya shodhana mahakashya (Cha. Sutra Sthana).
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All the above-mentioned drugs and diet have been investigated and found useful with many evidence-based types of research, and are prescribed as galactagogues ref.
 
All the above-mentioned drugs and diet have been investigated and found useful with many evidence-based types of research, and are prescribed as galactagogues ref.
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The concept of examination of breast milk is not practically applied in today's era. The diet, lifestyle, and psyche of the mother affect the quality and quantity of breast milk. The characteristic and quantity of breast milk affects the growth and development of the newborn.
 
The concept of examination of breast milk is not practically applied in today's era. The diet, lifestyle, and psyche of the mother affect the quality and quantity of breast milk. The characteristic and quantity of breast milk affects the growth and development of the newborn.
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Designing and care of the child’s room:
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==== Designing and care of the child’s room ====
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The kumaragara (or day care facility) should be prepared in such a manner as to prevent accidents and to protect the child from agantuja vyadhi (diseases due to external/extrinsic factors). In such healthy, emotionally stable and protected environment, children grow very healthy. Antimicrobial properties of all these drugs have been proven in different researches, and hence their use in newborn care and the neonatal nursery is quite evident. Till date, there is no evidence-based scientific explanation available for wearing stones and animal-based jewelry or ornaments. Most of these practices have passed down as customs or rituals since time immemorial.  
 
The kumaragara (or day care facility) should be prepared in such a manner as to prevent accidents and to protect the child from agantuja vyadhi (diseases due to external/extrinsic factors). In such healthy, emotionally stable and protected environment, children grow very healthy. Antimicrobial properties of all these drugs have been proven in different researches, and hence their use in newborn care and the neonatal nursery is quite evident. Till date, there is no evidence-based scientific explanation available for wearing stones and animal-based jewelry or ornaments. Most of these practices have passed down as customs or rituals since time immemorial.  
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Toys for children:
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==== Toys for children ====
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Toys are very fundamental constituents for the proper growth and development of creative and logical thoughts in babies. Toys play a crucial role as sensory stimuli. Acharya Charaka was well aware of this aspect of child development and therefore described toys in detail. All societies and cultures have toys, and their role in child development is universally accepted.  
 
Toys are very fundamental constituents for the proper growth and development of creative and logical thoughts in babies. Toys play a crucial role as sensory stimuli. Acharya Charaka was well aware of this aspect of child development and therefore described toys in detail. All societies and cultures have toys, and their role in child development is universally accepted.  
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The upbringing of the child:
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==== The upbringing of the child ====
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According to Artha Shastra of Chanakya (Vishnugupta), a child till the age of five years needs a lot of care and affection, while the next ten years require inculcating him/her with discipline and education and once he/she reaches 16 years of age, he/she should be treated as a friend. Children of 16 years of age are mature, physically and sexually, and by then are ready to acquire skills of work for earning.
 
According to Artha Shastra of Chanakya (Vishnugupta), a child till the age of five years needs a lot of care and affection, while the next ten years require inculcating him/her with discipline and education and once he/she reaches 16 years of age, he/she should be treated as a friend. Children of 16 years of age are mature, physically and sexually, and by then are ready to acquire skills of work for earning.
  

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