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Special issue with the Sunday Magazine
From the publishers of THE HINDU

Indian health traditions: October 08, 2000


Natal care

Dr. P.L.T. Girija

The author is an Ayurvedic physician based in Chennai.

Increasingly, women - young and old alike - are facing innumerable problems such as menstrual irregularities, severe pain and discomfort during menstruation, excess and heavy bleeding, absence of menstruation, white discharge, infection, infertility, cysts, fibroids and so on. A phenomenally high rate of women undergo hysterectomies today. But what is generally not known is that for all these problems Ayurveda offers effective treatment.

Stree rogam (gynaecology) and Prasuti tantra (Obstetrics) constitute among the eight branches of Ayurveda. Stree rogam deals with the signs and symptoms of various diseases related to women along with the diagnosis, pathology and treatment. Prasuti tantra is concerned with the methods of achieving excellence of reproductive dhatu (tissue), measures for the maintenance of healthy pregnancy, factors injurious to pregnancy, abortion and its management, factors responsible for the inhibition of foetal growth and its management, dietary and other regimen for a pregnant woman, child delivery and post-natal care.

The sage Agnivesa in the Charaka Samhita (the major text of Ayurveda) says women who are the source of progeny are afflicted by various Yoni (genital) disorders. Hence there is a need to understand the various diseases of the Yoni with their origin, symptoms and treatment. Thus Charaka Samhita describes 20 different types of disorders pertaining to women.

Diseases of women arise as a result of improper food and regimen. This results in the derangement of the three doshas, Vata, Pitta and Kapha along with the blood, situated in the reproductive organ, giving rise to numerous diseases. Depending upon the combination of the doshas involved, the diseases exhibit characteristic symptoms.

For example, when Vayu gets aggravated in the genitals and reproductive organs, it gives rise to piercing and various kinds of pain, stiffness, a sensation of ants crawling, hardness and numbness of the vagina, exhaustion, thin and rough menstrual bleeding, a feeling of instant relief after the discharge of menstrual blood etc. Similarly, burning sensation, inflammation, swelling, fever, heat, discolouration of menstrual blood, are some of the typical symptoms of aggravation of pitta in the reproductive organ. Cold itching sensation in the genitals with mild pain and pale menstrual flow are some of the symptoms of aggravation of Kapha.

Bleeding after conception, painful discharge of menstrual blood with pain in the back, waist, thigh and groin, prolapse of uterus, repeated abortions, non-retention of semen in the yoni, a fleshy growth in the reproductive organ, are some of the common disorders among the ones mentioned in the text. Ayurvedic texts pay special attention to pradaram (excessive and heavy menstrual bleeding). This is one of the common and dreaded gynaecological problems of today, which invariably ends in a hysterectomy.

In general, all chronic gynaecological disorders are treated at first by mild application of the five purificatory therapies - what is known as the Panchakarma. Use of oil both internally and externally along with mild sudation is very crucial to this treatment. Innumerable combinations of decoctions, powders, pills, pastes, oils, ghees for internal use, ointments and pastes for external application, medicinal tampons, vaginal douche, and fumigation are employed to cure these disorders.

Obstetrics is very elaborately dealt with in Ayurveda. The two main concerns of Prasuti are, ensuring a healthy progeny and ensuring a natural delivery free from any complication. This is achieved through a series of practices involving diet, medicines, regimen and the psychological well-being of the woman.

The essential preconditions for a healthy conception are healthy sukra (semen) and healthy artava (female reproductive tissue) and a healthy reproductive organ (garbhasayam). Ayurveda practices a unique treatment called Sodhana (cleansing) whereby the reproductive tissues are free from affliction by the doshas. Thus the man and the woman are prepared before cohabitation so that defects in conception are minimised.

From the first month of conception onwards, throughout pregnancy the pregnant woman is given various herbal decoctions and simple medicinal preparations such as Dhanvantaram gutika, Sukumara rasayanam, decoction of Bala (sida cordifolia) etc. In the first three months especially, the expectant mother should take food which is sweet, cold in potency and largely liquid in consistency. Milk, ghee, butter, rice, gruels prepared with sweet medicines are useful for the growth of the foetus. From the eighth month, Susruta recommends the use of meat soup to strengthen the mother. Application of medicated oils on the body and the use of tampons soaked in medicinal oils help in softening the placenta, pelvis, waist and back. Medicated enemas administered in the eighth month help in the downward movement of Vayu, elimination of urine and faeces with ease and ensure a normal, trouble-free delivery.

In certain conditions, where the vital fluid is lost during pregnancy, the foetus may shrink, lose its growth and remain in the uterus for a long period without any growth. A similar condition can also occur as a result of too much fasting, etc. In these conditions, medication and treatment are administered so that normality is restored, the foetus acquires full growth without any defect and eventually a normal delivery is brought about.

Obstetric care today has touched an all time low among the urban population. This is evident from a study conducted among an affluent, well-educated section of women in Chennai. This study revealed that 45 per cent of the deliveries were surgical (Caesarian section). This high rate of Caesarian deliveries though partly motivated by money consideration, is indicative of a lack of obstetric skills among the professionals of modern hospitals.

Dowhrudya

One often comes across, varying and erratic likes and dislikes, in a pregnant woman irrespective of the culture or the part of the world she belongs to. These are peculiar to the state of pregnancy and they vary in each woman. Some of these desires are very strong.

Ayurveda has a definite understanding of these varied desires and terms the condition as dowhrudyam. The reason for the manifestation of dowhrudyam is the presence of a second hrudaya in the foetus. Hrudaya is the seat of one's emotions. As such she has two hrudayas, one of her own and the other of the foetus. She is called a dowhrudini.

These longings and desires are to be satisfied - not doing so may cause abnormalities of the foetus. These desires are not always beneficial, and may prove harmful to the foetus (even when fulfilled). In such cases one should use one's yukthi or power of reasoning, so as to fulfill her desire and at the same time render it harmless.

Some suggestions in this regard are as follows:

1. If there is an excessive desire for salt and raw (sour) mango the same can be substituted by rock salt (saindhava lavana and aamalaki (Phyllanthus emblica).

2. Desires for ushna/ theekshna i.e. hot/pungent foods like pickles can be fulfilled by intake of lime juice and ginger.

3. Desire for charcoal and ash can be fulfilled by taking burnt aamalaki i.e. gooseberry alone or in combination with harithaki (Terminalia chebula) and vibhithaki (Terminalia bellerica).

4. Desire for clay, mud and brick can be replaced by gairika (red ochre) fried in ghee.


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