E-ISSN:2456-3110

Review Article

Antenatal Care

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 3 March
Publisherwww.maharshicharaka.in

Preconceptional and Antenatal Care through Life Style with special reference to Sadvritta: A Scoping Review

Dhananjay Inchekar A1*, Shrotriya Y2, A Tiwari M3
DOI:10.21760/jaims.9.3.21

1* Archana Dhananjay Inchekar, Satvavajay Counselor Professor and Head, Dept of Swasthavritta and Yoga, Manjushree Research Institute of Ayurvedic Science Piplaj, Gandhinagar, Gujarat, India.

2 Yogita Shrotriya, Professor and Head, Dept of SharirKriya, Manjushree Research Institute of Ayurvedic Science, Piplaj Gandhinagar, Gujarat, India.

3 Mrunal A Tiwari, PhD Scholar Professor and Head, Dept of Agad Tantra, Manjushree Research Institute of Ayurvedic Science, Piplaj Gandhinagar, Gujarat, India.

Sadvritta is a group of good conducts indicated to practice throughout life for everyone. Sadvritta plays significant role in prevention of all kind of diseases and in promotion of health. Female reproductive health is responsible for proper outcomes related to maternal and child health. There are guidelines in Ayurveda which consists of concepts of preconceptional, antenatal and post-natal health care of a mother and child. Wholesome life style with physical, psychological and verbal acts along with required medication and Panchakarma are mentioned. Special guidelines are mentioned for a couple as a Garbhadhan Vidhi (method of impregnation) which is supposed to follow at the time of preconception. Wholesome regimens at physical, mental and verbal level in life style of pregnant woman and a father at the time of conception is advised to maintain. Many factors described in Garbhini Paricharya and Sadvritta other than nutrition and medication are important for prevention. Emotional health of a mother is associated with the health of a child. Sadvritta and Ayurvedic life style consists guidelines which can reduce health issues due to stress. Many countries have developed national level health programmes for mother and child health. Goals of mother and child health programme emphases on antenatal, intra-natal and post- natal health care. Objectives of MCH programme are reduction of mortality and morbidity rates of mother and child. For it, care can be started at preconceptional phase. There may be a scope to advise Sadvritta guidelines to currently established MCH with Ayurveda health care. This article is an effort to view scope in MCH through Ayurveda and Sadvritta.

Keywords: Preconceptional Health, Sadvritta, Life Style in Pregnancy, Antenatal Care, Mother and Child Health in Ayurveda

Corresponding Author How to Cite this Article To Browse
Archana Dhananjay Inchekar, Satvavajay Counselor Professor and Head, Dept of Swasthavritta and Yoga, Manjushree Research Institute of Ayurvedic Science Piplaj, Gandhinagar, Gujarat, India.
Email: 		Dhananjay Inchekar A, Shrotriya Y, A Tiwari M, Preconceptional and Antenatal Care through Life Style with special reference to Sadvritta: A Scoping Review. J Ayu Int Med Sci. 2024;9(3):144-149.
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https://jaims.in/jaims/article/view/3007

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-01-14 2024-01-24 2024-02-03 2024-02-13 2024-02-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 21.87

© 2024by Dhananjay Inchekar A, Shrotriya Y, A Tiwari Mand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Female reproductive health is responsible for proper outcomes related to maternal and child health. Complete wellbeing is a goal for all phases of human life. Healthy child is desirable all over the world along with maternal health in families. Many countries have developed national health programmes for mother and child health. Goals of mother and child health programme emphases on antenatal, intra-natal and post-natal healthcare. Objectives of MCH programme are reduction of mortality and morbidity rates of mother and child.[1] For it, care has to plan at preconceptional phase. Early pregnancy care is too late to prevent many of the morbidities in mother and child. There is a scope by starting preconceptional health care. There are guidelines in Ayurveda consists of concepts of preconceptional, antenatal and post-natal health care of a mother and child. Guidelines are mentioned in detail as wholesome life style with physical, psychological and verbal acts along with required medication and Panchakarma. Preconceptional health of a reproductive woman is indicated to preserve. Guidelines of life style at menstruation are mentioned for a woman to preserve a health.[2] Special guidelines are mentioned for a couple for proper conception and healthy child as Garbhadhan Vidhi which is supposed to follow at the time of conception. Physical and psychological status of a male and female affects relative health of a foetus. Positive health of a mother and a father is a foundation of a health of a baby. Nutrition is described one of the important factors. Wholesome regimens at physical, mental and verbal level in life style, mental health of pregnant woman and a father at the time of conception is advised to maintain. Sadvritta is a group of a moral and ethical conducts. Sadvritta is a conduct of nobles in respect of physical, verbal and psychological acts according to Chakrapanidatta.[3] Sadvritta is indicated to practice for all fully in all the time. Those are important to apply them during preconceptional and antenatal phases. It is said that obstetrics is preventive branch at the most. Many factors described in Garbhini Paricharya and Sadvritta other than nutrition and medication are important for prevention.

Need of a study

There is a need to promote health of a woman

at phase of preconception for not only prevention but also for promotion of mother and child health. Nutrition, Medication and regular observation are established health care services. Many other factors in life style are associated with maternal and child health. Physical acts as exercise, travelling, over exertion may lead to affect badly to pregnancy outcomes. Emotional wellbeing plays an important role throughout pregnancy and should be preserved. Meditative and calm mind leads to improve maternal health. All-over whole life style of a reproductive woman affects during pregnancy. Guidelines related to wholesome life style are mentioned in Sadvritta may be helpful to improve pregnancy outcomes. There is an important role of Sadvritta in all phases of human life as in preconception and pregnancy for prevention of not only physical but Vishaj, Bhutaj and psychological diseases too.[4] This review is an effort to study scope of Sadvritta and Ayurvedic life style in preconceptional and antenatal health care.

Aim

To study a scope of preconceptional and antenatal care through life style with special reference to Sadvritta

Objectives

1. To study importance of life style including Sadvritta as a preventive measure

2. To review scope of life style including Sadvritta in preconceptional phase of a reproductive woman

3. To review scope of life style including Sadvritta in antenatal care

Materials and Methods

Literature was reviewed related to selected topic through books, modern and antient literary source. Online search with various searching databases as PubMed, Google Scholer, Scopus, Research get had carried out with keywords as Sadvritta in Garbhini, antenatal care, preconception and Ayurveda, Life style in pregnancy etc. More than 105 research publications were critically reviewed published in various countries. Related evidences were critically reviewed to identify scope of Sadvritta and life style in preconceptional and antenatal care. Ayurveda literature from Charak Samhita, Sushrut Samhita


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with commentaries had reviewed. As practices of Sadvritta consists preventive benefits, related material also reviewed with special reference to preconceptional and antenatal care.

Observations

Reproductive woman health guidelines as per phases in Ayurveda

Woman is considered responsible for health of a child. Ayurveda consists guidelines in following stages.

1. Menstruation

2. Preconceptional

3. Antenatal

4. Post natal

Menstrual health care is described as a Rajaswala Charya aims to protect woman’s general and reproductive health.[2] It is advised to diet which is easy to digest, to adopt celibacy. Preconceptional phase is important for physical, mental and intellectual preparation of a couple. Ayurveda care includes general care as proper eating, proper hygiene, and happiness with sexual desire, affection and mantra chanting. Thoughts for good, and Satvasampanna (who have best emotional and psychological strength) child, hearing noble stories, soft spoken way are indicated to practice for seven days. On eighth day it is indicated to be preparing for conception. Along with it, wholesome diet and life style is indicated.[5] Many more instructions are given for a couple at the time of conception.[6] Nutrition, daily regimens with specific does and don’t in life style, psychological and physical health status of a mother and a father at the time of conception is also needed to keep positive and stable. Ayurvedic Health (Swasthya) having excellent development of all dimensions known as a Supraja. (Ideal & excellent child) can be achieved by following all the measures indicated in Ayurveda.[7]

Recommendations of Life Style in Ayurveda

The guidelines regarding the diet as per every month of pregnancy, regimens, emotional health care and an additional guideline related to spiritual health as prayers, mantra are described in Ayurveda. Life style word represents Vritta which means routine activities

which are followed continuously. Physical, verbal and psychological acts are considered under life style. Preconceptional phase of a woman is a time to strengthen health and to prepare for conception. Therefore, Panchakarma is indicated prior to conception. Diet recommendations are specifically available for preconceptional phase. Acts and diet harmful to reproductive health are advised to avoid. Emotional and spiritual health care is taken care of in preconceptional and antenatal health care. Acharya Sushrut mentioned antenatal care should be taken from the very first day. Diet, should be selected as cow milk, fresh fruits, relishing mainly liquid and sweet. Unctuous and processed with appetizers.[8]

Table 1: Ahara - Vihar (Paricharya) of Reproductive woman in Ayurveda

SNPhase of Reproductive womanDiet careLife style careEmotional health careothers
1.MenstruationLaghu, Snigdha AaharRest, cleanliness (celibacy avoidance Ashtavidh Maithuna)Avoid anger fearAvoid day sleep, massage, Excessive laughing and talking
2.Preconception (desire child)Predominant of sesame and black gram,Clean, white cloth wearing,Harsh Prasann mindPurification (Panchakarma) Vaman, Virechana, Anuvasan, Asthapan Basti Prayers to Guru, Siddha, Dwija, Dev, Brahman, Agni, Tapasvi
3.AntenatalHighly nutritiousGarbhini ParicharyaPrasanna mindAvoid Garbhopaghatakar Bhava Follow all wholesome practices Sadvritta
4.Post natalBrimhana, DeepanaSutika ParicharyaFree from Fear, angerUdar Pattabandhana, Ushnodak Snana, abstain from anger, sexual act.

Benefits of Garbhini Masanumasik Paricharya (regimen as per month of pregnancy)

Preventive benefits are described as healthy child with strength, voice, compactness, and much superior to other family members.[6]


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It not only prevents diseases of pregnant woman and foetus but also preserves and promote health. Thus, beneficial to reduce mortality and morbidity in maternal and child health.

Factor responsible to promote health of a mother and foetus is mentioned as Vrittasoushtavya (wholesome life style of mother).[7]

Contraindicated life style for pregnant woman

It is taken care with guidelines to avoid practices titled as Garbhopaghatkar Bhava (factors harmful for foetus). All these contraindications can be groups as follows:

Table 2: Contraindications for pregnant woman

SNGroupActivities as risk factors
1.Which produce strain on body or mindHeavy exercise, coitus, harsh and violent activities, anger.
2.Work beyond to capacityCarrying overweight, vehicle riding, night awakening.
3.Dietary factorsNon veg diet, fasting, hot, pungent, unwholesome food, overnutrition.
4.othersConsuming alcohol, performing Panchakarma, Vega Dharan, wearing red garments, Teekshna medicines.

All mentioned above are Apathya or unwholesome practices. Ayurveda consists life style guidelines according to various phases of woman and guidelines are mentioned to practice for everyone at every place by all means as Sadvritta.

Scope of addition of health at preconception level includes menstrual health care and preconceptional health care. Health of a woman is considered to be preserved in Ayurveda by guidelines of Rajaswala Paricharya, Garbhini Parcharya and Sutika Paricharya. Charaka & Vagbhata mentioned the benefits of Garbhini Paricharya for physiological and anatomical health of Kukshi (abdomen), sacral region, flanks and back. Properly elimination of Vayu, Mala and Mutra occurs.[8]

Sadvritta as a Preventive Measure

Sadvritta is classified as Sharirik (physical), Manasik (psychological), Adhyatmik

(Spiritual), related to diet (Aahar Sambandhi), related to Adhyayan (study) and Samajik (social) ways of conducts. There are the social and moral conducts for everyone who wishes wellbeing and

long healthy happy life. Chakrapani, a commentator of Charak Samhita Sadvritta as practicing good and moral conducts with physical, verbal and psychological acts. Hence essential for preconceptional and pregnant woman to follow it. It is a scientific literature from Ayurveda about life style. Sadvritta here may be considering for a preconception phase and antenatal phase.

Ayurveda includes all above with spiritual practices as Japa (recitation of mantra), prayers as a part of life style. It is described as a preventive measure with a note that all should practice acts which have been advised by wise people and not mentioned here.[9] Role of Sadvritta is to sustain life span. Good conducts are effective to prevent health issues due to previous deeds. Daiva is known as Karmas (actions) of previous birth.[10] It is also related to health of reproductive woman and a child. Sadvritta prevents diseases due to Karma and Daiva too additional to the group of diseases that can be occurred due to Asatmendriyarth Samyog (unwholesome contacts of senses and objects) and Pradnyaparadh. As per various types of noble conducts, various effects and benefits are described briefly as Aatmahitam or wellbeing. Benefits for physical, mental, social and spiritual preventive health can be obtained. Importance of Sadvrita is its beneficial role for strengthening ‘Karma’ and prevent death prior to complete life span.[11] Life style guidelines as Swasthavritta, Sadvritta and Garbhini Paricharya are effective to reduce morbidity and mortality in maternal and child health. It covers all activities related to life style. Practices of Sadvritta and life style mentioned in Ayurveda prevent harm from the factors as Garbhopghatkar Bhavas (Physical, psychological and social factors which are described to avoid)

Health education of Sadvritta (good conducts) and Swasthavritta (healthy life style)

Ayurveda describe life style to follow by people and it is need to educate them related to Ayurveda.[12] Currently regular clinical checkup and medication in pregnancy are known up to some extent. Still Ayurvedic life style is yet to be included in health education. It prevents diseases, promotes maternal and child health.

Discussion

Antenatal care in diabetic woman should be seen as


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early on in pregnancy as possible, by experts as diabetologist and obstetrician. Women should be offered contact with the joint diabetes antenatal team (either face to face or virtual clinic appointments) every 1-2 weeks throughout pregnancy.[13]

World Health Organization (WHO) sets goal to provide preconceptional and antenatal care to a reproductive woman. Preconception care is the provision of biomedical, behavioural and social health interventions to women and couples before conception occurs as per WHO. Health status can be improved by it. Its ultimate aim is improved maternal and child health outcomes.

Preconceptional health care is currently considered as any preventive, promotive or curative health-care intervention. It is provided to reproductive women in the period before pregnancy (proximal – within 2 years or distal) and between gap of two pregnancies to improve health for women, newborn and child. A gap was identified that denotes need of a care in preconceptional phase.[14]

Sustainable Development Goal 3 is a health improvement step by authorities in which universal health coverage is aimed to improve areas of health services as maternal and child health. Ensuring healthy lives and promoting well-being at all ages are essential to sustainable development. Ayurveda states that the health of an individual is interrelated to sustain a healthy life, one should adhere to the principles of Swasthavritta, Dinacharya (daily regimen), Ritucharya (seasonal regimen) along with Sadvritta (good conduct and behaviour), Rasayana (rejuvenation and revitalization therapy), Vajikarana (aphrodisiac or virility treatment), and Achara Rasayana (customary law, codes, conducts, and behaviour which prevents the psychosomatic ailments). These practices are effective as preventive measures in healthy beings to prevent diseases and also controls the disease and complications in diseased persons through modified lifestyle approaches.[15] Too Early prenatal care is too late is mentioned in a review article by authors due to limitations found in mother and child care in UK. Early prenatal is defined as a care at first trimester. It is a time when organs are already formed and any unhealthy development cannot be prevented. The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynaecologists (ACOG)

recommend for prevention that “all health care should be taken for reproductive woman, particularly preconception care, should include counselling on appropriate medical care and behaviour to optimize pregnancy outcomes.[1]

Conclusion

Wholesome life style with Sadvritta plays an important role in preconceptional and antenatal phase to reduce morbidity and mortality in mother and child. Medication and regular clinical and pathological investigations are in practice. There may be a scope of life style modification from preconceptional phase to enhance health care to reproductive woman. Wholesome life style is beneficial at physical, psychological, social and spiritual level. There may be a scope to advise Sadvritta guidelines to currently established MCH with Ayurveda health care.

References

1. Atrash HK, Johnson K, Adams M, Cordero JF, Howse J. Preconception care for improving perinatal outcomes: the time to act. Matern Child Health J. 2006 Sep;10(5 Suppl):S3-11. doi: 10.1007/s10995-006-0100-4. Epub 2006 Jun 14. PMID: 16773452; PMCID: PMC1592246.

2. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 340

3. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 58

4. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 54

5. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 341


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6. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 342

7. Inchekar VA, Chavan VS. PREVENTIVE AND PROMOTIVE MEASURES IN ANTENATAL CARE WITH AYURVEDA AND YOGA FOR EXCELLENCE AND MULTI-DIMENSIONAL DEVELOPMENT OF FOETUS. World journal of pharmaceutical Research, vol.6,538-545issue8, DOI: 10.20959/wjpr20178-8980

8. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 321

9. Dallanacharya, Sushrut Samhita, nibandhasangrah commentary edited by Vaidya Yadavaji Trikamaji , sharir sthana, published by Choukhambha Sanskrit Sansthan, Varanasi, 6th edition, 1997; 2,16 , 345.

10. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 61

11. Chakrapanidatta, Ayurveda Dipika commentary for “Charaka Samhita”. Revised by Charaka and Dridhabala. Edited by Yadavji Trikamji Acharya. Reprint ed. Chaukhambha Sanskrit Sansthan, Varanasi. 2016; 243

12. Archana D. Inchekar. A study on role of Sadvritta in pandemic of Covid 19 as a preventive measure. IAIM, 2021; 8(9): 75-82. http://iaimjournal.com/

13. Chloe Broughton A, Isy Douek B An overview of the management of diabetes from preconception, during pregnancy and in the postnatal period Clinical Medicine 2019 Vol 19, No 5: 399–402 CME: DIABETES MEDICINE

14. WHO benchmarks for the training of Ayurveda. Geneva: World Health Organization; 2022. Licence: CChttps://creativecommons.org/licenses/by-nc-sa/3.0/igo/

15. Nesari TM. Ayurveda for achieving sustainable development goals. J Ayurveda Case Rep 2022;5:135-9.


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