Journal of Ayurveda and Integrated Medical Sciences

Introduction

Pregnancy is one of the most important periods in a woman's life, as it brings along numerous changes, not only in the physical aspects, but also socially and psychologically. There are plenty of researches done around the world about anxiety during pregnancy.

Several factors can trigger anxiety during pregnancy, including: Hormonal Changes, Fears and Uncertainties, Previous Pregnancy Experiences, Personal and Work-related Stress etc. It's important for pregnant individuals to communicate openly with healthcare providers, seek emotional support, and consider stress-reducing strategies to manage anxiety effectively.

Ayurveda offers various practices and remedies that serve as effective stress busters. These may include: Herbal Remedies, Yoga and Meditation, Balanced Diet, Shirodhara etc. Ayurveda emphasizes a balanced and mindful lifestyle, including proper sleep, regular exercise, and stress management practices, to maintain overall harmony. Incorporating these Ayurvedic principles into daily life can help manage stress and support a healthier, more balanced existence.

The Ayurveda explains the episodic nature of Ardhavabhedaka (Migraine). Pain is the major symptom in the Ardhavabhedaka which affects the person’s activities. While describing Shiroroga, many Acharya counted Ardhavabhedaka in Shiroroga Acharya Charak has stated that Vata either alone or in combination with Kapha, there will be severe pain in half side of the head, affecting particularly Manya, Bhru, Shankha, Karna, Akshi and Lalaat. The pain is like Shastra Arani Nibham.^[1]

According to Acharya Sushrut there will be severe tearing and pricking pain in one half of the head associated with giddiness. These features appear every fortnightly or ten days or any time, Ardhavabhedaka caused by all the three Doshas.^[2]

A definition of migraine is a recurring syndrome of headache, nausea, vomiting and/or other symptoms of neurologic dysfunction in varying admixtures. Migraine Attacks typically include: headache, which is of moderate or severe intensity, one-sided, pulsating in quality, aggravated by routine physical activity, with duration of hours to 2-3 days, nausea, attack frequency is anywhere between once a year

Method

Shirodhara is classified into three Karma i.e., Purva Karma, Pradhan Karma, Paschat Karma.

Purva Karma

Preparation of the patient - The patient is thoroughly examined whether he is fit with for procedure. Patient should be advised to pass stool and urine. Then pulse, temperature and blood pressure of the patients should be recorded. Patient is advised to lie down in supine position and Dhara Patra should be fixed 4 Angula above the forehead. The eye and ear should be covered with cotton to prevent the entry of liquid into eyes and ears.

Pradhana Karma

Shirodhara room should be cleaned well, ventilated and very quiet. Shirodhara is done in the morning time on empty stomach after massage. Any type of liquid (Taila, Milk, Kvatha, water) should be kept in Dharapatra.

Dhara should be poured continuously initially in the centre of the forehead neither very fast nor very slow. The liquid of Shirodhara should not be too hot or too cold. The stream of Dhara liquid should not be too thick or thin. When the liquid starts pouring then the vessel is moved in the pendulum manner. The continuous flow and the temperature should be maintained.

The liquid is collected in another vessel kept and is used to refill the Dharapatra before it becomes empty.

Shirodhara process is done for at least ½ an hour in the morning up to 7/14/21 days.

Paschat Karma

After the Shirodhara process is completed, and then cotton pads were removed over the eyes and ears. The head of the patient should be wiped out and dried. This is followed by a short duration of rest and massage of the body including head with oil and then a lukewarm bath. The patient is advised to have a Pathya Ahara (light diet). Patient should avoid exposure to cold, dust, wind.

Method of Administration of drug

Drug - Tila Taila

Dose - 500ml/day/patient

Discussion

As Taila molecules are Sukshma (extremely tiny), they are able to penetrate the skin through hair follicles, pores, and sweat glands. From there they reach lymph nodes and blood capillaries, which then transport them throughout the body by the circulatory system.^[11]As Shirodhara is considered under Snehan and Snehan is Yogya for Garbhini. The procedural effect of Shirodhara itself seems to produce a relaxation response. As Shirodhara is Vata Shamak. In Shirodhara, patients feel relaxation both physically as well as mentally. It is a purifying and rejuvenating therapy which eliminates toxins and mental exhaustion as well as relieves stress and any ill effects on the central nervous system.

Note - As seen in various researches, Shirodhara is advice during first and second trimester of pregnancy and Shirodhara with the Tila Taila is indeed recommended during the first and second trimesters of pregnancy to help alleviate stress and anxiety. Although no direct indication of Shirodhara is mentioned in Ayurvedic classics but can be considered under Snehan. However, caution is advised in the third trimester due to concerns about potential muscle relaxation, which could have implications for the fetus. Safety is paramount during pregnancy.

Conclusion

Shirodhara where in continuous pouring of Tila Taila in relaxed and comfortable position has sedative and soothing effect to the brain. Also, the Taila enters into the circulation does the Vata Shamana. Thus, Shirodhara pacify Vata, Pitta. This procedure has been successfully practiced to treat stress induced various disorders like anxiety, depression, tension headache, etc during pregnancy.

References

1. Shastri Kashinath, Gorakhanath Vidyotini Commentary on Charak Samhita Varanasi, Chaukhambha Bharti Academy, 2009;2: Siddhi Sthan 26

2. Shastri Ambika dutta, Sushrut Samhita, Ayurveda Tattva Sandipika, Varanasi Chaukhambha Sanskrit Sansthan Varanasi, 2012; 2: Uttartantra. Chap., 25/15: 166.