E-ISSN:2456-3110

Review Article

Garbhini Paricharya

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 2 February
Publisherwww.maharshicharaka.in

Clinical understanding of Garbhini Paricharya : Routine care for pregnant women through Ayurveda

Swami R1, Ramawat B2*
DOI:10.21760/jaims.9.2.33

1 Renu Swami, Post Graduate Scholar, Dept of Prasuti Tantra Striroga, VDYS Ayurveda Mahavidyalaya, Khurja, Uttar Pradesh, India.

2* Bajrang Ramawat, Post Graduate Scholar, Dept of Prasuti Tantra Striroga, Vdys Ayurveda Mahavidyalaya, Khurja, Uttar Pradesh, India.

Introduction: Ayurveda classics give importance to caring of mother before, during and after pregnancy. Care during nine months of pregnancy is termed as Antenatal care or Garbhini Paricharya. Garbini Paricharya is one of its concepts explaining the importance of establishment of health of a woman before delivery; directing physicians and Gharbhini to adopt certain recommendation of Aahara, Vihara & Yoga and Pranayama. Material & Method: Literature is collected by Brihatrayi and Laghutrayi, all available Ayurvedic classic, modern available texts, magazines, journals, and research papers. Result: Garbhini Paricharya as described in Ayurveda classics is unique and specific. So by following proper Ayurvedic Gharbhini Paricharya would result in proper development of foetus and prepare pregnant women for Sukhprasava physically, psychologically and spiritually. Discussion: Now present modern and busy working life women are facing many complications and other health related issue after conceiving and during the pregnancy period. Thousand year of ago our classical texts Ayurveda described most important Gharbhini Paricharya for Gharbhini. It is totally scientific and too much beneficial for foetus and mother both. The concept of prenatal care is now highlighted in modern science, which is mentioned in Ayurveda thousands of years ago.

Keywords: Ayurveda, Pregnancy, Antenatal care, Garbhasthapaka Dravya, Garbhini Paricharya, Masanumasika.

Corresponding Author How to Cite this Article To Browse
Bajrang Ramawat, Post Graduate Scholar, Dept of Prasuti Tantra Striroga, Vdys Ayurveda Mahavidyalaya, Khurja, Uttar Pradesh, India.
Email: 		Swami R, Ramawat B, Clinical understanding of Garbhini Paricharya : Routine care for pregnant women through Ayurveda. J Ayu Int Med Sci. 2024;9(2):213-220.
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https://jaims.in/jaims/article/view/3133

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-12-13 2023-12-23 2024-01-03 2024-01-13 2024-01-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 22.48

© 2024by Swami R, Ramawat Band 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

Pregnancy is the most important and sensitive phase in every woman’s life. It brings about emotional and physiological changes as well as poses extra demands on the body. Pregnancy requires the total Ahara to be high in calories, proteins, vitamins, and minerals, among other nutrients. The body needs more nourishment during this stage to support the developing foetus and the pregnant woman. Thus, wellness of the pregnant women is maintained through proper Garbhini Paricharya (Garbhini Paricharya means caring of the pregnant women in the form of Ahara (diet), Vihara (life style), Aaushada (medications) and Paramarsh (counselling), Mentioned in our text. It follows from the confirmation of pregnancy till after delivery. Thus, it is important for a pregnant lady to pay attention to her food and should never be neglected.

The main aim of Garbhini Paricharya is

1) To protect fetus from any hazards.

2) To promote proper growth and development of fetus

3) To perform normal delivery free from any foetal and maternal complications before and after.

It is a transformative period with incredible changes that, although natural, can be stressful if not taken care of at the appropriate time. Acharya Charaka has explained that due to the Prachalita Dhathus and Dhoshas, the lady will be prone for getting Vikrutis. Thus Garbhini should be treated just like a pot full filled with oil it care proper,[1] that is even the slightest excitement can create many severe problems to pregnant lady before and after and as well as the fetus. It has to be in our classics there are references regarding Garbhasrava and Garbhapaata.[2] While explaining about its causative factor there mentioned about Maatur Ahara Vihara Janitha, Douhridaavamanaja, Asadvruttajanita. So, Ahara, Vihara and Surrounding environment can play most important role in the effects of wellbeing of the future progeny.

Various Aharas, Viharas, and Aushadhas are explained in our scientific text for maintaining the physical and mental health of pregnant women3.So rate of abortions can be decreased by following proper antenatal care. Thus, great importance has been given to Garbhini Paricharya in our classics.

Garbhini Paricharya

The monthly regimen is broadly discussed under three headings

a) Masanumasikapathya (Month wise dietary regimen)

b) Garbhopaghathakara bhavas (Activities and substances which are harmful to fetus)

c) Garbhasthapakadravyas (Substances beneficial for maintenance of pregnancy)

Masanumasika Pathya (Month Wise Dietary Regimen)

First month of pregnancy

प्रथमे मासे शङ्किता चेद्गर्भमापन्ना क्षीरमनुपस्कृतं मात्रावच्छीतं काले काले पिबेत्

During first trimester the lady will be suffering from Shrama, Glani, Pipasa, Chardhi. Thus, the milk is the ideal source and it prevents dehydration due to nausea and vomiting. Milk is a complete diet mentioned in our text. It can be taken throughout the period of pregnancy.

Milk has Madhura, Sheeta and Drava Susanskrit Property (sweet, cold and liquid diet). It is easy to digest, Agni Dipaka (i.e., appetizers) and supply optimum nourishment which is required. Madhura rasa is excellent for formation of Dhatu, it is Vata Shamaka and anabolic in nature. Milk helps in provide proper nourishment and gives stability to the foetus.[4] It also prevents abortion. Milk increases intellectual level (Medhya), strength (Bala) and is lactogenic.[5] It is rich source of Proteins and Vitamins. Proteins are vital for building and maintaining tissues such as muscles. It contains Vit A, D, B1, B2, B6, B11, B12, Minerals, Calcium, Phosphorus; Zinc, Lactose provides slow release of energy.

Second Month Pregnancy

द्वितीये मासे क्षीरमेव च मधुरौषधसिद्धं;

Should take milk with Aausadh Dravya which having Madhura Rasa and liquids which are sweet and Sheet Virya.[6]

Third Month Pregnancy

विशेषतस्तु तृतीये षष्टिकौदनं पयसा भोजयेत्

According to Acharya Sushruta


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in this month pregnant lady should take milk with honey and ghee and Shashtika Shali (a variety of rice) cooked in milk.[7] Shali-Shashtik (Rice) is rich in carbohydrates, provides fuel for body, excellent source of Niacin, Vitamin D, Calcium, Fibre, Iron, Thiamine and Riboflavin.

तृतीये मासे क्षीरं मधुसर्पिर्भ्यामुपसंसृज्य;

From third month onwards, mentioned about the importance of Ghritha. Ghrita is Vata Pitta Prashamana.[8] Ghee is rich source of antioxidants and acts as an “Sanskarvahi Guna” in addition of vitamins and minerals from other food. Honey is also having great property of Anti-inflammatory and anti-oxidant property.[9]

Fourth month of pregnancy

Foetal heart is manifested in this phase, so woman is termed Dauhrudini Chetna/consciousness arise & desires are expressed via mother.[10]

चतुर्थे पयोनवनीतसंसृष्टमाहारयेज्जाङ्गलमांससहितं हृद्यमन्नं च भोजयेत्

From fourth month onwards, there is rapid growth of fetus. The muscular tissue of foetus develops, so more proteins are needed. So, its t can be gained by the usage of Jangalamamsa, Shashtikodana, Dhadhi, Ksheera, Navaneeta.[11]

चतुर्थे मासे क्षीरनवनीतमक्षमात्रमश्नीयात्;

Butter extracted from milk in the quantity of one Aksha (approximately 10 grams) or milk with butter should be given in this month.[4] Cooked Shashtika Shali with curd, pleasant food mixed with milk & butter and meat of wild animals can also be given.[12]

In fourth month Mamsashonitopachaya occurs to Garbha and lady feels emaciated. It is due to the lack of nourishment of maternal Dhathus, as the Aahara rasa is driven to nourish the fetal Mamsaraktaathidhathus.[13] Thus during this period, indication of Ksheerasarpi, Hridhyannapaana, Mamsa which all supply the nutrients for the development of fetal tissue as well as the mother.

Fifth month of Pregnancy

On comparison to other months, there is an excessive increase in Mansha and Rakta of the foetus during fifth month of Pregnancy.

पञ्चमे मासे क्षीरसर्पिः

Ksheera Sarpi - Ghrita prepared with butter extracted from milk is given in this month. Food Advised in fourth month can also be given but instead of butter, Ghrita is given in this month.[14]

Shastika rice with milk, Jangala Mamsa along with dainty food mixed with milk and Ghrita. Mamsa Vardhaka (foods which promote bulk in foetus), i.e., meat soup, black gram; Rakta Vardhaka Aahara (which increase blood), i.e., Pomegranate, Chikoo, Apple, spinach, beetroot, Amlaki, Guava etc. to be given. Mamsarasa provides nourishment to the growing foetus and also pacifies Vata. It is the excellent source of proteins, vitamins, fats, minerals (iron and other minerals) and is also a source of endogenous antioxidants.[15]

Pregnant women can easily digest and benefit from foods like Shali and Shashtika rice, wheat, Mudga (green gramme), parched rice flour, and sour and sweet fruits like Panasa (jack fruit), Kadali (banana), Amalaki, and Draksha.[16]

Sixth month of pregnancy

The foetus gains more strength and complexion during this month, while the woman has more fatigue because of the increased need for nutrition in the sixth month. The woman will be more prone to foot oedema or other complications related to fluid accumulation at the end of the second trimester. There is also a higher chance of developing a UTI.

षष्ठे मासे क्षीरसर्पिर्मधुरौषधसिद्धं

Grabhini should take Ksheera sarpi medicated with Madhura Oushadhas.[17]

षष्ठे श्वदंष्ट्रासिद्धस्य सर्पिषो मात्रां पाययेद् यवागूं वा

Ghee or rice medicated with Gokshura (Tribulus terrestris) should be given in this month.[18] Swadhamshtra Siddha Sarpi and Yavagu prevents the above condition as it has the property of Mootravirechaniya, Shothahara, Krimighna.

Seventh month of pregnancy

षष्ठे मासे क्षीरसर्पिर्मधुरौषधसिद्धं; तदेव सप्तमे मासे

The regimen of seventh month is same as that of sixth month.[19] Ghrita medicated with Vidarigandha etc drugs can also be given which helps in the proper development of the foetus.[20]

सप्तमे सर्पिः पृथक्पर्ण्यादिसिद्धम्, एवमाप्यायते गर्भः


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In seventh month by the usage of Madhuroushadha Siddhasarpi, Prithakparnyadi Siddha[21] Ksheerasarpi having the Brimhana property which helps in fetal development.[22]

Eighth month of pregnancy

अष्टमेबदरोदकेन बलातिबला….तैलेनानुवासयेत्, अनुलोमे हि वायौ सुखं प्रसूयते निरुपद्रवा च भवति

Basti i.e., Medicated enema, is administered during the eighth month. As Vata plays an important role in the whole process of delivery. Acharya Sushrutha has suggested Asthapana Basti (a medicated enema with non-unctuous substances like Kashaaya) with decoction of Badari mixed with Bala, Atibala, Shatapushpa Palala (pasted Sesamum seeds), milk, curds, Masthu (sour buttermilk), oil, salt, Madanaphala, Madhu and Ghrita and followed by Anuvasana Basti (amedicated - unctuous enema) with oils medicated with milk and decoction of drugs of Madhura group. These would help in clearing the retained faeces and helps in downward movement of Vata.[23]

अष्टमे तु मासे क्षीरयवागूं सर्पिष्मतीं काले काले पिबेत्;

Acharya Charaka suggested in this month Garbhini should take Ksheera Yavagu mixed with Ghrita. Snigdha Yavagu balances the Vata Dosha, strengthens the body, and nourishes bodily tissue.[24]

Ninth Month of Pregnancy

नवमे तु खल्वेनां मासे मधुरौषधसिद्धेन तैलेनानुवासयेत्

In this month, Anuvasana Basti with the oil medicated with Madhura group of drugs given in pregnant women. The Pichu (Vaginal tampons) with the same oil is also administered for the lubrication of the vaginal passage.[25]

Most of the women experience constipation in late pregnancy due to the pressure of the gravid uterus and by the effect of hormones. Thus, Anuvasanavasti helps in Anulomana of Apanavata. It helps in bringing normalcy of Apanavata and thus facilitates unobstructed labor.[26]. Yoni Pichu helps in softens the vaginal passage, facilitates relaxation during labour then prevents perinea tear.

Garbhopghatakara Bhava (Factors which harm the foetus)

The science of Ayurveda also recommends avoiding some Aahar Dravya and lifestyle-related activities

that are hazardous to both the Garbhini and the Garbha and should not do during pregnancy. These are termed as Garbhopghatakara Bhava. These factors may cause some congenital defects in the child and are not in the favour of the birth of a healthy child having all the good qualities. The following issues, such as intrauterine growth retardation, premature labour, abortion, and intrauterine mortality, may occur if the Garbhini is subjected to Garbhopaghatakara Bhavas.

The food articles which contain Teekshna (Sharp), Katu (pungent), Ushna (hot), Guru and Vishtambhi (Heavy and hard to digest) properties should be avoided. She should also avoid the alcoholic substances like wine and also excessive intake of meat. She should also avoid the food substances which cause constipation and which are Vidahi. Food items including onions, garlic, and yams should also be avoided. Avoiding even Kshara foods (alkalis) is advised by our Acharyas.

Garbhopaghatakara Bhavas

Acharya’sAhara (Diet)Vihara (Behaviour)
Charaka Pungent drugs, Tobacco/Smoking, Cocaine, Alcohol intake, Meat, Inadequate calorie intake, Caffeine (tea, coffee,
chocolates)		High pitch voice, Suppression of natural urges, Exercise, Coitus, Strenuous work, going outside alone to lonely places, visiting cremation places, haunted trees and entering shades of tree, Use of blood-stained clothes, Peeping into well
Sushrut Dry, Food kept overnight, Boiled food, Wet or moistened foodCoitus, Exercise, Night awakening, Day sleeping, Prolonged squatting & abnormal postures, Travelling, Suppression of natural urges, Bloodletting, Excessive satiation, Excessive emaciation
Ashtanga Sangraha Intake of Dry food
Ashtanga Hridaya Meat, Alcohol intake, Intake of food which is hard to digest (Vishtambhi)Excessive coitus, Exercise, carrying heavy weight, untimely sleep, squatting, grief, anger, excitement, suppression of natural urges, fasting, excessive walking,use of red garments, sleeping in supine position, bloodletting
Kashyap Excessive use of garlic in food, Use of cold waterLooking at declining moon & setting sun, Excitement, Exposure to solar or lunar eclipse, Excessive laughing, staying for longer periods in erect or flexed posture, wearing tight garments, Viewing the filled pots, garlands, pot filled with ghrita or curd.

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Thus, all the harmful physical and mental activities should be avoided which would harm the foetus.[27]

Garbhasthapaka Dravya (Drugs beneficial for maintenance of pregnancy)

Substances that help in maintenance of pregnancy and those drugs which are counter acting in the Garbhopaghatakara Bhavas. These drugs can also be beneficial in the recurrent abortion. These are to be used as a routine as they are helpful for the maintenance of proper health, growth and development of the mother and foetus. Some of the Garbhasthapaka Aushadhi are Aindri (Bacopa monnieri), Brahmi (Centella asiatica), Shatavari (Asparagus racemosus), Sahasravirya (Cynodon dactylon), Amogha (Stereospermum suaveolens), Avyatha (Tinospora cordifolia), Shiva (Terminalia chebula), Arista (Picrorhiza kurroa), Vatyapushpi (Sida cordifolia), Vishwaksenkanta (Callicarpa macrophylla) etc.[28]

The medicated ghee or milk prepared from these drugs can be taken orally or the bath with cold decoction of these drugs should be given in Pushya Nakshtara. These drugs should be kept in close contact with the mother and can be used as amulets around the right arm or on the head. Also, the drugs of Jeevaneeya Gana can be used in a similar way. Acharya Kasyapa has advocated that amulet of Trivritta (Operculina turpenthum) can also be tied in the waist of pregnant woman.

Yoga

Yoga offered a multi range of activity to unborn child and to mother in numerous ways. It soothes the mind, refocus the energy and prepare woman psychologically for labour process. Various Asana creates more space in pelvis which makes expulsion of foetus easy. Yoga like Trikonasan, Vrikshasan, Virabhadrasan, Vajrasana, Matsya Kridasana, Marjariasana, Tadasana, Bhadrasana, Chakki Chalanasana. Pranayama is a gift from Ayurveda to humanity for a long and healthy life, not just during pregnancy. It strengthens the body both physically and mentally. Breath holding for the longest possible time during labour can be quite beneficial for pushing. Because it gives the body more oxygen, the foetus also receives more oxygen. Bhramari Pranayama is an effective breathing exercise for releasing agitation, anger and calming the mind. It enhances concentration power and remove impurities from body.

Materials and Methods

Literature is collected by Brihatrayi and Laghutrayi, all available ayurvedic classic, modern available texts, magazines, journals, and research papers.

Result

Ayurveda is ultimate science of life focusing every stages of human life. Garbhini Paricharya is one of its concepts explaining the importance of establishment of health of a woman before delivery and to conduct Sukha Prshava. Garbhini to adapt certain changes in the daily activities, diet, mental and social behaviour. The dietetic regimen prescribed for the women having normal developments of foetus, a woman remains healthy and delivers the child possessing good health. By use of this fetal membranes, vaginal canal, abdomen, sacral region, flanks become soft, Vayu moves in to its right path: urine, faces and placenta are excreted or expelled easily by their respective passages. Women gains strength, easily delivers at proper time.

After a thorough analysis of numerous ancient texts, it can be concluded that Ayurveda has implemented the anti-natal care (Garbhini Paricharya) with a scientific approach, paying close attention to all the details needed to preserve and replenish a woman's health and prevent complications during pregnancy and childbirth. Hence, proper Garbhini Paricharya should be followed throughout pregnancy. It is also beneficial to the mother in post-natal period. It can be considered as Suputra Janana.

Discussion

The Masanumasika Paricharya helps in proper development of fetus. The life of pregnant women will be at risk during delivery or it is one of the most crucial times in her life. The Sarvashareeradhatu of mother will be in Shithilaavastha because of growth and development of fetus in her. This is further added by Pravahanavedana and Kledarakthasrava during delivery. Hence the woman is with Shunyashareera because of Prasavavedana and she is prone for certain diseases. The Suthikaparicharya itself helps in Punarnavikarana of her body.[29] The main modalities or achievements of Paricharyaie, Garbhashaya Shuddhi, Dhatuparipurnata, Sthanyavriddhi, Punarnavekarana


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are completely established. A stage of Physical, mental and physiological wellbeing is re-stabilized. Thus, proper implementation of Garbhiniparicharya and Sootikaparicharya ensures normal healthy delivery and Suputrajanana.

Most pregnant women have nausea and vomiting in the first trimester, making it difficult for them to eat a healthy diet. Utilising milk and cold, sweet liquid diets will help you stay hydrated and provide the nutrition you need. In addition, the anabolic nature of Madhura group medications will support the preservation of the mother's and the fetus's good health.

From the fourth month onward, the fetus's muscle tissue increases significantly, necessitating the usage of meat soup to supply extra protein. Most women experience foot oedema and other issues related to water retention by the end of the second trimester. By using Gokshura, a potent diuretic, in the sixth month, water retention and related complications can be avoided. These drugs are diuretic, anabolic, relieve emaciation and suppress Pitta and Kapha.

Tampon of oil may destroy pathogenic bacteria of vaginal canal and prevent puerperal sepsis. It may also soften and relax vaginal passage thus help in normal labour. Additionally, it could relax and soften the vaginal canal, supporting a healthy labour. Medicated milk containing Shatavari in the ninth month is explained in several textbooks, such as Arogya Kalpadruma, a Sampoorna Balachikitsa book it increases the production of breast milk. Acharya Sushruta has not specified any dietetic regimen in ninth month of pregnancy on the other hand in the regimen of eighth month after use of enema continuous use of unctuous gruels and meat soup of wild animals’ up to the period of delivery is advised. This indicates that the same diet mentioned is indicated in ninth month also.

Milk and Madhura groups of drugs have been suggested for entire pregnancy period. Because milk is a wholesome diet, the Madhura groups of drugs are anabolic, and thus use of these will help in maintenance of proper health of mother, growth and development of fetus. During anti-natal care, Garbhini has been advised to avoid factors which produce psychological or physical strain such as Vyayama (Exercise), Maithuna (Sexual Intercourse), Krodha (Anger). Though normal Maithuna and Vyayama

are beneficial, their excessive use or psychological trauma, sudden shock may precipitate abortion especially in women who prone for the same.

Women’s Carrying excess weight during pregnancy can cause abrupt increases in intra-abdominal pressure, which can lead to an abortion. Similarly, prolonged squatting in abnormal positions and lying down can affect the flow of blood through the uterus and placenta, causing intrauterine death of the foetus and other abnormalities. Excessive use of meat, wine, pulses and spices should be avoided during pregnancy, as it may cause the digestive abnormalities. Over eating may results in increase body weight of mother as well as fetus. It may cause pregnancy toxaemia and difficulty in labour.

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