www.aamj.in ANVESHANA AYURVEDA MEDICAL JOURNAL Review Article ISSN: 2395-4159 ROLE OF AHARA AND VIHARA IN PRENATAL CARE: AN AYURVEDIC PERSPECTIVE Singh Neelam Kumari1, Sengar Alok Singh2 1 Clinical Registrar of Stree Roga &Prasuti Tantra, CBP Ayurved Charak Sansthan, New Delhi, India 2 Lecturer of Samhita, Sidhant & Sanskrit, Govt. Ayurved College, Varanasi (UP), India Corresponding Author: [email protected] ABSTRACT Good care during pregnancy is important for the health of the mother and the development of the unborn baby. Systematic supervision (examination and advice) of a woman during pregnancy is called antenatal care. According to Ayurvedic perspective garbhini paricharya refers to antenatal care which recommends ahara (specific dietary regimen), vihara (normal daily activities) and modification in psychological behavior. In this article garbhini paricharya has been discussed in stepwise manner regarding nutritional supplementation to meet increased calorie requirement of pregnant women and behavioral alterations to enhance spiritual and mental status. Proper antenatal care during pregnancy reduces the complication for both mother and fetus. Key words: Garbhini, Pregnancy, Antenatal care, Garbhini Paricharya, Ahara, Vihara INTRODUCTION Antenatal care is the planned examination, observation and guidance given to the pregnant women from conception till the time of labour to reduce the maternal and perinatal mortality and morbitity rates and to improve the physical and mental health of women and children.1 Ayurveda has given great emphasis on garbhini paricharya (prenatal care) which has dual goal of easy parturition and healthy progeny. There is specific food regimen prescribed for pregnant women throughout nine months. The diet during pregnancy should be adequate to provide the needs of the growing fetus, the maintenance of maternal health, the strength and vitality required during labour and for successful lactation.2, 3 Month wise dietary regimen for pregnant woman: Dietary regimen described by different ancient texts has been compiled in table 1: 4, 5, 6, 7 Dietary regimen in first trimester: The most important event during 1st trimester is embryogenesis.8 The vata dosha is responsible for cell division during embryogenesis.9 Most women experience nausea, vomiting and loss of appetite during this period. So madhura, sheeta, dravapraya ahara (sweet, cold and liquid diet) are advised.10 These foods is easy to digest, agni deepak (appetizers), prevents dehydration and supply required optimum nourishment. Neelam and Alok: Role of Ahara and Vihara in Prenatal Care Milk is one of the best one among them as milk is vatapittashamak and kaphavardhak.11 Milk is natural source of folic acid and it is also a good source of carbohydrate, fat, proteins (almost all amino acids), calcium, minerals and enzyme which is essential for fetal and mother nourishment.12 Milk is prithvi and jala mahabhuta predominant which helps in moistening and shaping of an embryo.13 At 3rd month Acharya Charaka advised honey and ghee. Honey is the rich source of fructose sugar, which is the rich source of energy. Ghee and honey also provides immunity. During this period organogenesis occurs and most of the tissue and organs of the body are formed.14 This period is very much crucial; hence no drugs should be given during this period because drugs disturb the organogenesis and may lead to teratogenecity. Acharya Kashyapa has explained that fetus is not stable before 4th months, so no medicine should be given.15 Dietary regimen in second trimester: According to Ayurveda rakta and mansa dhatu development mostly occurs in second trimester.16 Fetal growth in second trimester occurs by cellular hyperplasia and cellular hypertrophy.17 Milk, butter, ghritha and Jangala mansa rasa (meat) are advised during this period. Because most protein should be supplied from these items and they furnish amino acids in optimal combinations. Jangala mansa (meat) is the excellent source of proteins, vitamins, fat, minerals (iron and other minerals) and source of a range of endogenous antioxidants. It also supplies good amount of calories.18 The high protein contents of meat helps in musculature tissue formation of the fetus and iron, B complex vitamins helps in blood formation. In the 6th month ghee or yavagu prepared with gokshura are advised.19 As gokshura (Tribulus terestris) have diuretic AAMJ / Vol. 1 / Issue 2 / Mar – Apr 2015 and nephroprotective properties which in turns reduces the pedal oedema.20 Dietary regimen in third trimester: In the 7th month ghrita medicated with prithakparnyadi (vidarigandhadi) group are advised to the garbhini.21 These group of drugs having a diuretic, anti-inflammatory, balya, brihana (anabolic), vata and pitta dosha pacifying properties.22, 23 Snigdha yavagu gives strength to the body, nourishes the body tissue and pacifies the vata dosha.24 Most women experience constipation in pregnancy due to pressure of gravid uterus over the bowel and effect of progesterone. Aasthapana basti (administration of drugs through anus) cleared the retained faces and is responsible for anuloman gati of apana vayu. This is followed by anuvasana basti which helps vata to move in right direction. Thus facilitates the easy delivery without complication. Vaginal tampooning with oil provides lubricative, antibacterial and ripening properties. Contraindicated diet for pregnant woman: Consumption of excessive heavy, hot and pungent substance like wine,25 vishtambhi food (hard to digest).26 Normal vihara (Lifestyle) for pregnant woman: Woman should remain in high spirit, pious, decorated with ornaments, wear clean white garments and perform religious rites, do auspicious deeds and worship deity, brahmanas and priest. Her sitting or sleeping place should be covered with soft cushion or mattress, not be very high, possess elevated upper portion for head rest and should be perfect and very comfortable.27 The husband and other family members are advised to take care of the pregnant woman diet and encourage those activities that are dear to her and beneficial to the fetus.28 The living place of garbhini should be fumigated and spiritual atmosphere should be maintained 93 Neelam and Alok: Role of Ahara and Vihara in Prenatal Care by performing daily worships vedic hymns and holy songs.29 Contraindicated vihara (Lifestyle) for pregnant woman: Excessive coitus, exercise such as carrying of heavy weight, squatting position, abnormal sitting posture, obnoxious garments, peeping in a well or pit, sleeping in supine position etc.30 vehicle ride, misdeed by indriya. DISCUSSION AND CONCLUSION In pregnancy there is increase in calorie requirement by 300 Kcal/day. In garbhini paricharya the concept behind using food articles having madhura rasa predominance might be helpful in meeting with increased calorie needs during pregnancy. After going through garbhini paricharya suggested by various acharya it is observed that use of milk and madhura drug Table 1: Dietary regimen described by different ancient texts Sushruta Vagbhata Months Charaka 1st Sheeta ksheera and satmya bhojana 2nd Madhura aushadhi sidhha ksheera Madhu sarpi sidhha ksheera 3rd 4th Ksheera and ten gram navaneeta 5th Ksheera and ghrita 6th 7th 8th 9 th has been advised in each month. Madhura rasa is congenial since birth, excellent for formation of dhatus, vata shamaka and anabolic in nature which help in maintenance of proper health of mother and growth and development of the fetus.31 Milk is a whole diet, it is also congenial, increases intellectual level (medhya), strength (bala) and lactogenic.32 Iodine is found in milk and dairy product which is essential for producing hormones made by thyroid gland which has direct effect on development of fetal brain.33 Ayurveda considers food to be the best source of nourishment as well as medicine for the pregnant woman. The month wise dietary regimen is unique to Ayurveda. It changes in accordance with fetus in the womb and at the same time ensure health of the mother. Thus the approach towards pregnancy is a holistic one. Madhura aushadhi sidhha ksheera and sarpi Madhura aushadhi sidhha ksheera and sarpi Madhura, sheeta, drava ahara Madhura, sheeta, drava ahara Madhura, sheeta, drava ahara Shastika odana with dadhi and dugdha navneeta sidhha jangal mansayukta hridya anna Shastika odana with dugdha, Ksheera sarpi yukta jangal mansayukta hridya anna Shwadanshtra (Tribulus terestris) sidhha sarpi or yavagu Vidarigandhadi sidhha sarpi Ksheerayavagu and sarpi Aasthapana basti followed by anuvasana basti Madhura aushadhi sidhha taila anuvasana and yonipichu Snigdha yavagu and jangal mansarasa till delivery AAMJ / Vol. 1 / Issue 2 / Mar – Apr 2015 Upsanskrita ksheera Madhura aushadhi sidhha ksheera Madhu sarpi sidhha ksheera Harita Yashtimadhu (Glycerrhiza glabra) or parusaka (Grewia asiatica) or madhupuspa with navneeta with madhura payo anupana Kakoli (Roscoea procera) sidhha ksheera Krishara Ksheera and ten gram navaneeta Sanskrita odana Ksheera and ghrita Paayasa Madhura aushadhi sidhha ksheera and sarpi Madhura aushadhi sidhha ksheera and sarpi Ksheerayavagu and sarpi Aasthapana basti followed by anuvasana basti Madhura aushadhi sidhha taila yonipichu Madhura dadhi Ghritakhanda Ghritapuraka Vividha anna 94 Neelam and Alok: Role of Ahara and Vihara in Prenatal Care REFERENCES th 1. 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