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During sexual intercourse, the woman should not be in prone posture, or lie on her sides. In the former case, ''vata dosha'' becomes stronger and inflicts the genital tract and in the latter case, lying on her right side, displaces ''kapha dosha'' into the mouth of the uterus and creates obstruction, while if she is on her left side, ''pitta dosha'' afflicts the ovum and sperm by its heat. Therefore, the woman should receive the sperm lying on her back, in this position; the doshas are in their states of normalcy. After coitus, vagina should be sprinkled with cold water.
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During sexual intercourse, the woman should not be in prone posture, or lie on her sides. In the former case, ''[[vata dosha]]'' becomes stronger and inflicts the genital tract and in the latter case, lying on her right side, displaces ''[[kapha dosha]]'' into the mouth of the uterus and creates obstruction, while if she is on her left side, ''[[pitta dosha]]'' afflicts the ovum and sperm by its heat. Therefore, the woman should receive the sperm lying on her back, in this position; the doshas are in their states of normalcy. After coitus, vagina should be sprinkled with cold water.
    
The woman who has overeaten, thirsty, frightened, dejected, in grief, anger or in love with a man other than her husband, or who is overpassionate (during the coital act) will fail to conceive or if conceived, will give birth to a child with some defects.  
 
The woman who has overeaten, thirsty, frightened, dejected, in grief, anger or in love with a man other than her husband, or who is overpassionate (during the coital act) will fail to conceive or if conceived, will give birth to a child with some defects.  
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Thus, the section detailing rituals that couples desirous of a healthy progeny – of the attributes of their liking – has been explained. [14]
 
Thus, the section detailing rituals that couples desirous of a healthy progeny – of the attributes of their liking – has been explained. [14]
 
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=== Role of ''mahabhutas'' in contributing to the complexion of the offspring  ===
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=== Role of ''[[mahabhuta]]s'' in contributing to the complexion of the offspring  ===
 
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Apart from the procedures mentioned above, ''mahabhutas'' also contribute in colour and complexion of skin. It is important to note that the ''teja'' (aura) associated with ''apa'' and ''akasha mahabuta'' are responsible for fair complexion, ''prithvi'' and ''vayu'' are responsible for black, and an equilibrium of all the five ''mahabhutas'' result in ''shyamavarna'' i.e. sky-like bluish complexion. [15]
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Apart from the procedures mentioned above, ''[[mahabhuta]]s'' also contribute in colour and complexion of skin. It is important to note that the ''[[teja]]'' (aura) associated with ''[[apa]]'' and ''[[akasha mahabuta]]'' are responsible for fair complexion, ''[[prithvi]]'' and ''[[vayu]]'' are responsible for black, and an equilibrium of all the five ''[[mahabhuta]]s'' result in ''shyamavarna'' i.e. sky-like bluish complexion. [15]
 
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=== Factors determining the psychological disposition of the progeny ===
 
=== Factors determining the psychological disposition of the progeny ===
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From this verse onwards, measures for the preservation of embryo (''garbha'') have been explained. Some of these rituals or practices require the pregnant woman to wear herbs, such as ''aindri'' (Citrulluscolocynthis Schrad – Gorakshakarkati), ''brahmi'' (Bacopamonnieri Pennel), ''satavirya'' (Cynodon doctylon Pers), ''sahasravirya'' (a variety of ''durva'' - cynodon species, also known as ''durvadwaya''), ''amogha'' (''patala'' – Stereospermumsuaveolens DC), ''avyatha'' (''guduchi'' – Tinospora cordifolia Miers), ''shiva''(''haritaki'' – Terminaliachebula Linn), ''arishta'' (katukarohini – Piccrorhizakurroa Royle ex Benth), ''vatyapushpi'' (Pitabala – Sidacordifolia Linn), and ''vishwaksenakanta'' (''priyangu'' – Callicarpa macrophylla Vahl.),on her head or her right hand. Or she may drink milk or ghee processed with the above mentioned herbs, or bathe at every occasion of ''pushyanakshatra'' with water boiled using these herbs, and she should keep these herbs readily available always. Similarly, the regular use of all of the ''jivaniya'' class of herbs (life promoter group of herbs) in the (above) prescribed manner is also beneficial. Thus, the procedures for stabilization of embryo (''garbha'') have been described in this verse. [20]
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From this verse onwards, measures for the preservation of embryo (''[[garbha]]'') have been explained. Some of these rituals or practices require the pregnant woman to wear herbs, such as ''aindri'' (Citrulluscolocynthis Schrad – Gorakshakarkati), ''brahmi'' (Bacopamonnieri Pennel), ''satavirya'' (Cynodon doctylon Pers), ''sahasravirya'' (a variety of ''durva'' - cynodon species, also known as ''durvadwaya''), ''amogha'' (''patala'' – Stereospermumsuaveolens DC), ''avyatha'' (''guduchi'' – Tinospora cordifolia Miers), ''shiva''(''haritaki'' – Terminaliachebula Linn), ''arishta'' (katukarohini – Piccrorhizakurroa Royle ex Benth), ''vatyapushpi'' (Pitabala – Sidacordifolia Linn), and ''vishwaksenakanta'' (''priyangu'' – Callicarpa macrophylla Vahl.),on her head or her right hand. Or she may drink milk or ghee processed with the above mentioned herbs, or bathe at every occasion of ''pushyanakshatra'' with water boiled using these herbs, and she should keep these herbs readily available always. Similarly, the regular use of all of the ''jivaniya'' class of herbs (life promoter group of herbs) in the (above) prescribed manner is also beneficial. Thus, the procedures for stabilization of embryo (''[[garbha]]'') have been described in this verse. [20]
 
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=== Factors that could damage or destroy the embryo ===
 
=== Factors that could damage or destroy the embryo ===
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Any ailment or disease afflicting a pregnant woman should be treated very delicately, by means of medicaments and diet that are mainly soft, palatable, cooling, pleasant and mild. She should not be subjected to emetics, purgatives, or ''nasya'' (errhines), or to practices such as bloodletting. She should not be, at any time, administered corrective and unctuous enema, except in very serious emergency situations. In her final trimester, the pregnant woman, if in emergency conditions wherein emesis is urgently required, should only be treated by means of very mild emetics etc., or by its substitutes. A pregnant woman should be handled like a pot brimful of oil, which can spill on irritation i.e., very delicately. [22]
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Any ailment or disease afflicting a pregnant woman should be treated very delicately, by means of medicaments and diet that are mainly soft, palatable, cooling, pleasant and mild. She should not be subjected to emetics, purgatives, or ''[[nasya]]'' (errhines), or to practices such as bloodletting. She should not be, at any time, administered corrective and unctuous enema, except in very serious emergency situations. In her final trimester, the pregnant woman, if in emergency conditions wherein emesis is urgently required, should only be treated by means of very mild emetics etc., or by its substitutes. A pregnant woman should be handled like a pot brimful of oil, which can spill on irritation i.e., very delicately. [22]
 
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=== Occurrences of bleeding during pregnancy ===
 
=== Occurrences of bleeding during pregnancy ===
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If the pregnant woman, in her second trimester or later, as a consequence of excessive anger, grief, intolerance, envy, fear, sex, exercise, agitation, suppression of body urges, faulty eating, faulty lying down and standing habits, excessive hunger and thirst or as the result of malnutrition, starts to bleed, then the following course of treatment should be adopted to safeguard the conception from any mishap:
 
If the pregnant woman, in her second trimester or later, as a consequence of excessive anger, grief, intolerance, envy, fear, sex, exercise, agitation, suppression of body urges, faulty eating, faulty lying down and standing habits, excessive hunger and thirst or as the result of malnutrition, starts to bleed, then the following course of treatment should be adopted to safeguard the conception from any mishap:
• As soon as the blood discharge is noticed, the patient should be instructed to lie down on a soft and comfortable couch with her head placed slightly lower than the rest of herbody.  
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• As soon as the blood discharge is noticed, the patient should be instructed to lie down on a soft and comfortable couch with her head placed slightly lower than the rest of her body.  
• The physician should then place a cotton swab, immersed in medicated ghee prepared with yashtimadhu (Glycyrrhiza glabraLinn) and then kept in cold water, near or in the vaginal passage. She should also be annointed with shatadhautaor sahasradhauta ghrita (ghee washed a hundred or a thousand times with water or medicated decoctions) on or below the navel region. Similarly, she could also be sprinkled with cold milk or decoction of madhuka and nyagrodhadi class of (Ficusbengalensis Linn) herbs on or below her navel region, or she should take bath in tub of cold water. Cloth pieces soaked in the juice of ksheerivriksha (latex-yielding trees) class of herbs, or a cotton swab soaked in milk and ghee processed with leaf-buds of nyagrodhadi (Ficusbengalensis Linn) class of drugs should be inserted into her vagina. She should also consume ghee made up of milk in a quantity of aksha (about 10-12 ml) and treated with the same drugs as mentioned above. She should be offered a concoction made up of stamens of kamala (Nelumbo nucifera Gaertn.), utpala (Nymphaea alba Linn), and kumuda (a variety of Nymphaea species), mixed with honey and sugar linctus. She should eat singhataka (Trapabispinosa Roxb. – chestnut), pushkarabeeja (lotus seeds –Nelumbonucifera Gaertn.) and kasheruka (Scirpusgrossus Linn. f.). She may be given goat’s milk boiled with gandhapriyangu (Callicarpamacrophylla Vahl.), nilotpala (blue variety of Nymphaeaalba Linn), shaluka (rhizome of lotus), fruits of udumbara (Ficusracemosa Linn.) and leaf-buds of nyagrodha (Ficusbengalensis Linn). She should eat soft, fragrant and cooked shali rice of red variety (Orizasativa Linn.), added with honey and sugar along with milk boiled with roots of bala (Sidacordifolia Linn.), atibala (Abutilonindicum Linn.), shali, sashtika (both varieties of Orizasativa Linn.) ikshu (sugarcane- Saccharumofficinarum Linn.), and kakoli. Or she should eat the above rice along with the soup made of meat that is well-seasoned with ghee, of lava (Common Quail), kapinjala (Grey Partridge), kuranga (Roe deer), sambara (Indian Sambar), shasha (Rabbit), harina (Black Buck), ena (Antelope) orkalapuchchaka (Black tailed Deer), while sitting comfortably in a cool and well ventilated place. She should be protected from anger, grief, overexertion, activities that are sexual or intensely physical in nature, and should be entertained with pleasing and comforting stories. By following these methods, the embryo (garbha) is saved from abortion. [24]
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• The physician should then place a cotton swab, immersed in medicated ghee prepared with yashtimadhu (Glycyrrhiza glabraLinn) and then kept in cold water, near or in the vaginal passage. She should also be annointed with shatadhauta or sahasradhauta ghrita (ghee washed a hundred or a thousand times with water or medicated decoctions) on or below the navel region. Similarly, she could also be sprinkled with cold milk or decoction of madhuka and nyagrodhadi class of (Ficusbengalensis Linn) herbs on or below her navel region, or she should take bath in tub of cold water. Cloth pieces soaked in the juice of ksheerivriksha (latex-yielding trees) class of herbs, or a cotton swab soaked in milk and ghee processed with leaf-buds of nyagrodhadi (Ficusbengalensis Linn) class of drugs should be inserted into her vagina. She should also consume ghee made up of milk in a quantity of aksha (about 10-12 ml) and treated with the same drugs as mentioned above. She should be offered a concoction made up of stamens of kamala (Nelumbo nucifera Gaertn.), utpala (Nymphaea alba Linn), and kumuda (a variety of Nymphaea species), mixed with honey and sugar linctus. She should eat singhataka (Trapabispinosa Roxb. – chestnut), pushkarabeeja (lotus seeds –Nelumbonucifera Gaertn.) and kasheruka (Scirpusgrossus Linn. f.). She may be given goat’s milk boiled with gandhapriyangu (Callicarpamacrophylla Vahl.), nilotpala (blue variety of Nymphaeaalba Linn), shaluka (rhizome of lotus), fruits of udumbara (Ficusracemosa Linn.) and leaf-buds of nyagrodha (Ficusbengalensis Linn). She should eat soft, fragrant and cooked shali rice of red variety (Orizasativa Linn.), added with honey and sugar along with milk boiled with roots of bala (Sidacordifolia Linn.), atibala (Abutilonindicum Linn.), shali, sashtika (both varieties of Orizasativa Linn.) ikshu (sugarcane- Saccharumofficinarum Linn.), and kakoli. Or she should eat the above rice along with the soup made of meat that is well-seasoned with ghee, of lava (Common Quail), kapinjala (Grey Partridge), kuranga (Roe deer), sambara (Indian Sambar), shasha (Rabbit), harina (Black Buck), ena (Antelope) orkalapuchchaka (Black tailed Deer), while sitting comfortably in a cool and well ventilated place. She should be protected from anger, grief, overexertion, activities that are sexual or intensely physical in nature, and should be entertained with pleasing and comforting stories. By following these methods, the embryo ([[garbha]]) is saved from abortion. [24]
 
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If a pregnant woman with a large and well-formed foetus starts experiencing bleeding or other forms of uterine discharge as aresult of indulgence in hot and pungent food articles, the foetus will cease growing. Such a foetus will stay for a long time in the mother’s womb and this condition is referred to as Upavistaka (or prolonged gestation).  
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If a pregnant woman with a large and well-formed foetus starts experiencing bleeding or other forms of uterine discharge as a result of indulgence in hot and pungent food articles, the foetus will cease growing. Such a foetus will stay for a long time in the mother’s womb and this condition is referred to as Upavistaka (or prolonged gestation).  
 
Similarly, in a pregnant woman who suffers from malnutrition due to overindulgence in rituals requiring fasting, or who avoids unctuous articles and indulges in vata-provoking dietary or lifestyle activities, foetus will not develop due to it getting weaned away from nutrition, and such foetus will remain in the womb for a long period of time without developing. This condition is called Nagodara (elephantine gestation). [26]
 
Similarly, in a pregnant woman who suffers from malnutrition due to overindulgence in rituals requiring fasting, or who avoids unctuous articles and indulges in vata-provoking dietary or lifestyle activities, foetus will not develop due to it getting weaned away from nutrition, and such foetus will remain in the womb for a long period of time without developing. This condition is called Nagodara (elephantine gestation). [26]
 
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Now (we) shall expound the specific therapeutic courses of treatment recommended for the management of ''upavistaka'' (intrauterine growth retardation because of decreased nutrient transfer) and nagodara (IUGR because of malnourishment). Ghee and milk which have been medicated with ''bhautika'' (drugs having anti-evil spirits / germs action), ''jivaniya'' (life-promoting), ''brimhaniya'' (bulk promoting), ''madhura'' (sweet) and ''vatahara'' (''vata'' alleviating) drugs help stimulate the development of the fetus. Immature or undeveloped fetus (i.e. poultry eggs) with milk also acts as an effective growth stimulant for the fetus. Ample use of medicated ghee also serves to nourish the mother and her fetus. These therapeutic courses should be supplemented with walking, moving in carriages (that do not jerk a lot), physical cleansing and engaging in mild exercises and other forms of physical activities. [27]
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Now (we) shall expound the specific therapeutic courses of treatment recommended for the management of ''upavistaka'' (intrauterine growth retardation because of decreased nutrient transfer) and nagodara (IUGR because of malnourishment). Ghee and milk which have been medicated with ''bhautika'' (drugs having anti-evil spirits / germs action), ''jivaniya'' (life-promoting), ''brimhaniya'' (bulk promoting), ''madhura'' (sweet) and ''vatahara'' (''[[vata]]'' alleviating) drugs help stimulate the development of the fetus. Immature or undeveloped fetus (i.e. poultry eggs) with milk also acts as an effective growth stimulant for the fetus. Ample use of medicated ghee also serves to nourish the mother and her fetus. These therapeutic courses should be supplemented with walking, moving in carriages (that do not jerk a lot), physical cleansing and engaging in mild exercises and other forms of physical activities. [27]
 
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If the fetus dies in the womb as a result of excessive increase of ''doshas'' caused due to over-indulgence in pungent and hot things, or due to suppression of urges to pass flatulence, urine and bowel movement, or due to faulty eating, faulty sitting, lying down or standing or due to compression (of the womb) and injuries, or passion, grief, envy, horror, fear etc., or due to intensive/extreme physical activities, then the stomach will be still, rigid, bloated up, cold and stony-hard. This condition would be accompanied by severe pain in the stomach, but the labor pains do not set in and there is no discharge. The woman’s eyes will droop and she may feel nauseous, pain, is in agony, giddiness, and breathlessness with intense restlessness. The natural urges also will not be proper as routine. If these features are seen in a pregnant woman, then it should be construed that the fetus is dead. [30]
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If the fetus dies in the womb as a result of excessive increase of ''[[dosha]]s'' caused due to over-indulgence in pungent and hot things, or due to suppression of urges to pass flatulence, urine and bowel movement, or due to faulty eating, faulty sitting, lying down or standing or due to compression (of the womb) and injuries, or passion, grief, envy, horror, fear etc., or due to intensive/extreme physical activities, then the stomach will be still, rigid, bloated up, cold and stony-hard. This condition would be accompanied by severe pain in the stomach, but the labor pains do not set in and there is no discharge. The woman’s eyes will droop and she may feel nauseous, pain, is in agony, giddiness, and breathlessness with intense restlessness. The natural urges also will not be proper as routine. If these features are seen in a pregnant woman, then it should be construed that the fetus is dead. [30]
 
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According to some scholars, the treatment of dead fetus (which acts like a foreign body within the womb) consists of administering medicines which are used to expel the placenta. Others suggest using mantras, prayers and spiritual offerings as explained in the Atharva Veda. Yet others believe that it should be removed by surgical means by an expert surgeon.  
 
According to some scholars, the treatment of dead fetus (which acts like a foreign body within the womb) consists of administering medicines which are used to expel the placenta. Others suggest using mantras, prayers and spiritual offerings as explained in the Atharva Veda. Yet others believe that it should be removed by surgical means by an expert surgeon.  
 
 
If the dead fetus is immature (i.e., in its early stages of development), then once the dead fetus is extracted, the woman should drink, to her fill, alcoholic drinks such ''assura, sidhu, arishta, madhu, madira'' and ''asava'' in order to cleanse her uterus, relieve herself from pain and also to become euphoric (i.e., overcome her grief). Then she should be given food articles that are nourishing and strength-enhancing but without fat or oil in them, such as gruels that are suitable for that moment till the excess moisture of the ''dosha'' and ''dhatus'' are absorbed. Then she should be treated with ''snehapana'' (administration of unctuous substances), enema and diets processed with medications possessing appetizing, vitalizing, bulk-promoting, sweet and ''vata''-alleviating properties. If the dead fetus is a mature one, once the dead fetus is removed, that day itself she should be treated with unction measures. [31]
+
If the dead fetus is immature (i.e., in its early stages of development), then once the dead fetus is extracted, the woman should drink, to her fill, alcoholic drinks such ''assura, sidhu, arishta, madhu, madira'' and ''asava'' in order to cleanse her uterus, relieve herself from pain and also to become euphoric (i.e., overcome her grief). Then she should be given food articles that are nourishing and strength-enhancing but without fat or oil in them, such as gruels that are suitable for that moment till the excess moisture of the ''[[dosha]]'' and ''[[dhatu]]s'' are absorbed. Then she should be treated with ''snehapana'' (administration of unctuous substances), enema and diets processed with medications possessing appetizing, vitalizing, bulk-promoting, sweet and ''[[vata]]''-alleviating properties. If the dead fetus is a mature one, once the dead fetus is removed, that day itself she should be treated with unction measures. [31]
 
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*In the fifth month of pregnancy, milk along with ghee should be given.
 
*In the fifth month of pregnancy, milk along with ghee should be given.
 
*In the sixth month of pregnancy, milk with ghee processed with sweet-tasting drugs should be given to drink.
 
*In the sixth month of pregnancy, milk with ghee processed with sweet-tasting drugs should be given to drink.
*In the seventh month of pregnancy, she should be given the same regimen as prescribed in the sixth month. Experienced women are of the opinion that during this period, the fetus develops scalp hair and it causes burning sensation in the mother. But this view is negated by Lord Atreya, who says that due to the pressure created by the fetus, the three ''doshas'' of the mother reach the chest region and cause burning sensation in her, causing itching which, in turn, causes ''kikkisa'' (stretch-marks or striae gravidarum -linea albicantes – the white abdominal lines seen during and after pregnancy on the abdomen). To manage this condition, she should regularly be given butter medicated with sweet-tasting drugs, the quantity of which she can hold in her single palm, along with a decoction of ''kola'' (Zizyphus jujube Lam). Her breasts and abdomen should be massaged with a paste of ''chandana'' (Santalumalbum Linn.), ''mrinala'' (stalk of lotus) or powder of ''shirisha'' (Albizia lebbeck Benth), ''dhataki'' (Woodfordiafruticosa Kurz), ''sarshapa'' (Mustard – Brassicanigra Koch), and ''madhuka'' (Glycyrrhizaglabra Linn.) or paste of ''kutaja'' (Holarrhenaantidysenterica Wall.), seed of ''arjaka'' (Ocimumgratissimum Linn.), ''musta'' (Cyperusrotundus Linn.), ''haridra'' (Curcumalonga Linn.) or paste of ''nimba'' (Azadirachtaindica A. Juss), ''kola'' (Zizyphusjujuba Lam.), ''surasa'' (Ocimumsanctum Linn.) and ''manjishta'' (Rubiacordifolia Linn.) or ''triphala'' (three pungent fruits – Terminaliachebula Linn., Terminaliabelerica Roxb. and Emblicaofficinalis Gaertn.) mixed with the blood of ''prishta'' (spotted deer), massage with oil prepared with leaf of ''karavira'' (Neriumindicum Mill.) and sprinkling with water processed with ''jati'' (''Malati'' – Aganosma dichotoma K. Schum.) and ''madhuka'' (Glycyrrhizaglabra Linn.) plant. Thus, itching should be avoided to prevent stretch-mark on skin (and therefore, avoiding disfiguring the skin). If itching is too severe to tolerate then it should be overcome by an application of ''unmardana'' (anointing) and ''udgharshana'' (rubbing with pastes) procedures. During this period, she should eat sweet-tasting food that is ''vata'' alleviating in nature and is light on oil, fat and salt, and should drink less water immediately after the food.  
+
*In the seventh month of pregnancy, she should be given the same regimen as prescribed in the sixth month. Experienced women are of the opinion that during this period, the fetus develops scalp hair and it causes burning sensation in the mother. But this view is negated by Lord Atreya, who says that due to the pressure created by the fetus, the three ''[[dosha]]s'' of the mother reach the chest region and cause burning sensation in her, causing itching which, in turn, causes ''kikkisa'' (stretch-marks or striae gravidarum -linea albicantes – the white abdominal lines seen during and after pregnancy on the abdomen). To manage this condition, she should regularly be given butter medicated with sweet-tasting drugs, the quantity of which she can hold in her single palm, along with a decoction of ''kola'' (Zizyphus jujube Lam). Her breasts and abdomen should be massaged with a paste of ''chandana'' (Santalumalbum Linn.), ''mrinala'' (stalk of lotus) or powder of ''shirisha'' (Albizia lebbeck Benth), ''dhataki'' (Woodfordiafruticosa Kurz), ''sarshapa'' (Mustard – Brassicanigra Koch), and ''madhuka'' (Glycyrrhizaglabra Linn.) or paste of ''kutaja'' (Holarrhenaantidysenterica Wall.), seed of ''arjaka'' (Ocimumgratissimum Linn.), ''musta'' (Cyperusrotundus Linn.), ''haridra'' (Curcumalonga Linn.) or paste of ''nimba'' (Azadirachtaindica A. Juss), ''kola'' (Zizyphusjujuba Lam.), ''surasa'' (Ocimumsanctum Linn.) and ''manjishta'' (Rubiacordifolia Linn.) or ''triphala'' (three pungent fruits – Terminaliachebula Linn., Terminaliabelerica Roxb. and Emblicaofficinalis Gaertn.) mixed with the blood of ''prishta'' (spotted deer), massage with oil prepared with leaf of ''karavira'' (Neriumindicum Mill.) and sprinkling with water processed with ''jati'' (''Malati'' – Aganosma dichotoma K. Schum.) and ''madhuka'' (Glycyrrhizaglabra Linn.) plant. Thus, itching should be avoided to prevent stretch-mark on skin (and therefore, avoiding disfiguring the skin). If itching is too severe to tolerate then it should be overcome by an application of ''unmardana'' (anointing) and ''udgharshana'' (rubbing with pastes) procedures. During this period, she should eat sweet-tasting food that is ''[[vata]]'' alleviating in nature and is light on oil, fat and salt, and should drink less water immediately after the food.  
 
*In the eighth month, she should take gruel prepared with milk and mixed with ghee in all her meals in their appropriate times. Bhadrakapya has opposing views on this and believes that it causes ''paingalya'' (tawny discoloration of the eyes of fetus) in the fetus, and hence  should not be practiced. On this point, Lord Atreya believes that while the risk of paingalya may be there, it does not indicate in any way that the above regimen should not be applied. The woman following this regimen remains free from all disorders and gives birth to a child endowed with excellent health, strength, complexion, voice and compactness of body.  
 
*In the eighth month, she should take gruel prepared with milk and mixed with ghee in all her meals in their appropriate times. Bhadrakapya has opposing views on this and believes that it causes ''paingalya'' (tawny discoloration of the eyes of fetus) in the fetus, and hence  should not be practiced. On this point, Lord Atreya believes that while the risk of paingalya may be there, it does not indicate in any way that the above regimen should not be applied. The woman following this regimen remains free from all disorders and gives birth to a child endowed with excellent health, strength, complexion, voice and compactness of body.  
 
*Finally, in the ninth month of pregnancy, she should be treated with unctuous enema prepared with sweet-tasting drugs. A cotton swab soaked in the same oil should be kept in her genital tract in order to lubricate the passage of the fetus.  
 
*Finally, in the ninth month of pregnancy, she should be treated with unctuous enema prepared with sweet-tasting drugs. A cotton swab soaked in the same oil should be kept in her genital tract in order to lubricate the passage of the fetus.  
   −
If the specific dietary regimen and therapeutic measures mentioned above are followed right from the first month of pregnancy to the ninth month, the entire child-bearing region of the woman’s body – including her womb, waist, sides of pelvis, and her back - become soft at the time of delivery, ''vata'' functions in a normal way, urine and bowel movement pass smoothly, skin and nails become soft, her strength and complexion are improved and the woman delivers the child effortlessly. [32]
+
If the specific dietary regimen and therapeutic measures mentioned above are followed right from the first month of pregnancy to the ninth month, the entire child-bearing region of the woman’s body – including her womb, waist, sides of pelvis, and her back - become soft at the time of delivery, ''[[vata]]'' functions in a normal way, urine and bowel movement pass smoothly, skin and nails become soft, her strength and complexion are improved and the woman delivers the child effortlessly. [32]
 
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=== Infra structure of maternity home ===
 
=== Infra structure of maternity home ===
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If in spite of acute labor pains, she is not able to deliver, some advise that the woman must be instructed to get up, hold a pestle and pound grains repeatedly, taking breaks and deep breaths, and moving about periodically. Lord Atreya, however, does not consider it right. According to him, a pregnant woman should always be advised to avoid strenuous exercises and particularly during parturition, since all the body elements and humors are in a state of commotion, ''vata'', aggravated by the strain involved in the exercise of pounding, could even be fatal to the pregnant woman. Woman during this situation will be difficult to cure. Other sages advise against the pounding exercises but advocating deep breathing and moving about.
+
If in spite of acute labor pains, she is not able to deliver, some advise that the woman must be instructed to get up, hold a pestle and pound grains repeatedly, taking breaks and deep breaths, and moving about periodically. Lord Atreya, however, does not consider it right. According to him, a pregnant woman should always be advised to avoid strenuous exercises and particularly during parturition, since all the body elements and humors are in a state of commotion, ''[[vata]]'', aggravated by the strain involved in the exercise of pounding, could even be fatal to the pregnant woman. Woman during this situation will be difficult to cure. Other sages advise against the pounding exercises but advocating deep breathing and moving about.
    
The woman should be made to inhale the powders of ''kushta'' (Saussurea lappa C.B.Clarke.), ''ela'' (Elettaria cardamomum Maton), ''langalaki'' (Gloriosa superb Linn.), ''vacha'' (Acorus calamus Linn.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirbilva'' (Pongamia pinnata Mirr.) and ''chavya'' (Piper chaba Hunter), which can be administered frequently . Similarly the fumigation done with leaves of ''bhurja'' (Betula utilis D. Don.) or pith of ''shimsapa'' (Dalbergia sissoo Roxb.) could be used for inhalation. During this period, she should be given a light massage over her waist, sides, back and legs with lukewarm oil followed by a kneading massage. With these measures the fetus descends down. [38]
 
The woman should be made to inhale the powders of ''kushta'' (Saussurea lappa C.B.Clarke.), ''ela'' (Elettaria cardamomum Maton), ''langalaki'' (Gloriosa superb Linn.), ''vacha'' (Acorus calamus Linn.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirbilva'' (Pongamia pinnata Mirr.) and ''chavya'' (Piper chaba Hunter), which can be administered frequently . Similarly the fumigation done with leaves of ''bhurja'' (Betula utilis D. Don.) or pith of ''shimsapa'' (Dalbergia sissoo Roxb.) could be used for inhalation. During this period, she should be given a light massage over her waist, sides, back and legs with lukewarm oil followed by a kneading massage. With these measures the fetus descends down. [38]
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The attending women should instruct her thus, “Don’t strain (bear down) when there is no labor pain, because if you do, the efforts may go in vain, and moreover the off spring may be born with deformities or afflicted with diseases like ''shwasa'' (dyspnoea), ''kasa'' (cough), ''shosha'' (emaciation) or ''pleeha'' (spleenic disorders). As when there is no natural urge to sneeze, or pass flatulence, urine or bowel movements, they will not appear or if appear will be with a lot of effort, similarly if the woman strains when there is no labour pain, the foetus will not come out or if at all it comes out, it will be with great difficulty. On the other hand, just as when there is a strong urge to pass bodily wastes, one should not suppress them, not straining when there is acute labor pain will lead to difficult labour. The woman should be advised to follow the following instructions - Initially she should strain (bear down) with mild force, gradually with stronger efforts. While she is bearing down hard, the attendants should keep repeating words such as ‘She has just delivered a worthy son, fortunate son’.Such words make the woman feel happy and motivate her to continue pushing the baby out. [40]
+
The attending women should instruct her thus, “Don’t strain (bear down) when there is no labor pain, because if you do, the efforts may go in vain, and moreover the off spring may be born with deformities or afflicted with diseases like ''shwasa'' (dyspnoea), ''kasa'' (cough), ''shosha'' (emaciation) or ''pleeha'' (spleenic disorders). As when there is no natural urge to sneeze, or pass flatulence, urine or bowel movements, they will not appear or if appear will be with a lot of effort, similarly if the woman strains when there is no labour pain, the foetus will not come out or if at all it comes out, it will be with great difficulty. On the other hand, just as when there is a strong urge to pass bodily wastes, one should not suppress them, not straining when there is acute labor pain will lead to difficult labour. The woman should be advised to follow the following instructions - Initially she should strain (bear down) with mild force, gradually with stronger efforts. While she is bearing down hard, the attendants should keep repeating words such as ‘She has just delivered a worthy son, fortunate son’. Such words make the woman feel happy and motivate her to continue pushing the baby out. [40]
 
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=== Procedure to remove placenta post-delivery ===
 
=== Procedure to remove placenta post-delivery ===
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Immediately after the delivery of the child, one should confirm whether the placenta has been expelled out or not. If it is not expelled, then one of the female attendants should forcefully press her abdomen from above the navel region with her right hand and holding her back with left, should give a good shake to the body of the patient. The hip region of the patient should be pressed with the heels and her buttocks should be taken by hand and strongly pressed by the attendant. Her throat should be rubbed with the braid of her hair. The genital tract should be fumigated with the leaves of ''bhurja'' (Betula utilis D. Don.), ''kachamani'' (quartz) and ''sarpanirmoka'' (slough of serpent). She should be given paste of ''kushta'' (Saussurea lappa C. B. Clarke) and ''talisa'' (Abies webbiana Lindl.) mixed with the soup of ''balwaja'' (a hemp-like plant) or strong liquor of ''maireya'' and ''sura''-like beverages for drinking, or the soup of ''kulaththa'' (Dolichos biflorus Linn. - horse gram) or decoctions of ''mandukaparni'' (Centella asiatica Urban.) and ''pippali'' (Piper longum Linn.). The paste of ''laghu ela'' (Elettaria cardamomum Moton.), ''kilima'' (Devadaru – Cedrus deodara Loud.), ''kushta'' (Saussurea lappa C.B. Clarke), ''shunthi'' (Zingiber officinale Rosc.), ''vidanga'' (Embeliaribes Burm f.), ''pippali'' (Piper longum Linn.), ''kalagaru'' (Aquilaria agallocha Roxb. – black variety), ''chavya'' (Piper chaba Junter.), ''chitraka'' (Plumbago zeylanica Roxb.) and ''upakunjika'' (Nigella sativa Linn.)and crushed pieces of the right ear of a living untamed bull, pounding it on grinding stone and keeping it for some time in one of the decoctions of ''Balwaja'' (-?-) etc.;The liquid portion of this decoction should be administered to the patient as a drink. A cotton swab soaked in the oil prepared with ''shatapushpa'' (Foeniculum vulgare Mill.), ''kushta'' (Saussurea lappa C. B. Clarke), ''Madana'' (Randia dumetorum Lam.) and ''hingu'' (Ferula narthex Boiss.) should be inserted into her vaginal passage, and with the same oil, ''anuvasana basti'' (unctuous enema) should be administered to her. The decoction of ''Balwaja''(-?-) should be mixed with apaste of ''madanaphala''(Randia duemtorum Lam.), ''devadali'' (Luffaechinata Roxb.),''ikshvaku'' (Legenaria siceraria Standl.), ''dhamargava'' (Luffa cylindrica M. Roem.), ''kutaja'' (Holarrhena antidysenterica Wall.), ''kritavedhana'' (Luffa acutangula Roxb.) and ''gajapippali'' (Scindapsus officilanlis Schott.) and administered in the form of ''asthapana basti'' (non-unctuous enema).This non-unctuous enema will lead to the expulsion of the retained placenta while passing flatulence, urine and bowel movementsby the downward movement of ''vayu''. Bodily wastes have a tendency to come out of the body naturally, but may get obstructed inside the abdomen, obstructing the ejection of the placenta too. [41]
+
Immediately after the delivery of the child, one should confirm whether the placenta has been expelled out or not. If it is not expelled, then one of the female attendants should forcefully press her abdomen from above the navel region with her right hand and holding her back with left, should give a good shake to the body of the patient. The hip region of the patient should be pressed with the heels and her buttocks should be taken by hand and strongly pressed by the attendant. Her throat should be rubbed with the braid of her hair. The genital tract should be fumigated with the leaves of ''bhurja'' (Betula utilis D. Don.), ''kachamani'' (quartz) and ''sarpanirmoka'' (slough of serpent). She should be given paste of ''kushta'' (Saussurea lappa C. B. Clarke) and ''talisa'' (Abies webbiana Lindl.) mixed with the soup of ''balwaja'' (a hemp-like plant) or strong liquor of ''maireya'' and ''sura''-like beverages for drinking, or the soup of ''kulaththa'' (Dolichos biflorus Linn. - horse gram) or decoctions of ''mandukaparni'' (Centella asiatica Urban.) and ''pippali'' (Piper longum Linn.). The paste of ''laghu ela'' (Elettaria cardamomum Moton.), ''kilima'' (Devadaru – Cedrus deodara Loud.), ''kushta'' (Saussurea lappa C.B. Clarke), ''shunthi'' (Zingiber officinale Rosc.), ''vidanga'' (Embeliaribes Burm f.), ''pippali'' (Piper longum Linn.), ''kalagaru'' (Aquilaria agallocha Roxb. – black variety), ''chavya'' (Piper chaba Junter.), ''chitraka'' (Plumbago zeylanica Roxb.) and ''upakunjika'' (Nigella sativa Linn.)and crushed pieces of the right ear of a living untamed bull, pounding it on grinding stone and keeping it for some time in one of the decoctions of ''Balwaja'' (-?-) etc.;The liquid portion of this decoction should be administered to the patient as a drink. A cotton swab soaked in the oil prepared with ''shatapushpa'' (Foeniculum vulgare Mill.), ''kushta'' (Saussurea lappa C. B. Clarke), ''Madana'' (Randia dumetorum Lam.) and ''hingu'' (Ferula narthex Boiss.) should be inserted into her vaginal passage, and with the same oil, ''anuvasana basti'' (unctuous enema) should be administered to her. The decoction of ''Balwaja''(-?-) should be mixed with apaste of ''madanaphala''(Randia duemtorum Lam.), ''devadali'' (Luffaechinata Roxb.),''ikshvaku'' (Legenaria siceraria Standl.), ''dhamargava'' (Luffa cylindrica M. Roem.), ''kutaja'' (Holarrhena antidysenterica Wall.), ''kritavedhana'' (Luffa acutangula Roxb.) and ''gajapippali'' (Scindapsus officilanlis Schott.) and administered in the form of ''asthapana [[basti]]'' (non-unctuous enema).This non-unctuous enema will lead to the expulsion of the retained placenta while passing flatulence, urine and bowel movementsby the downward movement of ''vayu''. Bodily wastes have a tendency to come out of the body naturally, but may get obstructed inside the abdomen, obstructing the ejection of the placenta too. [41]
 
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While administering the various procedures described in the preceding verse to remove the placenta from the mother’s body, certain measures should also be performed on the newly born child, such as gently striking the stones near the root of the ear, and sprinkling of cold or hot water over its face, to rejuvenate its vital breath that might have stopped due to distress. If the child is not movingor does not revive, it should then be fanned with a winnowing basket made of bamboo etc. till it regains consciousness (the procedures to be continued till consciousness is established). Once respiration is established and gets normalized, then he should be given a good bath and cleansed thoroughly. [42]
+
While administering the various procedures described in the preceding verse to remove the placenta from the mother’s body, certain measures should also be performed on the newly born child, such as gently striking the stones near the root of the ear, and sprinkling of cold or hot water over its face, to rejuvenate its vital breath that might have stopped due to distress. If the child is not moving or does not revive, it should then be fanned with a winnowing basket made of bamboo etc. till it regains consciousness (the procedures to be continued till consciousness is established). Once respiration is established and gets normalized, then he should be given a good bath and cleansed thoroughly. [42]
 
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=== Procedure for cleaning the baby after birth ===
 
=== Procedure for cleaning the baby after birth ===
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Improper cutting of the umbilical cord and administering of measures explained in the preceding verse could lead to complications such as ''ayamottundita'' (vertical swelling), ''vyayamottundita'' (horizontal swelling), ''pindalika'' (lumpy swellings or formation of a circular ring around the umblicus), ''vinamika'' (swelling in the margins with depression at centre), and ''vijrumbhika'' (swelling with constant increase in size as in umblical hernia). In case of these complications, by carefully observing the severity of the condition (mild to severe involvement of the ''doshas''), it should be treated using massages, unction, and sprinkling of ghee prepared with drugs that are non-irritants and ''vata'' and ''pitta'' pacifying. [45]
+
Improper cutting of the umbilical cord and administering of measures explained in the preceding verse could lead to complications such as ''ayamottundita'' (vertical swelling), ''vyayamottundita'' (horizontal swelling), ''pindalika'' (lumpy swellings or formation of a circular ring around the umblicus), ''vinamika'' (swelling in the margins with depression at centre), and ''vijrumbhika'' (swelling with constant increase in size as in umblical hernia). In case of these complications, by carefully observing the severity of the condition (mild to severe involvement of the ''[[dosha]]s''), it should be treated using massages, unction, and sprinkling of ghee prepared with drugs that are non-irritants and ''[[vata]]'' and ''[[pitta]]'' pacifying. [45]
 
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=== Birth-rites per Vedic rituals ===
 
=== Birth-rites per Vedic rituals ===
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After the delivery (i.e., in the post-partum period) when the new mother feels hungry and needs nourishment, suitable fatty substances like ghee, oil, and majja (muscle fat or marrow), duly mixed with the powders of pippali (Piper longum Linn.), pippalimula (root of Piper longum Linn.), chavya (Piper chaba Hunter.), chitraka (Plumbagozeylanica Linn.) and shrungabera (Zingiberofficinale Rocs.) should be given to her, according to her status of  appetitie. Once she has eaten, she should be given a good massage on her abdomen with ghee and oil and then a big clean cloth should be wrapped around her abdomen so that vayu may not find a place to cause any ailment. Once the food eaten is digested, she should take liquid gruel prepared with pippali (Piper longum Linn.) etc., mixed with unctuous substances in copious amounts. She should take a warm water bath before taking meals, though. This regimen should be continued for five to seven nights. [48]
+
After the delivery (i.e., in the post-partum period) when the new mother feels hungry and needs nourishment, suitable fatty substances like ghee, oil, and majja (muscle fat or marrow), duly mixed with the powders of pippali (Piper longum Linn.), pippalimula (root of Piper longum Linn.), chavya (Piper chaba Hunter.), chitraka (Plumbagozeylanica Linn.) and shrungabera (Zingiberofficinale Rocs.) should be given to her, according to her status of  appetite. Once she has eaten, she should be given a good massage on her abdomen with ghee and oil and then a big clean cloth should be wrapped around her abdomen so that vayu may not find a place to cause any ailment. Once the food eaten is digested, she should take liquid gruel prepared with pippali (Piper longum Linn.) etc., mixed with unctuous substances in copious amounts. She should take a warm water bath before taking meals, though. This regimen should be continued for five to seven nights. [48]
 
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The breast milk which does not fit the above description is to considered vitiated and unfit for the child’s consumption. Milk that assumes a darkish or reddish hue, astringent in after-taste, clear, of no marked smell, dry, watery, frothy and light in texture or form, and is not satisfying causes emaciation, gives rise to vatika disorders, and thus, should be considered vata-vitiated. Milk that looks blackish, bluish, yellow, or coppery, has an after-taste which is sour or pungent, which smells like a corpse or like blood, and which is very warm is pitta-vitiated and could cause pittaja disorders. Finally, the milk that is very white, very sweet with a saltish after-taste, that has odour like ghee, oil, flesh-marrow or bone-marrow, is viscid, thready and sinks in water without mixing, gives rise to disorders of kapha and should be considered as kapha-vitiated milk. [55]
+
The breast milk which does not fit the above description is to considered vitiated and unfit for the child’s consumption. Milk that assumes a darkish or reddish hue, astringent in after-taste, clear, of no marked smell, dry, watery, frothy and light in texture or form, and is not satisfying causes emaciation, gives rise to vatika disorders, and thus, should be considered [[vata]]-vitiated. Milk that looks blackish, bluish, yellow, or coppery, has an after-taste which is sour or pungent, which smells like a corpse or like blood, and which is very warm is pitta-vitiated and could cause pittaja disorders. Finally, the milk that is very white, very sweet with a saltish after-taste, that has odour like ghee, oil, flesh-marrow or bone-marrow, is viscid, thready and sinks in water without mixing, gives rise to disorders of [[kapha]] and should be considered as [[kapha]]-vitiated milk. [55]
 
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If any of the three varieties of vitiated milks described in the preceding verse is in advertently consumed by the child, after ascertaining the specific features of the milk or the symptoms that are associated with a dosha affliction, emetics, purgatives and unctuous and non-unctuous enema specific to that afflicted dosha should be administered. The dietetic guidelines to a woman with vitiated milk are as follows: her food and drink should consist mainly of barley, wheat, sali and shashtika rice, mudga (Phaseolus mungo Linn. - green gram), harenuka (Lathyrus ashaca Linn.), sura, sauviraka, maireya and medaka varieties of wines, lashuna (Alium sativum Linn.) and karanja (Pongamia pinnata Merr.). The milk should be examined at frequent intervals for specific features and the appropriate corrective measures should be adopted. The decoctions of patha (Cissmpelos pareira Linn.), shunthi (Zingiberofficinale Rosc.), devadaru (Cedrusdeodara Loud.), musta (Cyperusrotundus Linn.), murva (Clemaistrilobaheyne ex Roth), guduchi (Tinosporacordifolia Miers.), indrayava (Holarrhenaantidysentrica wall.), kiratatikta (SwertiachirataBuch. -Ham.), katukarohini (Picrorhizakurroa Royle ex Benth.) and sariva (Hemidesmusindicus R. B.) are said to be beneficial. Similarly, other drugs with bitter, astringent, pungent and sweet tastes could also be administered, depending upon the nature of the disorder, dosage and season. [56]
+
If any of the three varieties of vitiated milks described in the preceding verse is in advertently consumed by the child, after ascertaining the specific features of the milk or the symptoms that are associated with a [[dosha]] affliction, emetics, purgatives and unctuous and non-unctuous enema specific to that afflicted [[dosha]] should be administered. The dietetic guidelines to a woman with vitiated milk are as follows: her food and drink should consist mainly of barley, wheat, sali and shashtika rice, mudga (Phaseolus mungo Linn. - green gram), harenuka (Lathyrus ashaca Linn.), sura, sauviraka, maireya and medaka varieties of wines, lashuna (Alium sativum Linn.) and karanja (Pongamia pinnata Merr.). The milk should be examined at frequent intervals for specific features and the appropriate corrective measures should be adopted. The decoctions of patha (Cissmpelos pareira Linn.), shunthi (Zingiberofficinale Rosc.), devadaru (Cedrusdeodara Loud.), musta (Cyperusrotundus Linn.), murva (Clemaistrilobaheyne ex Roth), guduchi (Tinosporacordifolia Miers.), indrayava (Holarrhenaantidysentrica wall.), kiratatikta (SwertiachirataBuch. -Ham.), katukarohini (Picrorhizakurroa Royle ex Benth.) and sariva (Hemidesmusindicus R. B.) are said to be beneficial. Similarly, other drugs with bitter, astringent, pungent and sweet tastes could also be administered, depending upon the nature of the disorder, dosage and season. [56]
 
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=== Lactation-stimulants (or galactogogues) ===
 
=== Lactation-stimulants (or galactogogues) ===
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This verse describes the procedure of construction of the nursery. It should be built by a skillful architect and should be sturdy, beautiful, well lighted, protected from draught, well ventilated (with air-entry from only one direction), free from pests, animals, fanged creatures, mice and moths. It should be well accessible to places of water storage, grinding, lavatory, bath and cooking, should be comfortable during all seasons, and furnished with beds, seats and spreads suited to each season. Moreover, protective measures, holy offerings, auspicious rites, and oblations should be performed and the facility should be provided with clean and experienced physicians and with a compassionate and caring staff. Thus, the metod of construction of a child care nursery has been described. [59]
+
This verse describes the procedure of construction of the nursery. It should be built by a skillful architect and should be sturdy, beautiful, well lighted, protected from draught, well ventilated (with air-entry from only one direction), free from pests, animals, fanged creatures, mice and moths. It should be well accessible to places of water storage, grinding, lavatory, bath and cooking, should be comfortable during all seasons, and furnished with beds, seats and spreads suited to each season. Moreover, protective measures, holy offerings, auspicious rites, and oblations should be performed and the facility should be provided with clean and experienced physicians and with a compassionate and caring staff. Thus, the method of construction of a child care nursery has been described. [59]
 
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Thus, to sum up this chapter, measures described here will fulfill the longing of the individual of desirred progeny and these are of great importance. By taking recourse to these measures in the manner prescribed, a wise man, free from envy or ill-will, is blessed (with a child) according to his wishes. [68]
+
Thus, to sum up this chapter, measures described here will fulfill the longing of the individual of desired progeny and these are of great importance. By taking recourse to these measures in the manner prescribed, a wise man, free from envy or ill-will, is blessed (with a child) according to his wishes. [68]
 
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== Tattva Vimarsha (Fundamental Principles) ==
 
== Tattva Vimarsha (Fundamental Principles) ==
 
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*Posture plays an important role in facilitating the union of the sperm and the ovum. Improper posture may lead to dosha prakopa, or dosha vitiation. Also, physical and mental wellbeing of both partners is essential for successful coitus and furthering one’s lineage. [6]
+
*Posture plays an important role in facilitating the union of the sperm and the ovum. Improper posture may lead to [[dosha]] prakopa, or [[dosha]] vitiation. Also, physical and mental wellbeing of both partners is essential for successful coitus and furthering one’s lineage. [6]
 
*Sexual intercourse, when done with happy and joyous mood results in good progeny. Entering the bed by placing the right and left leg first by male and female partners respectively needs scientific exploration. It may merely be auspicious as per rituals. [7] Healthy progeny and succession of lineage, amply supported by recitations of mantra (to invoke the Gods and bless the progeny), was the sole purpose of sexual intercourse. Pleasure and eroticism were not the prime purpose of sexual acts, per the vedic rituals documented. [8]
 
*Sexual intercourse, when done with happy and joyous mood results in good progeny. Entering the bed by placing the right and left leg first by male and female partners respectively needs scientific exploration. It may merely be auspicious as per rituals. [7] Healthy progeny and succession of lineage, amply supported by recitations of mantra (to invoke the Gods and bless the progeny), was the sole purpose of sexual intercourse. Pleasure and eroticism were not the prime purpose of sexual acts, per the vedic rituals documented. [8]
 
*For the husband to practice celibacy for the period of one week following his wife’s menstrual period is advised to ensure healthy sperm, in turn helping beget a healthy offspring. During this period specific dietetic, behavioural and psychological regimen are advised to be followed by both the partners for attaining physical and psychological well-being, which will further support conception. [9]
 
*For the husband to practice celibacy for the period of one week following his wife’s menstrual period is advised to ensure healthy sperm, in turn helping beget a healthy offspring. During this period specific dietetic, behavioural and psychological regimen are advised to be followed by both the partners for attaining physical and psychological well-being, which will further support conception. [9]
 
*The ideal time for performing the Putreshti procedure is mentioned as a week or so of cessation of menstrual flow of the female partner, so that ovulation starts. After this they may cohabit for eight nights. [11]  
 
*The ideal time for performing the Putreshti procedure is mentioned as a week or so of cessation of menstrual flow of the female partner, so that ovulation starts. After this they may cohabit for eight nights. [11]  
*Predominance of a particular mahabhuta at the time of conception plays an important role in begetting a progeny of desired physique and complexion. [15]
+
*Predominance of a particular [[mahabhuta]] at the time of conception plays an important role in begetting a progeny of desired physique and complexion. [15]
 
*Psyche of the child to be born is decided by the deeds of the previous life of the individual as well as the mental disposition of the parents at the time of conception and the mental status of the mother during her pregnancy. [16]
 
*Psyche of the child to be born is decided by the deeds of the previous life of the individual as well as the mental disposition of the parents at the time of conception and the mental status of the mother during her pregnancy. [16]
 
*To beget a good progeny, healthy male and female reproductive systems, proper ovulatory cycles and potent seeds are essential. [17]
 
*To beget a good progeny, healthy male and female reproductive systems, proper ovulatory cycles and potent seeds are essential. [17]
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*Upavishtaka and Nagodara, both suggestive of intrauterine growth retardation (IUGR) result due to improper nutrition to the growing foetus. [26] Proper nutrition will help correct the same. [27] Santarpana chikitsa which are vatahara are to be adopted. [28]  
 
*Upavishtaka and Nagodara, both suggestive of intrauterine growth retardation (IUGR) result due to improper nutrition to the growing foetus. [26] Proper nutrition will help correct the same. [27] Santarpana chikitsa which are vatahara are to be adopted. [28]  
 
*Garbhini udavarta, a condition caused due to reverse movement of apana vata can have implications during child birth. [29]  
 
*Garbhini udavarta, a condition caused due to reverse movement of apana vata can have implications during child birth. [29]  
*In children, the dosha, dushya etc. causing the disease are the same as that in adults, the only difference being drug dosage. [65]
+
*In children, the [[dosha]], [[dushya]] etc. causing the disease are the same as that in adults, the only difference being drug dosage. [65]
    
== Vidhi Vimarsha (Applied Inferences) ==
 
== Vidhi Vimarsha (Applied Inferences) ==
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=== Ritukala – Ideal period in menstrual cycle for conception ===
 
=== Ritukala – Ideal period in menstrual cycle for conception ===
   −
For conception, the period after stoppage of menstruation,i.e., from the 4th day onwards to 12 days corresponding to the 16th day of the menstrual cycle is considered to be the ideal period for impregnation. During the first half of the menstrual cycle, i.e., from 1st day to 14th day, estrogen hormone is dominant, and under its influence, the cervical mucus becomes watery with a high concentration of sodium chloride. This consistency is ideal for spermatozoa to travel through the cervical canal. After ovulation on the 14th day, the formation of corpus luteum leads to the dominance of progesterone hormone, and this leads to change in a characteristic of cervical mucus from watery to viscous because of increased protein content and decrease in sodium chloride. This hampers the migration of sperm in the cervical canal. Hence the ritukala of 12 days in the first half of the cycle is justified.  
+
For conception, the period after stoppage of menstruation, i.e., from the 4th day onwards to 12 days corresponding to the 16th day of the menstrual cycle is considered to be the ideal period for impregnation. During the first half of the menstrual cycle, i.e., from 1st day to 14th day, estrogen hormone is dominant, and under its influence, the cervical mucus becomes watery with a high concentration of sodium chloride. This consistency is ideal for spermatozoa to travel through the cervical canal. After ovulation on the 14th day, the formation of corpus luteum leads to the dominance of progesterone hormone, and this leads to change in a characteristic of cervical mucus from watery to viscous because of increased protein content and decrease in sodium chloride. This hampers the migration of sperm in the cervical canal. Hence the ritukala of 12 days in the first half of the cycle is justified.  
 
                 [[File:gtypemucus.png]]                      [[File:ltypemucus.png]]
 
                 [[File:gtypemucus.png]]                      [[File:ltypemucus.png]]
 
  Under effect of progesterone preventing sperm penetration              Cervical mucus under estrogenic effect <br>  
 
  Under effect of progesterone preventing sperm penetration              Cervical mucus under estrogenic effect <br>  
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Ideal position for coitus and factors affecting conception:  
 
Ideal position for coitus and factors affecting conception:  
In the prone position, pressure on abdomen affects the natural movement of vata dosha, while the left-lateral position stimulates the enzyme secretions in the gut and leads to pitta prakopa. Therefore, a comfortable, supine position is recommended for coitus for conception, as all body humors are in their proper positions. A sprinkling of cold water or cold compresses of vulva after coitus is useful to prevent the reverse flow of semen from the female genital tract. Mental comfort, urge for sex and willingness for sex with the same partner are very important factors for the conception and formation of a healthy fetus. As neuro-endocrinal harmony is essential during the act of coitus, one should be free of urges or thoughts of hunger, thirst, passing flatulence, urination or bowel movements, and should be free from emotions like stress, anger, anxiety while having sexual intercourse.  
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In the prone position, pressure on abdomen affects the natural movement of [[vata dosha]], while the left-lateral position stimulates the enzyme secretions in the gut and leads to [[pitta]] prakopa. Therefore, a comfortable, supine position is recommended for coitus for conception, as all body humors are in their proper positions. A sprinkling of cold water or cold compresses of vulva after coitus is useful to prevent the reverse flow of semen from the female genital tract. Mental comfort, urge for sex and willingness for sex with the same partner are very important factors for the conception and formation of a healthy fetus. As neuro-endocrinal harmony is essential during the act of coitus, one should be free of urges or thoughts of hunger, thirst, passing flatulence, urination or bowel movements, and should be free from emotions like stress, anger, anxiety while having sexual intercourse.  
    
=== Ambiance for coitus ===
 
=== Ambiance for coitus ===
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=== Effect of chanting mantras ===
 
=== Effect of chanting mantras ===
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Keeping the body and its doshas in harmony with its environment are essential to good conception, as it is with staying healthy, per Ayurvedic texts. This is consistent with the vedic concept of Yatha Pinde Tatha Brahmande (As the Body, so the Universe) – that problems occur when there is disequilibrium between the body and its surroundings.  
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Keeping the body and its [[dosha]]s in harmony with its environment are essential to good conception, as it is with staying healthy, per Ayurvedic texts. This is consistent with the vedic concept of Yatha Pinde Tatha Brahmande (As the Body, so the Universe) – that problems occur when there is disequilibrium between the body and its surroundings.  
    
Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis<ref> Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing </ref>. Hence chanting or reciting mantras or shlokas is recommended for maintenance of a psychosomatic balance of the body. In Vedic rituals, shloka (sacred hymns) to be chanted are said to invoke Lord Brahma, the creator of the universe and the progenitor of all the activities of the universe, Lord Brihaspati, the power behind every activity, Lord Vishnu, the preserver of the universe, Soma and Agni, the prime principles in all living beings, Ashvinau, the symbol of health and well-being in every creature, and Mitra and Varuna, the forces necessary to sustain life in the universe. Therefore, vedic scriptures, including Ayurvedic texts, emphasize on paying one’s obeisance to deities and forces of the universe, in the form of Gods, if one desires a healthy offspring.
 
Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis<ref> Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing </ref>. Hence chanting or reciting mantras or shlokas is recommended for maintenance of a psychosomatic balance of the body. In Vedic rituals, shloka (sacred hymns) to be chanted are said to invoke Lord Brahma, the creator of the universe and the progenitor of all the activities of the universe, Lord Brihaspati, the power behind every activity, Lord Vishnu, the preserver of the universe, Soma and Agni, the prime principles in all living beings, Ashvinau, the symbol of health and well-being in every creature, and Mitra and Varuna, the forces necessary to sustain life in the universe. Therefore, vedic scriptures, including Ayurvedic texts, emphasize on paying one’s obeisance to deities and forces of the universe, in the form of Gods, if one desires a healthy offspring.
   −
Chanting of mantras is known to have physical, mental and spiritual benefits. Mantra chanting form the basis of yogic meditation practices to help calm one’s mind and ease anxieties, which could have adverse effects on one’s progeny. [[Ayurveda]] science also mentions the role of the atma, along with the union of sperm and ovum, as a prerequisite, in the formation of the garbha. For the atma (of the newborn) to be of best satva and good prior karma, the ambiance and environment of the area should be spiritual, and chanting helps in creating such an environment.
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Chanting of mantras is known to have physical, mental and spiritual benefits. Mantra chanting form the basis of yogic meditation practices to help calm one’s mind and ease anxieties, which could have adverse effects on one’s progeny. [[Ayurveda]] science also mentions the role of the [[atma]], along with the union of sperm and ovum, as a prerequisite, in the formation of the [[garbha]]. For the [[atma]] (of the newborn) to be of best satva and good prior karma, the ambiance and environment of the area should be spiritual, and chanting helps in creating such an environment.
    
=== Do’s and Dont’s before coitus ===
 
=== Do’s and Dont’s before coitus ===
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=== Regimens and factors affecting desired progeny ===  
 
=== Regimens and factors affecting desired progeny ===  
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For getting the desired result (i.e., a healthy progeny of the desired traits), one has to apply the factors either in the form of the same element (dravya samanya) or the elements having similar constitution and properties (guna samanya) or similar the effort (karma samanya), giving the similar to get similar output. All the above mentioned dietary, ritualistic practices, and do's and don'ts need to be of the desired dravya, guna and karma samanya to get the desired result, i.e., healthy and long living progeny with good complexion and intelligence. Whatever the mother sees, tastes, touches, feels, thinks and the way she behaves or thinks socially or spiritually has a deep impact on the future temperament and behavior of the child. A popular example of this ‘karma based garbha samskara’ is the mythological story of Abhimanyu, the warrior son of Arjuna, in the Mahabharata. Abhimanyu, even when he was a fetus in his mother (Subhadra)’s womb, learned the technique of entering the Chakravyuha (a special type of battle formation) from his maternal uncle Lord Krishna. If the mother takes dravya having predominant jala mahabhuta dravya, there will be an increase in the kapha dhatu of the fetus, giving it a fair complexion. Similarly, other mahabhuta-dominant dravyas contribute to other types of complexions in the baby.
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For getting the desired result (i.e., a healthy progeny of the desired traits), one has to apply the factors either in the form of the same element (dravya samanya) or the elements having similar constitution and properties ([[guna]] samanya) or similar the effort (karma samanya), giving the similar to get similar output. All the above mentioned dietary, ritualistic practices, and do's and don'ts need to be of the desired dravya, [[guna]] and karma samanya to get the desired result, i.e., healthy and long living progeny with good complexion and intelligence. Whatever the mother sees, tastes, touches, feels, thinks and the way she behaves or thinks socially or spiritually has a deep impact on the future temperament and behavior of the child. A popular example of this ‘karma based garbha samskara’ is the mythological story of Abhimanyu, the warrior son of Arjuna, in the Mahabharata. Abhimanyu, even when he was a fetus in his mother (Subhadra)’s womb, learned the technique of entering the Chakravyuha (a special type of battle formation) from his maternal uncle Lord Krishna. If the mother takes dravya having predominant jala mahabhuta dravya, there will be an increase in the kapha dhatu of the fetus, giving it a fair complexion. Similarly, other [[mahabhuta]]-dominant dravyas contribute to other types of complexions in the baby.
 
In Korea, for prenatal development, expectant mothers are advised to do certain practices called ‘Taegyo.<ref> Lee, Yuna, Lee, Jiyoung, Korean Traditional Taegyo Prenatal Education based on Sajudang Lee’s “Taegyo Singi”, 2016, International Journal of Childbirth Education, Pg 34-37 </ref>'  Expectant mothers are advised to stay calm, avoid evil thoughts, listening to soft music, reading inspiring stories aloud, staying vigilant of surroundings and prudent in speech and action. Following these practices provides a safe and healthy environment for the fetal development.
 
In Korea, for prenatal development, expectant mothers are advised to do certain practices called ‘Taegyo.<ref> Lee, Yuna, Lee, Jiyoung, Korean Traditional Taegyo Prenatal Education based on Sajudang Lee’s “Taegyo Singi”, 2016, International Journal of Childbirth Education, Pg 34-37 </ref>'  Expectant mothers are advised to stay calm, avoid evil thoughts, listening to soft music, reading inspiring stories aloud, staying vigilant of surroundings and prudent in speech and action. Following these practices provides a safe and healthy environment for the fetal development.
 
Research in Pre-natal education
 
Research in Pre-natal education
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=== Effects of karma of the progeny’s prior birth ===
 
=== Effects of karma of the progeny’s prior birth ===
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As explained in this chapter, with the effect of karma samanya there is garbha sanskara on the fetus inside the mother’s womb. Therefore, the birth of an individual in any race depends on the karma of the parents and the karma from the child’s previous life. According to Charaka, an individual goes through the cycle of birth and death according to Karma Siddhanta. In fact, the birth of an individual has multiple facets like poorvakarma, matrija karma, pitrija karma, garbhadhana, garbhini paricharya and much more. One should not forget the effect of, i.e., karma on the fetus, the mother, and the father. Therefore, in spite of following of all do’s and don’ts strictly, there can be bad progeny because of it's (and the parent's) karma.
+
As explained in this chapter, with the effect of karma samanya there is [[garbha]] sanskara on the fetus inside the mother’s womb. Therefore, the birth of an individual in any race depends on the karma of the parents and the karma from the child’s previous life. According to Charaka, an individual goes through the cycle of birth and death according to Karma Siddhanta. In fact, the birth of an individual has multiple facets like poorvakarma, matrija karma, pitrija karma, garbhadhana, garbhini paricharya and much more. One should not forget the effect of, i.e., karma on the fetus, the mother, and the father. Therefore, in spite of following of all do’s and don’ts strictly, there can be bad progeny because of it's (and the parent's) karma.
    
=== Factors for healthy progeny ===
 
=== Factors for healthy progeny ===
   −
As explained earlier, according to yukti pramana, the formation of garbha is multidimensional and requires normalcy of all components i.e. fertile period, healthy uterus, sufficient and healthy nutrients, and most importantly, healthy gametes.  
+
As explained earlier, according to yukti pramana, the formation of [[garbha]] is multidimensional and requires normalcy of all components i.e. fertile period, healthy uterus, sufficient and healthy nutrients, and most importantly, healthy gametes.  
    
=== Maintenance of products of conception ===
 
=== Maintenance of products of conception ===
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=== Precaution for the treatment of disorders in pregnant females ===
 
=== Precaution for the treatment of disorders in pregnant females ===
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As explained by Charaka, a pregnant woman is like a vessel full of oil and should be treated with care, meaning that all doshas, dhatu, mala and ojas of the pregnant woman are at such a critical physiological stage that if one does not attend to her in a timely and proper way it may lead to damage to the foetus or the mother or both. Hence the disorders which may occur during pregnancy are to be treated with special care. For the antenatal mother, the diet or medications which should be used for curing any ailment should be mild and effective. Panchakarma treatment, because of its use of invasive and strong medicines, is to be avoided. Basti and abhyanga to kati are advocated in the eighth month of pregnancy, and these are comparatively safer procedures and may also help in a normal labor. During the eighth month, the fetus is sufficiently developed and viable, and even if the mother gets labor pain while undergoing treatment (mild to aggressive courses, as the need may be), the fetus can be preserved, and there are fewer chances of compromising fetal life.  
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As explained by Charaka, a pregnant woman is like a vessel full of oil and should be treated with care, meaning that all [[dosha]]s, [[dhatu]], [[mala]] and [[ojas]] of the pregnant woman are at such a critical physiological stage that if one does not attend to her in a timely and proper way it may lead to damage to the foetus or the mother or both. Hence the disorders which may occur during pregnancy are to be treated with special care. For the antenatal mother, the diet or medications which should be used for curing any ailment should be mild and effective. [[Panchakarma]] treatment, because of its use of invasive and strong medicines, is to be avoided. [[Basti]] and abhyanga to kati are advocated in the eighth month of pregnancy, and these are comparatively safer procedures and may also help in a normal labor. During the eighth month, the fetus is sufficiently developed and viable, and even if the mother gets labor pain while undergoing treatment (mild to aggressive courses, as the need may be), the fetus can be preserved, and there are fewer chances of compromising fetal life.  
 
The effects of drug use during pregnancy on the fetus has been researched and documented. The mother as well the fetus, if subjected to certain drugs /treatment, can lead to side-effects on either or both.  FDA has specified a certain list of drugs (X category) which are contraindicated during pregnancy <ref> https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/labeling/ucm093307.htm
 
The effects of drug use during pregnancy on the fetus has been researched and documented. The mother as well the fetus, if subjected to certain drugs /treatment, can lead to side-effects on either or both.  FDA has specified a certain list of drugs (X category) which are contraindicated during pregnancy <ref> https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/labeling/ucm093307.htm
 
Ix Gawade T, Ghorpade M, Effect of bala siddha taila anuvasana basti on labour pains; Ayurlog: National journal of Research in [[Ayurveda]] science’ Vol 3, Feb 2015
 
Ix Gawade T, Ghorpade M, Effect of bala siddha taila anuvasana basti on labour pains; Ayurlog: National journal of Research in [[Ayurveda]] science’ Vol 3, Feb 2015
  </ref>. In [[Ayurveda]], the principles of antenatal treatment are given for shamana as well as shodhana, other drugs and treatment are contraindicated. In practice, for any ailments occurring during pregnancy, herbal medicines are preferred over herbo mineral medicines.
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  </ref>. In [[Ayurveda]], the principles of antenatal treatment are given for shamana as well as [[shodhana]], other drugs and treatment are contraindicated. In practice, for any ailments occurring during pregnancy, herbal medicines are preferred over herbo mineral medicines.
    
=== Disorders of the fetus and its treatment ===
 
=== Disorders of the fetus and its treatment ===
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First-trimester abortion is seen in about 80% of total abortions. Any bleeding during the first trimester (up to 12 weeks) may either end in inevitable abortion, preterm labor and in rare cases may proceed to full term. Emotional factors like severe anger, stress, jealousy all are suspected to cause the high release of CRH (Corticotropin-releasing hormone) which may trigger uterine contractions.   
 
First-trimester abortion is seen in about 80% of total abortions. Any bleeding during the first trimester (up to 12 weeks) may either end in inevitable abortion, preterm labor and in rare cases may proceed to full term. Emotional factors like severe anger, stress, jealousy all are suspected to cause the high release of CRH (Corticotropin-releasing hormone) which may trigger uterine contractions.   
 
Uterine bleeding from implantation site or deciduas may be triggered because of coitus, trauma, exercise and faulty regimen. Bleeding may further release prostaglandins which could trigger uterine contractions and hence abortion.
 
Uterine bleeding from implantation site or deciduas may be triggered because of coitus, trauma, exercise and faulty regimen. Bleeding may further release prostaglandins which could trigger uterine contractions and hence abortion.
Management of such condition is aimed at relieving uterine contractions and bleeding. Since there are vata and shonita dushti in abortion, treatment should follow the principle of vatarakta chikitsa viz. sheeta and snigdha lepa, and brimhana, vatahara, raktavardhaka diet, and drugs. Sura (alcohol-containing preparations) is mainly advised to relieve the pain and to increase the hemopoiesis.
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Management of such condition is aimed at relieving uterine contractions and bleeding. Since there are [[vata]] and shonita dushti in abortion, treatment should follow the principle of vatarakta chikitsa viz. sheeta and snigdha lepa, and [[brimhana]], vatahara, raktavardhaka diet, and drugs. Sura (alcohol-containing preparations) is mainly advised to relieve the pain and to increase the hemopoiesis.
   −
As explained earlier, garbhapata (abortion) due to ama dosha (during the first trimester) is very critical to treat. Treatment of ama dosha is apatarpana while that of garbha and garbhini needs santarpana, which are antagonistic and hence very tedious to treat. In practice, Madhura varga dravyas such as shatavari (Asparagus racemosus) and medicated ghee phalaghrita are used in case of threatened abortion. These promote proper nourishment and growth and stop bleeding.
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As explained earlier, garbhapata (abortion) due to ama dosha (during the first trimester) is very critical to treat. Treatment of ama dosha is apatarpana while that of [[garbha]] and garbhini needs santarpana, which are antagonistic and hence very tedious to treat. In practice, Madhura varga dravyas such as shatavari (Asparagus racemosus) and medicated ghee phalaghrita are used in case of threatened abortion. These promote proper nourishment and growth and stop bleeding.
    
==== Growth retardation of fetus and its treatment ====
 
==== Growth retardation of fetus and its treatment ====
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Intrauterine growth retardation of the fetus occurs due to malnourishment of mother as well as pregnancy disorders which cause vaginal discharge and bleeding. According to severity, they are categorized as garbhashosha (mentioned in Charaka Sharirsthana 2nd chapter) upavishtaka, nagodara, lina garbha (not directly mentioned but clinical features with the absence of movements of fetus suggest this condition).  These conditions occur either because of improper nourishment of mother with vata and pitta dominant diet or because of decreased transfer of nutrients from mother to fetus as a consequence of fetal metabolic disorder or placental abnormality. The treatment principle applicable here is brimhana supplying nourishment to mother and fetus.  
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Intrauterine growth retardation of the fetus occurs due to malnourishment of mother as well as pregnancy disorders which cause vaginal discharge and bleeding. According to severity, they are categorized as garbhashosha (mentioned in Charaka Sharirsthana 2nd chapter) upavishtaka, nagodara, lina garbha (not directly mentioned but clinical features with the absence of movements of fetus suggest this condition).  These conditions occur either because of improper nourishment of mother with [[vata]] and [[pitta]] dominant diet or because of decreased transfer of nutrients from mother to fetus as a consequence of fetal metabolic disorder or placental abnormality. The treatment principle applicable here is [[brimhana]] supplying nourishment to mother and fetus.  
 
All the dietary articles mentioned in the management have vatahara and dhatupushtikara properties, as there are vataprakopa and dhatukshya in these conditions. In the case of lina garbha, there is the absence of fetal movements, to expel such fetus, treatments which increase uterine contractions and induce labor are indicated because such fetus resembles fetus papyraceous or mummified fetus.
 
All the dietary articles mentioned in the management have vatahara and dhatupushtikara properties, as there are vataprakopa and dhatukshya in these conditions. In the case of lina garbha, there is the absence of fetal movements, to expel such fetus, treatments which increase uterine contractions and induce labor are indicated because such fetus resembles fetus papyraceous or mummified fetus.
Practically the herbs used in fetal growth restriction are yashtimadhu, shatavari, gambhari and preparations like phalghrita, laghumalinivasanta. These herbs and preparations are rasayana and improve dhatvagni and rasa dhatu nirmana. They also help in clearing any obstruction in the channels (srotas) which are supplying nourishment to the fetus through the mother.  As mentioned in classics, ksheer basti given to the mother in severe IUGR conditions stimulates fetal growth.   
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Practically the herbs used in fetal growth restriction are yashtimadhu, shatavari, gambhari and preparations like phalghrita, laghumalinivasanta. These herbs and preparations are [[rasayana]] and improve dhatvagni and [[rasa dhatu]] nirmana. They also help in clearing any obstruction in the channels (srotas) which are supplying nourishment to the fetus through the mother.  As mentioned in classics, ksheer basti given to the mother in severe IUGR conditions stimulates fetal growth.   
    
==== Garbhini Udavarta and its management ====
 
==== Garbhini Udavarta and its management ====
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As a result of progesterone hormone which relaxes all the smooth muscles, there is decreased bowel and intestinal movements. Especially during the later months of pregnancy, along with progesterone, the pressure of the uterus on intestines and rectum leads to decreased peristalsis. This is observed most commonly during the 8th month. Garbhini udavarta is a similar condition with constipation and gaseous distention. This condition is to be relieved as straining for defecation may lead to hemorrhoids, bleeding hemorrhoids and leaking of membranes. Medicated enema of decoction is to be administered to clear the bowel as oral medications may aggravate uterine contractions. Enema with oil should be administered afterward for oleation of the tract, and this may further help in the formation of canal/pathway for parturition.   
 
As a result of progesterone hormone which relaxes all the smooth muscles, there is decreased bowel and intestinal movements. Especially during the later months of pregnancy, along with progesterone, the pressure of the uterus on intestines and rectum leads to decreased peristalsis. This is observed most commonly during the 8th month. Garbhini udavarta is a similar condition with constipation and gaseous distention. This condition is to be relieved as straining for defecation may lead to hemorrhoids, bleeding hemorrhoids and leaking of membranes. Medicated enema of decoction is to be administered to clear the bowel as oral medications may aggravate uterine contractions. Enema with oil should be administered afterward for oleation of the tract, and this may further help in the formation of canal/pathway for parturition.   
   −
The position in pregnancy to administer basti is nyubja sthithi – hunchback /flexed posture. Conventionally, the left-lateral position is used. In nyubja sthithi, the fetus moves in a ventral position relieving the pressure on colon and rectum, making it easy for basti to be administered and reach descending colon easily.  
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The position in pregnancy to administer [[basti]] is nyubja sthithi – hunchback /flexed posture. Conventionally, the left-lateral position is used. In nyubja sthithi, the fetus moves in a ventral position relieving the pressure on colon and rectum, making it easy for [[basti]] to be administered and reach descending colon easily.  
    
==== Mrita garbha (intrauterine death) and its management ====
 
==== Mrita garbha (intrauterine death) and its management ====
   −
All the factors which are contraindicated during pregnancy and are known to cause harm to the fetus, if continued by the mother can cause upavishtaka, nagodara, garbhashosa. If left untreated, excessive accumulation of doshas with maternal illness may lead to placental insufficiency and fetal disorders where it fails to metabolize nutrients and causes fetal death.  The symptoms of mritagarbha (fetal death) also signify causes as antepartum hemorrhage, hypovolemia and its complications in the mother. [30]
+
All the factors which are contraindicated during pregnancy and are known to cause harm to the fetus, if continued by the mother can cause upavishtaka, nagodara, garbhashosa. If left untreated, excessive accumulation of [[dosha]]s with maternal illness may lead to placental insufficiency and fetal disorders where it fails to metabolize nutrients and causes fetal death.  The symptoms of mritagarbha (fetal death) also signify causes as antepartum hemorrhage, hypovolemia and its complications in the mother. [30]
   −
To expel the dead fetus, the treatments to be administered are to initiate uterine contractions and induce labor. If necessary surgical treatment for removal of a dead fetus is also believed to save the mother from serious complications like DIC (disseminated intravascular coagulopathy) may occur if fetal fibrin is absorbed in maternal circulation.  After the removal of the dead fetus, the physician should administer sura varga (alcoholic preparations) for the relief of pain and purification of the gut and genito-urinary system and also for the sense of exhilaration. Loss of fetus in such a later stage can be very stressful for mother and anxiety, depression and other psychotic complications may arise if proper care is not taken. Once there is complete shuddhi of koshtha and garbhashaya, one should give brimhana treatment to promote tissue bulk and nutrition. As there is the removal of the kleda from all dhatus during the management and shuddhi, santarpana is very essential.
+
To expel the dead fetus, the treatments to be administered are to initiate uterine contractions and induce labor. If necessary surgical treatment for removal of a dead fetus is also believed to save the mother from serious complications like DIC (disseminated intravascular coagulopathy) may occur if fetal fibrin is absorbed in maternal circulation.  After the removal of the dead fetus, the physician should administer sura varga (alcoholic preparations) for the relief of pain and purification of the gut and genito-urinary system and also for the sense of exhilaration. Loss of fetus in such a later stage can be very stressful for mother and anxiety, depression and other psychotic complications may arise if proper care is not taken. Once there is complete shuddhi of koshtha and garbhashaya, one should give [[brimhana]] treatment to promote tissue bulk and nutrition. As there is the removal of the kleda from all dhatus during the management and shuddhi, santarpana is very essential.
    
=== Monthly regimen during pregnancy ===
 
=== Monthly regimen during pregnancy ===
   −
Regular intake of recommended diet and daily routine is essential for fetal growth as well as maternal well-being. Daily use of milk and milk products is an important aspect of garbhini paricharya. Milk can nourish all body tissues and is considered a wholesome diet, fulfilling the requirement of fetal as well as maternal growth. Milk is sheeta, snigdha, and madhura and increases the ojas in the body. Ojas is said to be the essence of all body tissues and revitalizes to produce new body elements. The regimen is rich in proteins as well as carbohydrates which are essential for fetal growth and development. Due care is taken while prescribing the regimen to prevent vata prakopa.  Disturbance in vata balance may cause many diseases of the fetus as well as the mother.  From the eighth month onwards, the preparation of birth canal for pariturition begins and also there is the descent of fetal presenting part in the pelvis. To relieve the symptoms of this pressure on pelvis and augment the formation of lower segment, to prepare cervix to become ripe and easily dilatable, basti and pichu (vaginal tampon) of oil are advised<ref> Meharban Singh – Care Of the New Born, 7thed. New Delhi. Sagar Publications, 2010. </ref>. ix Basti keeps vata dosha balanced & its gati in anulom (downward) direction, preventing the obstruction in the path of vata dosha to help the process of labor, natural and in ease.
+
Regular intake of recommended diet and daily routine is essential for fetal growth as well as maternal well-being. Daily use of milk and milk products is an important aspect of garbhini paricharya. Milk can nourish all body tissues and is considered a wholesome diet, fulfilling the requirement of fetal as well as maternal growth. Milk is sheeta, snigdha, and madhura and increases the [[ojas]] in the body. [[Ojas]] is said to be the essence of all body tissues and revitalizes to produce new body elements. The regimen is rich in proteins as well as carbohydrates which are essential for fetal growth and development. Due care is taken while prescribing the regimen to prevent [[vata]] prakopa.  Disturbance in [[vata]] balance may cause many diseases of the fetus as well as the mother.  From the eighth month onwards, the preparation of birth canal for pariturition begins and also there is the descent of fetal presenting part in the pelvis. To relieve the symptoms of this pressure on pelvis and augment the formation of lower segment, to prepare cervix to become ripe and easily dilatable, [[basti]] and pichu (vaginal tampon) of oil are advised<ref> Meharban Singh – Care Of the New Born, 7thed. New Delhi. Sagar Publications, 2010. </ref>. ix [[Basti]] keeps [[vata dosha]] balanced & its gati in anulom (downward) direction, preventing the obstruction in the path of [[vata dosha]] to help the process of labor, natural and in ease.
    
Antenatal patients are prescribed Ayurvedic regimen throughout pregnancy with proper diet advice. The medicines given are shatavari, phalghrita especially during the first trimester.
 
Antenatal patients are prescribed Ayurvedic regimen throughout pregnancy with proper diet advice. The medicines given are shatavari, phalghrita especially during the first trimester.
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Use of a herbomineral preparation Garbhapala rasa because of its lead content is under controversy. Appropriate preparation of this herbominearal compound following Ayurvedic Formulary of India ensures proper development of the fetus and prevents bleeding and threatened abortion during the first trimester. Along with the physical development of the fetus, the spiritual and psychological development is also taken care of. Given this, the do's and don't's includes visiting scenic and places of interest, associating with likable people, eating prescribed diet, reading and listening to interesting stories are advised.  
 
Use of a herbomineral preparation Garbhapala rasa because of its lead content is under controversy. Appropriate preparation of this herbominearal compound following Ayurvedic Formulary of India ensures proper development of the fetus and prevents bleeding and threatened abortion during the first trimester. Along with the physical development of the fetus, the spiritual and psychological development is also taken care of. Given this, the do's and don't's includes visiting scenic and places of interest, associating with likable people, eating prescribed diet, reading and listening to interesting stories are advised.  
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The lifestyle, diet, exercise, synthetic drugs, food additives like artificial colors, preservatives, the onslaught of electromagnetic radiations have become an integral part of the day today life (ref:https://infoayushdarpan.wordpress.com/2017/01/18/the-role-of-masanumasik-formulations/). This affects the growth and development of the fetus. Decoctions made in the form of Ghana vati as mentioned by Ashtanga and Sushruta are used as a monthly treatment for all antenatal patients which facilitate proper nourishment and hence the growth of fetus preventing any illness. Research has shown that application of matra basti and yoni pichu of Bala tssail given from the first day of 9th month results in normal labor without prolongation with spontaneous onset Ref. Also, it reduces postpartum complications like a backache, lower abdominal pain, and abdominal distention.
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The lifestyle, diet, exercise, synthetic drugs, food additives like artificial colors, preservatives, the onslaught of electromagnetic radiations have become an integral part of the day today life (ref:https://infoayushdarpan.wordpress.com/2017/01/18/the-role-of-masanumasik-formulations/). This affects the growth and development of the fetus. Decoctions made in the form of Ghana vati as mentioned by Ashtanga and Sushruta are used as a monthly treatment for all antenatal patients which facilitate proper nourishment and hence the growth of fetus preventing any illness. Research has shown that application of matra [[basti]] and yoni pichu of Bala taila given from the first day of 9th month results in normal labor without prolongation with spontaneous onset Ref. Also, it reduces postpartum complications like a backache, lower abdominal pain, and abdominal distention.
    
Kikkisa (striae gravidarum) which occurs on abdominal and breast area due to itching is to be treated with local application of drugs which relieves itching and burning sensation. Also, certain herbs are varnya in nature i.e. to improve color and complexion of skin. Ointments, oil, and lepa are prepared from these formulations and prescribed to mother to apply on abdominal area, thighs, and breast from the second month itself to prevent kikkisa.  
 
Kikkisa (striae gravidarum) which occurs on abdominal and breast area due to itching is to be treated with local application of drugs which relieves itching and burning sensation. Also, certain herbs are varnya in nature i.e. to improve color and complexion of skin. Ointments, oil, and lepa are prepared from these formulations and prescribed to mother to apply on abdominal area, thighs, and breast from the second month itself to prevent kikkisa.  
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The intensity of increased labor pain and the onset of gripping pain in lower pelvis signifies further descent of fetus and full dilatation of the cervix. The bearing down efforts is encouraged in lying down position. Chanting also encourages the mother to bear down properly.
 
The intensity of increased labor pain and the onset of gripping pain in lower pelvis signifies further descent of fetus and full dilatation of the cervix. The bearing down efforts is encouraged in lying down position. Chanting also encourages the mother to bear down properly.
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The proper timing of bearing down is full dilatation and presence of intense pain (uterine contractions). The two forces, voluntary (which are maternal bearing down effort) and involuntary (uterine contractions), when combined, lead to further descent and expulsion of a fetus with birth passage properly formed after full dilatation of the cervix.  Expulsion of the fetus is controlled by apana vayu located in shroni (pelvis). If there is no movement of apana vayu and the mother bears down, it causes vata prakopa and leads to vikata navajata (baby born with deformities). Secondly, whenever there is an appropriate movement of apana vayu, but the woman suppresses that urge to bear down, that too leads to vata prakopa and causes deformities in the baby, the formation of caput succedaneum and fetal distress, both occur as a result of premature bearing down efforts and absence of bearing down respectively.  The consequence of premature bearing down has increased the incidence of remote complication like vaginal and uterine prolapse.  
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The proper timing of bearing down is full dilatation and presence of intense pain (uterine contractions). The two forces, voluntary (which are maternal bearing down effort) and involuntary (uterine contractions), when combined, lead to further descent and expulsion of a fetus with birth passage properly formed after full dilatation of the cervix.  Expulsion of the fetus is controlled by apana vayu located in shroni (pelvis). If there is no movement of apana vayu and the mother bears down, it causes [[vata]] prakopa and leads to vikata navajata (baby born with deformities). Secondly, whenever there is an appropriate movement of apana vayu, but the woman suppresses that urge to bear down, that too leads to [[vata]] prakopa and causes deformities in the baby, the formation of caput succedaneum and fetal distress, both occur as a result of premature bearing down efforts and absence of bearing down respectively.  The consequence of premature bearing down has increased the incidence of remote complication like vaginal and uterine prolapse.  
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After the birth of a baby, in the case of retained placenta, the therapies administered are to increase uterine contractions and increase intra-abdominal pressure for placental detachment and descent in the vagina. All these measures, along with basti, are vatahara and are vata shamaka measures for the restoration of prakrita gati of vata dosha to expel out the placenta along with stool and urine.
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After the birth of a baby, in the case of retained placenta, the therapies administered are to increase uterine contractions and increase intra-abdominal pressure for placental detachment and descent in the vagina. All these measures, along with [[basti]], are vatahara and are [[vata]] shamaka measures for the restoration of prakrita gati of [[vata dosha]] to expel out the placenta along with stool and urine.
    
=== Care of the Newborn ===
 
=== Care of the Newborn ===
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=== Samskara After birth ===
 
=== Samskara After birth ===
 
   
 
   
[[Ayurveda]] Acharyas follow some medicinal practices in combination with ritualistic customs. The very first feed to the baby should be applied in a ritualistic and hygienic way. Therefore, in jatakarmasamskara, the father has to take a bath before holding the baby, followed by reciting mantras softly in the ear of the baby, followed by making the baby lick gold with honey and ghee. Licking initiates swallowing movement in the newly born baby, and once such sucking and swallowing movements start, it is safe to initiate breastfeeding. Breastfeeding is recommended immediately after birth since breastmilk provides colostrum (stanya piyusha) which gives the baby ample amount of protein, cholesterol, and immunoglobins. Colostrum is said to be essential for the growth of brain and memory of the baby. Cholesterols in the colostrum have essential linoleic fatty acids and various species-specific properties that are essential for nervine and enhancement of immunity. According to the recent practice of neonatal care, breastfeeding should be initiated within 15 minutes after birth, in the case of normal labor, and within 2 hours of birth in case of cesarean section. Precautions should be taken to prevent neonatal sepsis. Are ther any special ayurvedic ways being used now?
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[[Ayurveda]] Acharyas follow some medicinal practices in combination with ritualistic customs. The very first feed to the baby should be applied in a ritualistic and hygienic way. Therefore, in jatakarmasamskara, the father has to take a bath before holding the baby, followed by reciting mantras softly in the ear of the baby, followed by making the baby lick gold with honey and ghee. Licking initiates swallowing movement in the newly born baby, and once such sucking and swallowing movements start, it is safe to initiate breastfeeding. Breastfeeding is recommended immediately after birth since breastmilk provides colostrum (stanya piyusha) which gives the baby ample amount of protein, cholesterol, and immunoglobins. Colostrum is said to be essential for the growth of brain and memory of the baby. Cholesterols in the colostrum have essential linoleic fatty acids and various species-specific properties that are essential for nervine and enhancement of immunity. According to the recent practice of neonatal care, breastfeeding should be initiated within 15 minutes after birth, in the case of normal labor, and within 2 hours of birth in case of cesarean section. Precautions should be taken to prevent neonatal sepsis. Are there any special ayurvedic ways being used now?
    
=== Prescribed post-partum measures for women ===
 
=== Prescribed post-partum measures for women ===
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Parturition and postpartum phase cause significant changes physiologically, psychologically and anatomically especially, in her hormones and the neuro-endocrinal axis. All dhatus of the mother are at a low ebb (kshaya) during labor, and therefore there is vata prakopa and agnimandya. Therefore, in the postpartum phase, a physician should administer vatahara, deepana, and brimhana upakrama and should help restore the woman’s body tissues in a systematic manner, taking care of her digestive capacity. To regain homeostasis, the regimen of diet for first ten days postpartum are prescribed.   
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Parturition and postpartum phase cause significant changes physiologically, psychologically and anatomically especially, in her hormones and the neuro-endocrinal axis. All dhatus of the mother are at a low ebb (kshaya) during labor, and therefore there is [[vata]] prakopa and agnimandya. Therefore, in the postpartum phase, a physician should administer vatahara, [[deepana]], and [[brimhana]] upakrama and should help restore the woman’s body tissues in a systematic manner, taking care of her digestive capacity. To regain homeostasis, the regimen of diet for first ten days postpartum are prescribed.   
 
The measures prescribed in these texts are for the woman after delivery to transition from the effects of labor into a state of normalcy and good health smoothly. These measures help in the involution of the uterus and pelvic cavity, contraction of the distended abdomen, and help in restoring digestion. Immediate care will help in easing the fatigue of labor too. Experienced practitioners endorse these measures clinically.
 
The measures prescribed in these texts are for the woman after delivery to transition from the effects of labor into a state of normalcy and good health smoothly. These measures help in the involution of the uterus and pelvic cavity, contraction of the distended abdomen, and help in restoring digestion. Immediate care will help in easing the fatigue of labor too. Experienced practitioners endorse these measures clinically.
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Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..  
 
Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..  
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Characteristics of Breast milk, the effect of a mother's diet on breast milk and its management: Shuddha stanya (pure breast milk) is necessary for the newborn. According to [[Ayurveda]] whenever the pakva ahara rasa enters the stana (breast), its madhura rasa get converted into stanya (breast milk). Therefore, whatever the mother eats converts into stanya. If the mother takes a diet that causes dosha prakopa, then such a vitiated dosha vitiates the stanya and the vitiated stanya causes disease in the newborn baby. Therefore, the mother should take balanced and healthy diet which does not vitiate doshas.
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Characteristics of Breast milk, the effect of a mother's diet on breast milk and its management: Shuddha stanya (pure breast milk) is necessary for the newborn. According to [[Ayurveda]] whenever the pakva ahara rasa enters the stana (breast), its madhura rasa get converted into stanya (breast milk). Therefore, whatever the mother eats converts into stanya. If the mother takes a diet that causes [[dosha]] prakopa, then such a vitiated [[dosha]] vitiates the stanya and the vitiated stanya causes disease in the newborn baby. Therefore, the mother should take balanced and healthy diet which does not vitiate [[dosha]]s.
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Some of the properties of stanya afflicted with vitiated doshas are as follows: vitiated vata dosha has tikta, kashya rasa and therefore, the stanya afflicted with vitiated vata dosha becomes tikata and kashya (bitter). Similar samprapti (etiology) is applicable in cases of pitta and kapha dosha prakopa as well.  
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Some of the properties of stanya afflicted with vitiated [[dosha]]s are as follows: vitiated [[vata dosha]] has tikta, kashya rasa and therefore, the stanya afflicted with vitiated [[vata dosha]] becomes tikata and kashya (bitter). Similar samprapti (etiology) is applicable in cases of [[pitta]] and [[kapha dosha]] prakopa as well.  
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As explained earlier, stanya produced from the adya ahara rasa dhatu (from the first dhatu..) is afflicted with vitiated kapha/shleshma dosha. Shodhana treatment is key for treating stanya dushti vikara (i.e. breastmilk infections). Shodhana should be followed by the administration of tikta, katu, and kashaya rasa drugs like vachaharidradi gana or charakokta patha mahaushadi suradarvadi stanya shodhana mahakashya (Cha. Sutra Sthana).
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As explained earlier, stanya produced from the adya ahara [[rasa dhatu]] (from the first [[dhatu]]..) is afflicted with vitiated [[kapha]]/shleshma [[dosha]]. [[Shodhana]] treatment is key for treating stanya dushti vikara (i.e. breastmilk infections). [[Shodhana]] should be followed by the administration of tikta, katu, and kashaya rasa drugs like vachaharidradi gana or charakokta patha mahaushadi suradarvadi stanya shodhana mahakashya [Cha.Sa.[[Sutra Sthana]]4]
    
All the above-mentioned drugs and diet have been investigated and found useful with many evidence-based types of research, and are prescribed as galactagogues ref.
 
All the above-mentioned drugs and diet have been investigated and found useful with many evidence-based types of research, and are prescribed as galactagogues ref.
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