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tathA~asyA harSheNApyAyyante prANAH||40||  

tathA~asyA harSheNApyAyyante prANAH||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]

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]

यदा च प्रजाता स्यात्तदैवैनामवेक्षेत- काचिदस्या अपरा प्रपन्ना न वेति|  

यदा च प्रजाता स्यात्तदैवैनामवेक्षेत- काचिदस्या अपरा प्रपन्ना न वेति|  

aparAM hi vAtamUtrapurIShANyanyAni cAntarbahirmArgANi [5] sajjanti||41||  

aparAM hi vAtamUtrapurIShANyanyAni cAntarbahirmArgANi [5] sajjanti||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.) mixedwith the soup of balwaja (a hemp-like plant) or strong liquor of maireya and sura-like beveragesfor 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]

तस्यास्तु खल्वपरायाः प्रपतनार्थे कर्मणि क्रियमाणे जातमात्रस्यैव कुमारस्य कार्याण्येतानि कर्माणि भवन्ति; तद्यथा-अश्मनोः सङ्घट्टनं कर्णयोर्मूले, शीतोदकेनोष्णोदकेन वा मुखपरिषेकः [१] , तथा स क्लेशविहतान् प्राणान् पुनर्लभेत|  

तस्यास्तु खल्वपरायाः प्रपतनार्थे कर्मणि क्रियमाणे जातमात्रस्यैव कुमारस्य कार्याण्येतानि कर्माणि भवन्ति; तद्यथा-अश्मनोः सङ्घट्टनं कर्णयोर्मूले, शीतोदकेनोष्णोदकेन वा मुखपरिषेकः [१] , तथा स क्लेशविहतान् प्राणान् पुनर्लभेत|