Jatisutriya Sharira

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Sharira Sthana Chapter 8. Obstetrics, Maternal Health and Neonatal Care

Jatisutriya Sharira
Section/Chapter Sharira Sthana Chapter 8
Preceding Chapter Sharira Sankhya Sharira
Succeeding Chapter None
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana
Translator and commentator Rajagopala S., Gujarathi J., Deole Y. S.
Reviewer Patwardhan K.
Editors Bhalerao S., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s04.009

Abstract

The word Jati literally means birth. Hence this chapter describes aspects related to pre-conception, conception, methods of procreation and post-pregnancy. It deals with obstetrics and midwifery care, measures for good parental health and effective neonatal care. It also describes pioneering concepts such as architecture of a maternity home, attending wet nurses (and the concept of a milk bank), and well-furnished nurseries. It also prescribes measures for good upbringing of children. Keywords: Jatisutriya, Dhatri, obstetric care, Prenatal care (garbhini paricharya), maternal health,Garbha‎‎, fetus, post-pregnancy regimen, post natal care (Sutika Paricharya), Congenital disorders, Neonatal care, infant care, upbringing of child.

Introduction

The Sharira Sthana and Chikitsa Sthana provide valuable insights into obstretics, midwifery and gynaecology in the Vedic ages. Since Ayurveda is holistic in its treatment of various aspects of life sciences, these sections go beyond in their treatment of these branches of medicine, prescribing ground rules for effective neonatology and improved parental health. This chapter starts with certain guidelines for purification of the parents, including spiritual practices and appropriate rules for coitus, to improve the odds of giving birth to a healthy and desired offspring. For purification, therapies such as Panchakarma are advocated. A very specific - and contentious - spiritual procedure called putreshti yajna is also explained here, with an aim towards giving birth to a son (or a child of desired gender) with all excellent qualities.

Next, the chapter talks of fertilization and its features, and confirmation of conception. At this stage, sound parental health is also important. Couples are advised to follow various dietary measures as well as rules to engage in physical and mental activities, etc. The subsequent part of the chapter deals with obstetrics and midwifery –detailing the development of the embryo to fetus and the milestones of intrauterine growth and development are explained. Certain sections of this chapter are controversial and could attract legal attention today, such as the practice of pumsavana (ways to get the offspring of a desired gender). Also, with our current understanding of genetics, it is not possible to change the gender after fertilization. The role of learned brahmins, vaidya and experienced old ladies in midwifery is given a lot of importance in this chapter.

Toys and playtime are essential for normal growth and development of a child, and the final section of this chapter describes the ideal characteristics of toys, play area, clothes and the child nursery.

Summarizing the eighth chapter, it deals with Obstetrics and Neonatology while also touching upon parental health and early child care, introducing certain concepts that are now considered modern best practices in the field,

Sanskrit text, Transliteration and English Translation

अथातो जातिसूत्रीयं शारीरं व्याख्यास्यामः||१|| इति ह स्माह भगवानात्रेयः||२||

athātō jātisūtrīyaṁ śārīraṁ vyākhyāsyāmaḥ||1|| iti ha smāha bhagavānātrēyaḥ||2||

athAto jAtisUtrIyaM shArIraM vyAkhyAsyAmaH||1|| iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Jatisutriya Sharira" (Obstetrics, Maternal Health and Neonatal Care). Thus said Lord Atreya. [1-2]

Note: Jati means birth and Sutra is which is described in short. Jatisutriya is description of different methods and procedures of birth in short. It deals with continuation of one’s own lineage in this discourse on Sharira.

स्त्रीपुंसयोरव्यापन्नशुक्रशोणितगर्भाशययोः श्रेयसीं प्रजामिच्छतोस्तदर्थाभिनिर्वृत्तिकरं [१] कर्मोपदेक्ष्यामः||३||

strīpuṁsayōravyāpannaśukraśōṇitagarbhāśayayōḥ śrēyasīṁ prajāmicchatōstadarthābhinirvr̥ttikaraṁ [1]karmōpadēkṣyāmaḥ||3||

strIpuMsayoravyApannashukrashoNitagarbhAshayayoH shreyasIMprajAmicchatostadarthAbhinirvRuttikaraM [1] karmopadekShyAmaH||3||

Now we shall explain the procedures required for begetting a progeny of excellent qualities, to be practiced by man and woman of unaltered (pure, undamaged) sperm, ovum and uterus. [3]

अथाप्येतौ स्त्रीपुंसौ स्नेहस्वेदाभ्यामुपपाद्य, वमनविरेचनाभ्यां संशोध्य, क्रमेण प्रकृतिमापादयेत्|
संशुद्धौ चास्थापनानुवासनाभ्यामुपाचरेत्; उपाचरेच्च मधुरौषधसंस्कृताभ्यां घृतक्षीराभ्यां पुरुषं, स्त्रियं तु तैलमाषाभ्याम्||४||

athāpyētau strīpuṁsau snēhasvēdābhyāmupapādya, vamanavirēcanābhyāṁ saṁśōdhya, kramēṇaprakr̥timāpādayēt|
saṁśuddhau cāsthāpanānuvāsanābhyāmupācarēt; upācarēcca madhurauṣadhasaṁskr̥tābhyāṁghr̥takṣīrābhyāṁ puruṣaṁ, striyaṁ tu tailamāṣābhyām||4||

athApyetau strIpuMsau snehasvedAbhyAmupapAdya, vamanavirecanAbhyAM saMshodhya, krameNaprakRutimApAdayet|
saMshuddhau cAsthApanAnuvAsanAbhyAmupAcaret; upAcarecca madhurauShadhasaMskRutAbhyAMghRutakShIrAbhyAM puruShaM, striyaM tu tailamAShAbhyAm||4||

Such a couple (desiring good progeny) should first undergo purification therapies described earlier in this treatise - unction and sudation procedures followed by emesis and purgation - and gradually get back to normalcy. Once purified, the couple should undergo non-unctuous and unctuous enema. Then, the man should be administered with sweet-tasting drugs processed with ghee and milk while the woman should take sesame oil and black gram. [4]

Abstinence from coitus during menstruation

ततः पुष्पात् प्रभृति त्रिरात्रमासीत ब्रह्मचारिण्यधःशायिनी, पाणिभ्यामन्नमजर्जरपात्राद्भुञ्जाना [१] , न चकाञ्चिन्मृजामापद्येत|
ततश्चतुर्थेऽहन्येनामुत्साद्य सशिरस्कं स्नापयित्वा शुक्लानि वासांस्याच्छादयेत् पुरुषं च|
ततः शुक्लवाससौ स्रग्विणौ सुमनसावन्योन्यमभिकामौ संवसेयातां स्नानात् प्रभृति युग्मेष्वहःसु पुत्रकामौ, अयुग्मेषुदुहितृकामौ||५||

tataḥ puṣpāt prabhr̥ti trirātramāsīta brahmacāriṇyadhaḥśāyinī, pāṇibhyāmannamajarjarapātrādbhuñjānā[1] , na ca kāñcinmr̥jāmāpadyēta|
tataścaturthē'hanyēnāmutsādya saśiraskaṁ snāpayitvā śuklāni vāsāṁsyācchādayēt puruṣaṁ ca|
tataḥ śuklavāsasau sragviṇau sumanasāvanyōnyamabhikāmau saṁvasēyātāṁ snānāt prabhr̥tiyugmēṣvahaḥsu putrakāmau, ayugmēṣu duhitr̥kāmau||5||

tataH puShpAt prabhRuti trirAtramAsIta brahmacAriNyadhaHshAyinI,pANibhyAmannamajarjarapAtrAdbhu~jjAnA [1] , na ca kA~jcinmRujAmApadyeta|
tatashcaturthe~ahanyenAmutsAdya sashiraskaM snApayitvA shuklAni vAsAMsyAcchAdayet puruShaM ca|
tataH shuklavAsasau sragviNau sumanasAvanyonyamabhikAmau saMvaseyAtAM snAnAt prabhRutiyugmeShvahaHsu putrakAmau, ayugmeShu duhitRukAmau||5||

While menstruating, the woman should abstain from coitus for three nights, sleep on the ground, consume food with her hand from unbroken utensils, and should not clean her body by any means. On the fourth day, she should be anointed well with oil and should be given a good head bath, cleansed well, and then made to wear white coloured apparel. The man should follow similar rituals as the woman on her fourth day of menstruation. Then onwards, the two, wearing white apparels and garlands, with pleasant disposition, loving each other, should enter into acts of coitus - on even days if desirous of a male child, and on odd days for a female child. [5]

Postures and circumstances to be avoided for coitus

न च न्युब्जां पार्श्वगतां वा संसेवेत|
न्युब्जाया वातो बलवान् स योनिं पीडयति, पार्श्वगताया दक्षिणे पार्श्वे श्लेष्मा स च्युतः पिदधाति गर्भाशयं, वामे पार्श्वे पित्तंतदस्याः पीडितं विदहति रक्तं शुक्रं च, तस्मादुत्ताना बीजं गृह्णीयात्; तथाहि यथास्थानमवतिष्ठन्ते दोषाः|
पर्याप्ते चैनां शीतोदकेन परिषिञ्चेत्|
तत्रात्यशिता क्षुधिता पिपासिता भीता विमनाः शोकार्ता क्रुद्धाऽन्यं च पुमांसमिच्छन्ती मैथुने चातिकामा वा न गर्भं धत्ते,विगुणां वा प्रजां जनयति|
अतिबालामतिवृद्धां दीर्घरोगिणीमन्येन वा विकारेणोपसृष्टां वर्जयेत्|
पुरुषेऽप्येत एव दोषाः|
अतः सर्वदोषवर्जितौ स्त्रीपुरुषौ संसृज्येयाताम्||६||

na ca nyubjāṁ pārśvagatāṁ vā saṁsēvēta|
nyubjāyā vātō balavān sa yōniṁ pīḍayati, pārśvagatāyā dakṣiṇē pārśvē ślēṣmā sa cyutaḥ pidadhātigarbhāśayaṁ, vāmē pārśvē pittaṁ tadasyāḥ pīḍitaṁ vidahati raktaṁ śukraṁ ca, tasmāduttānā bījaṁgr̥hṇīyāt; tathāhi yathāsthānamavatiṣṭhantē dōṣāḥ|
paryāptē caināṁ śītōdakēna pariṣiñcēt|
tatrātyaśitā kṣudhitā pipāsitā bhītā vimanāḥ śōkārtā kruddhā'nyaṁ ca pumāṁsamicchantī maithunēcātikāmā vā na garbhaṁ dhattē, viguṇāṁ vā prajāṁ janayati|
atibālāmativr̥ddhāṁ dīrgharōgiṇīmanyēna vā vikārēṇōpasr̥ṣṭāṁ varjayēt|
puruṣē'pyēta ēva dōṣāḥ|
ataḥ sarvadōṣavarjitau strīpuruṣau saṁsr̥jyēyātām||6||

na ca nyubjAM pArshvagatAM vA saMseveta|
nyubjAyA vAto balavAn sa yoniM pIDayati, pArshvagatAyA dakShiNe pArshve shleShmA sa cyutaHpidadhAti garbhAshayaM, vAme pArshve pittaM tadasyAH pIDitaM vidahati raktaM shukraM ca,tasmAduttAnA bIjaM gRuhNIyAt; tathAhi yathAsthAnamavatiShThante doShAH|
paryApte cainAM shItodakena pariShi~jcet|
tatrAtyashitA kShudhitA pipAsitA bhItA vimanAH shokArtA kruddhA~anyaM ca pumAMsamicchantImaithune cAtikAmA vA na garbhaM dhatte, viguNAM vA prajAM janayati|
atibAlAmativRuddhAM dIrgharogiNImanyena vA vikAreNopasRuShTAM varjayet|
puruShe~apyeta eva doShAH|
ataH sarvadoShavarjitau strIpuruShau saMsRujyeyAtAm||6||

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.

A very young (sexually immature) girl or a very old woman, woman suffering from chronic illness or suffering with any other disorders should not procreate. This condition applies for a male partner too. Hence only a man and a woman who are free from all defects, and are of suitable age should engage in coitus. [6]

Preparations before coitus

सञ्जातहर्षौ मैथुने चानुकूलाविष्टगन्धं स्वास्तीर्णं सुखं शयनमुपकल्प्य मनोज्ञं हितमशनमशित्वा नात्यशितौ दक्षिणपादेनपुमानारोहेत् वामपादेन स्त्री||७||

sañjātaharṣau maithunē cānukūlāviṣṭagandhaṁ svāstīrṇaṁ sukhaṁ śayanamupakalpya manōjñaṁhitamaśanamaśitvā nātyaśitau dakṣiṇapādēna pumānārōhēt vāmapādēna strī||7||

sa~jjAtaharShau maithune cAnukUlAviShTagandhaM svAstIrNaM sukhaM shayanamupakalpya manoj~jaMhitamashanamashitvA nAtyashitau dakShiNapAdena pumAnArohet vAmapAdena strI||7||

The couple that is sufficiently aroused and fully engrossed in the sexual act, after having their favorite food (wholesome, not overeaten), should lie on bed which is well adorned with pleasant perfumes and bedecked with comfortable mattresses of one’s choice for the sexual act, man placing his right foot first and woman her left. [7]

Mantra before the sexual act

तत्र मन्त्रं प्रयुञ्जीत- “अहिरसि आयुरसि सर्वतः प्रतिष्ठाऽसि धाता त्वा ददतु विधाता त्वा दधातु ब्रह्मवर्चसा भव” इति|
“ब्रह्मा बृहस्पतिर्विष्णुःसोमःसूर्यस्तथाऽश्विनौ|
भगोऽथ मित्रावरुणौ वीरं [२] ददतु मे सुतम्”
इत्युक्त्वा संवसेयाताम्||८||

tatra mantraṁ prayuñjīta- “ahirasi āyurasi sarvataḥ pratiṣṭhā'si dhātā tvā dadatu vidhātā tvā dadhātubrahmavarcasā bhava” iti|
“brahmā br̥haspatirviṣṇuḥsōmaḥsūryastathā'śvinau|
bhagō'tha mitrāvaruṇau vīraṁ [2] dadatu mē sutam”
ityuktvā saṁvasēyātām||8||

tatra mantraM prayu~jjIta- “ahirasi Ayurasi sarvataH pratiShThA~asi dhAtA tvA dadatu vidhAtA tvAdadhAtu brahmavarcasA bhava” iti|
“brahmA bRuhaspatirviShNuHsomaHsUryastathA~ashvinau|
bhago~atha mitrAvaruNau vIraM [2] dadatu me sutam”
ityuktvA saMvaseyAtAm||8||

Then, they should recite the mantra meaning: ‘Thou art the day; Thou art the life; Thou art well established from all sides. May the supporter endow Thee; may the dispenser dispense to Thee: be Thou born with Brahmic splendor’. May Brahma, Brhaspati, Visnu, Soma, Surya and the two Ashwins, as also Bhaga, Mitra and Varuna, bless me with a heroic son.’ Having uttered this, the couple should commence the sexual act. [8]

Daily rituals to be followed a week before coitus by a woman desirous of a healthy male child

सा चेदेवमाशासीत-बृहन्तमवदातं हर्यक्षमोजस्विनं शुचिं सत्त्वसम्पन्नं पुत्रमिच्छेयमिति, शुद्धस्नानात् प्रभृत्यस्यैमन्थमवदातयवानां मधुसर्पिर्भ्यां संसृज्य श्वेताया गोः सरूपवत्सायाः पयसाऽऽलोड्य राजते कांस्ये वा पात्रे काले काले सप्ताहंसततं प्रयच्छेत् पानाय|
प्रातश्च शालियवान्नविकारान् दधिमधुसर्पिर्भिः पयोभिर्वा संसृज्य भुञ्जीत, तथा सायमवदातशरणशयनासनपानवसनभूषणाच स्यात्|
सायं प्रातश्च शश्वच्छ्वेतं महान्तं वृषभमाजानेयं वा हरिचन्दनाङ्गदं पश्येत्|
सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत|
सौम्याकृतिवचनोपचारचेष्टांश्च स्त्रीपुरुषानितरानपि चेन्द्रियार्थानवदातान् पश्येत्|
सहचर्यश्चैनां प्रियहिताभ्यां सततमुपचरेयुस्तथा भर्ता|
न च मिश्रीभावमापद्येयातामिति|
अनेन विधिना सप्तरात्रं स्थित्वाऽष्टमेऽहन्याप्लुत्याद्भिः सशिरस्कं सह भर्त्रा अहतानि वस्त्राण्याच्छादयेदवदातानि,अवदाताश्च स्रजो भूषणानि च बिभृयात्||९||

sā cēdēvamāśāsīta- br̥hantamavadātaṁ haryakṣamōjasvinaṁ śuciṁ sattvasampannaṁ putramicchēyamiti,śuddhasnānāt prabhr̥tyasyai manthamavadātayavānāṁ madhusarpirbhyāṁ saṁsr̥jya śvētāyā gōḥsarūpavatsāyāḥ payasālōḍya rājatē kāṁsyē vā pātrē kālē kālē saptāhaṁ satataṁ prayacchēt pānāya|
prātaśca śāliyavānnavikārān dadhimadhusarpirbhiḥ payōbhirvā saṁsr̥jya bhuñjīta, tathāsāyamavadātaśaraṇaśayanāsanapānavasanabhūṣaṇā ca syāt|
sāyaṁ prātaśca śaśvacchvētaṁ mahāntaṁ vr̥ṣabhamājānēyaṁ vā haricandanāṅgadaṁ paśyēt|
saumyābhiścaināṁ kathābhirmanōnukūlābhirupāsīta|
saumyākr̥tivacanōpacāracēṣṭāṁśca strīpuruṣānitarānapi cēndriyārthānavadātān paśyēt|
sahacaryaścaināṁ priyahitābhyāṁ satatamupacarēyustathā bhartā|
na ca miśrībhāvamāpadyēyātāmiti|
anēna vidhinā saptarātraṁ sthitvā'ṣṭamē'hanyāplutyādbhiḥ saśiraskaṁ saha bhartrā ahatānivastrāṇyācchādayēdavadātāni, avadātāśca srajō bhūṣaṇāni ca bibhr̥yāt||9||

sA cedevamAshAsIta- bRuhantamavadAtaM haryakShamojasvinaM shuciM sattvasampannaMputramiccheyamiti, shuddhasnAnAt prabhRutyasyai manthamavadAtayavAnAM madhusarpirbhyAMsaMsRujya shvetAyA goH sarUpavatsAyAH payasA~a~aloDya rAjate kAMsye vA pAtre kAle kAle saptAhaMsatataM prayacchet pAnAya|
prAtashca shAliyavAnnavikArAn dadhimadhusarpirbhiH payobhirvA saMsRujya bhu~jjIta, tathAsAyamavadAtasharaNashayanAsanapAnavasanabhUShaNA ca syAt|
sAyaM prAtashca shashvacchvetaM mahAntaM vRuShabhamAjAneyaM vA haricandanA~ggadaM pashyet|
saumyAbhishcainAM kathAbhirmanonukUlAbhirupAsIta|
saumyAkRutivacanopacAraceShTAMshca strIpuruShAnitarAnapi cendriyArthAnavadAtAn pashyet|
sahacaryashcainAM priyahitAbhyAM satatamupacareyustathA bhartA|
na ca mishrIbhAvamApadyeyAtAmiti|
anena vidhinA saptarAtraM sthitvA~aShTame~ahanyAplutyAdbhiH sashiraskaM saha bhartrA ahatAnivastrANyAcchAdayedavadAtAni, avadAtAshca srajo bhUShaNAni ca bibhRuyAt||9||

A woman desirous of having a male child with large limbs, fair complexion, with eyes like those of a lion (full of vigor), pure, and with good mental disposition should, after her menstrual period, first take a purificatory bath, then be given a light porridge of well cleaned white barley grains duly sweetened by adding honey and ghee, diluted in the milk of a white cow having a white calf, in a utensil made of silver or bronze, regularly in the morning and evening for a week.

During mornings and evenings, she should eat a diet prepared with sali rice and/or barley mixed with curd, honey, ghee or with milk. Her room, bed, seat, drink, dress and ornaments etc. all should be of white color. In the evenings and mornings, she should look at a white majestic bull / stallion duly smeared with white sandal paste without fail. She should also be entertained with pleasant tales of her interest, acceptable to her mood. She should also look at men and women having good personality, speech, behaviour and manners, as well as visuals and objects that are white in color.

Her companions and husband should also entertain her with things, discussion topics, and activities that are pleasant to her, and not stressful. The couple, should, however avoid sexual contact during this period. Following this regimen for a week, on the eighth day she, along with her husband, after taking a head bath with pure (consecrated – abhimantritam) water, get prepared for coitus by adorning themselves with new white apparel, garlands and ornaments. [9]

Rituals at the end of the week

तत ऋत्विक् प्रागुत्तरस्यां दिश्यगारस्य प्राग्प्रवणमुदक्प्रवणं वा प्रदेशमभिसमीक्ष्य, गोमयोदकाभ्यां स्थण्डिलमुपलिप्य, प्रोक्ष्यचोदकेन, वेदीमस्मिन् स्थापयेत्|
तां पश्चिमेनाहतवस्त्रसञ्चये श्वेतार्षभे वाऽप्यजिन उपविशेद् ब्राह्मणप्रयुक्तः, राजन्यप्रयुक्तस्तु वैयाघ्रे चर्मण्यानडुहे वा,वैश्यप्रयुक्तस्तु रौरवे बास्ते वा|
तत्रोपविष्टः पालाशीभिरैङ्गुदीभिरौदुम्बरीभिर्माधूकीभिर्वा समिद्भिरग्निमुपसमाधाय, कुशैः परिस्तीर्य, परिधिभिश्च परिधाय,लाजैः शुक्लाभिश्च गन्धवतीभिः सुमनोभिरुपकिरेत्|
तत्र प्रणीयोदपात्रं पवित्रपूतमुपसंस्कृत्य सर्पिराज्यार्थं यथोक्तवर्णानाजानेयादीन् समन्ततः स्थापयेत्||१०||

tata r̥tvik prāguttarasyāṁ diśyagārasya prāgpravaṇamudakpravaṇaṁ vā pradēśamabhisamīkṣya,gōmayōdakābhyāṁ sthaṇḍilamupalipya, prōkṣya cōdakēna, vēdīmasmin sthāpayēt|
tāṁ paścimēnāhatavastrasañcayē śvētārṣabhē vā'pyajina upaviśēd brāhmaṇaprayuktaḥ,rājanyaprayuktastu vaiyāghrē carmaṇyānaḍuhē vā, vaiśyaprayuktastu rauravē bāstē vā|
tatrōpaviṣṭaḥ pālāśībhiraiṅgudībhiraudumbarībhirmādhūkībhirvā samidbhiragnimupasamādhāya, kuśaiḥparistīrya, paridhibhiśca paridhāya, lājaiḥ śuklābhiśca gandhavatībhiḥ sumanōbhirupakirēt|
tatra praṇīyōdapātraṁ pavitrapūtamupasaṁskr̥tya sarpirājyārthaṁ yathōktavarṇānājānēyādīn samantataḥsthāpayēt||10||

tata Rutvik prAguttarasyAM dishyagArasya prAgpravaNamudakpravaNaM vA pradeshamabhisamIkShya,gomayodakAbhyAM sthaNDilamupalipya, prokShya codakena, vedImasmin sthApayet|
tAM pashcimenAhatavastrasa~jcaye shvetArShabhe vA~apyajina upavished brAhmaNaprayuktaH,rAjanyaprayuktastu vaiyAghre carmaNyAnaDuhe vA, vaishyaprayuktastu raurave bAste vA|
tatropaviShTaH pAlAshIbhirai~ggudIbhiraudumbarIbhirmAdhUkIbhirvA samidbhiragnimupasamAdhAya,kushaiH paristIrya, paridhibhishca paridhAya, lAjaiH shuklAbhishca gandhavatIbhiH sumanobhirupakiret|
tatra praNIyodapAtraM pavitrapUtamupasaMskRutya sarpirAjyArthaM yathoktavarNAnAjAneyAdInsamantataH sthApayet||10||

At the end of one week, a priest should select a place on the north side of the house, having a downward slope towards the east or the north. The selected place/ground should be duly smeared with cowdung and water. After sprinkling the place with water, he should prepare and fix the altar.

On the west of the altar, the priest should take his seat on an undamaged cotton cushion or on the skin of a white bull, if he is officiating on behalf of a brahmana patron, on the skin of a tiger or bull if kshatriya, and on the skin of a deer or a ram, in case of a vaisya.

Thus seated, he should kindle the scared fire with the twigs of palasha (Butea monosperma Kuntze), ingudi (Balanites aegyptica Delile), udumbara (Ficus racemosa Linn) or madhuka (Madhuka indica J.F.Gmel), spread the kusha (Desmostachya bipinnata Stapf.) grass around, and fix the enclosure of fire with big stalks of palasha (Butea monospermakuntze) on all four sides, and then spread the altar with parched/roasted paddy and white coloured flowers having sweet fragrance. Then, he should prepare a water pot, clean and sanctified by mantras, make available adequate amount of ghee for offerings, and place auspicious objects (such as bulls or stallions) of said qualities and colors, etc. in and around the place of offering as mentioned earlier. [10]

Additional rituals before cohabiting

ततः पुत्रकामा पश्चिमतोऽग्निं दक्षिणतो ब्राह्मणमुपविश्यान्वालभेत सह भर्त्रा यथेष्टं पुत्रमाशासाना|
ततस्तस्या आशासानाया ऋत्विक् प्रजापतिमभिनिर्दिश्य योनौ तस्याः कामपरिपूरणार्थं काम्यामिष्टिं निर्वर्तयेद् ‘विष्णुर्योनिंकल्पयतु’ इत्यनयर्चा|
ततश्चैवाज्येन स्थालीपाकमभिघार्य त्रिर्जुहुयाद्यथाम्नायम्|
मन्त्रोपमन्त्रितमुदपात्रं तस्यै दद्यात् सर्वोदकार्थान् कुरुष्वेति|
ततः समाप्ते कर्मणि पूर्वं दक्षिणपादमभिहरन्ती प्रदक्षिणमग्निमनुपरिक्रामेत् सह भर्त्रा|
ततो [१] ब्राह्मणान् स्वस्ति वाचयित्वाऽऽज्यशेषं [२] प्राश्नीयात् पूर्वं पुमान्, पश्चात् स्त्री; न चोच्छिष्टमवशेषयेत्|
ततस्तौ सह संवसेयातामष्टरात्रं, तथाविधपरिच्छदावेव च स्यातां [३] , तथेष्टपुत्रं जनयेताम्||११||

tataḥ putrakāmā paścimatō'gniṁ dakṣiṇatō brāhmaṇamupaviśyānvālabhēta saha bhartrā yathēṣṭaṁputramāśāsānā|
tatastasyā āśāsānāyā r̥tvik prajāpatimabhinirdiśya yōnau tasyāḥ kāmaparipūraṇārthaṁ kāmyāmiṣṭiṁnirvartayēd ‘viṣṇuryōniṁ kalpayatu’ ityanayarcā|
tataścaivājyēna sthālīpākamabhighārya trirjuhuyādyathāmnāyam|
mantrōpamantritamudapātraṁ tasyai dadyāt sarvōdakārthān kuruṣvēti|
tataḥ samāptē karmaṇi pūrvaṁ dakṣiṇapādamabhiharantī pradakṣiṇamagnimanuparikrāmēt saha bhartrā|
tatō [1] brāhmaṇān svasti vācayitvājyaśēṣaṁ [2] prāśnīyāt pūrvaṁ pumān, paścāt strī; nacōcchiṣṭamavaśēṣayēt|
tatastau saha saṁvasēyātāmaṣṭarātraṁ, tathāvidhaparicchadāvēva ca syātāṁ [3] , tathēṣṭaputraṁjanayētām||11||

tataH putrakAmA pashcimato~agniM dakShiNato brAhmaNamupavishyAnvAlabheta saha bhartrAyatheShTaM putramAshAsAnA|
tatastasyA AshAsAnAyA Rutvik prajApatimabhinirdishya yonau tasyAH kAmaparipUraNArthaMkAmyAmiShTiM nirvartayed ‘viShNuryoniM kalpayatu’ ityanayarcA|
tatashcaivAjyena sthAlIpAkamabhighArya trirjuhuyAdyathAmnAyam|
mantropamantritamudapAtraM tasyai dadyAt sarvodakArthAn kuruShveti|
tataH samApte karmaNi pUrvaM dakShiNapAdamabhiharantI pradakShiNamagnimanuparikrAmet sahabhartrA|
tato [1] brAhmaNAn svasti vAcayitvA~a~ajyasheShaM [2] prAshnIyAt pUrvaM pumAn, pashcAt strI; nacocchiShTamavasheShayet|
tatastau saha saMvaseyAtAmaShTarAtraM, tathAvidhaparicchadAveva ca syAtAM [3] , tatheShTaputraMjanayetAm||11||

Thereafter the woman, desirous of progeny, should sit with her husband on the west side of the altar, while the priest should sit to the south, and together they should perform the holy oblation to fire expressing their longing for a progeny. Then, the priest, addressing the God of procreation (Prajapati) for the fulfilment of her desire in her womb, should perform the ‘boon bestowing rite’, by chanting the said hymn ‘May Visnu bless the womb and make it fertile’. Then, the priest should prepare a bolus of cooked rice in an earthen pot by mixing the oblation with ghee, offering it to the holy fire thrice according to the prescribed methods. He should then give the sanctified pot of water to the woman to be used for all her purposes.

On the completion of the rite, she should, placing her right foot first, walk around the fire keeping to her right and accompanied by her husband. Then, after taking the the blessing of the brahmanas, the couple should consume the remains of the sacrificial ghee - first the husband and then the wife - taking care not to leave any leftovers. On completion of this ritual, they shall cohabit for a period of eight nights, wearing the dress etc., as prescribed earlier. In this manner they will be able to beget a progeny, as desired. [11]

या तु स्त्री श्यामं लोहिताक्षं व्यूढोरस्कं महाबाहुं च पुत्रमाशासीत, या वा कृष्णं कृष्णमृदुदीर्घकेशं शुक्लाक्षं शुक्लदन्तंतेजस्विनमात्मवन्तम्; एष एवानयोरपि होमविधिः|
किन्तु परिबर्हो वर्णवर्जं स्यात्|
पुत्रवर्णानुरूपस्तु यथाशीरेव तयोः परिबर्होऽन्यः कार्यः स्यात्||१२||

yā tu strī śyāmaṁ lōhitākṣaṁ vyūḍhōraskaṁ mahābāhuṁ ca putramāśāsīta, yā vā kr̥ṣṇaṁkr̥ṣṇamr̥dudīrghakēśaṁ śuklākṣaṁ śukladantaṁ tējasvinamātmavantam; ēṣa ēvānayōrapi hōmavidhiḥ|
kintu paribarhō varṇavarjaṁ syāt|
putravarṇānurūpastu yathāśīrēva tayōḥ paribarhō'nyaḥ kāryaḥ syāt||12||

yA tu strI shyAmaM lohitAkShaM vyUDhoraskaM mahAbAhuM ca putramAshAsIta, yA vA kRuShNaMkRuShNamRududIrghakeshaM shuklAkShaM shukladantaM tejasvinamAtmavantam; eSha evAnayorapihomavidhiH|
kintu paribarho varNavarjaM syAt|
putravarNAnurUpastu yathAshIreva tayoH paribarho~anyaH kAryaH syAt||12||

As regards the woman desirous of a child with sky blue complexion, red eye, broad chest and long limbs, or a woman who seeks off spring with black complexion, with black, soft and long hair, glittering white eye and teeth, radiant and self-restrained, the rituals to be followed are the same as described above. The preparations and materials required will not be of the same color but it should be made, in either case, to match the desired complexion of the child to be born, agreeable to the mother’s desire. [12]

Rituals for those belonging to the "shudra" lineage

शूद्रा तु नमस्कारमेव कुर्यात् (देवाग्निद्विजगुरुतपस्विसिद्धेभ्यः [४] )||१३||

śūdrā tu namaskāramēva kuryāt (dēvāgnidvijagurutapasvisiddhēbhyaḥ [4] )||13||

shUdrA tu namaskArameva kuryAt (devAgnidvijagurutapasvisiddhebhyaH [4] )||13||

Those belonging to shudra lineage, the mere act of salutation/pray (to the God, holy fire, brahmanas, teachers/elders/preceptors, and saints and seers) should suffice. [13]

Advice for the mother desiring certain traits in her offspring

या या च यथाविधं पुत्रमाशासीत तस्यास्तस्यास्तां तां पुत्राशिषमनुनिशम्य तांस्ताञ्जनपदान्मनसाऽनुपरिक्रामयेत्|
ततो [५] या या येषां येषां जनपदानां मनुष्याणामनुरूपं पुत्रमाशासीत सा सा तेषां तेषां जनपदानांमनुष्याणामाहारविहारोपचारपरिच्छदाननुविधत्स्वेति वाच्या स्यात्|
इत्येतत् सर्वं पुत्राशिषां समृद्धिकरं कर्म व्याख्यातं भवति||१४||

yā yā ca yathāvidhaṁ putramāśāsīta tasyāstasyāstāṁ tāṁ putrāśiṣamanuniśamyatāṁstāñjanapadānmanasā'nuparikrāmayēt|
tatō [5] yā yā yēṣāṁ yēṣāṁ janapadānāṁ manuṣyāṇāmanurūpaṁ putramāśāsīta sā sā tēṣāṁ tēṣāṁjanapadānāṁ manuṣyāṇāmāhāravihārōpacāraparicchadānanuvidhatsvēti vācyā syāt|
ityētat sarvaṁ putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātaṁ bhavati||14||

yA yA ca yathAvidhaM putramAshAsIta tasyAstasyAstAM tAM putrAshiShamanunishamyatAMstA~jjanapadAnmanasA~anuparikrAmayet|
tato [5] yA yA yeShAM yeShAM janapadAnAM manuShyANAmanurUpaM putramAshAsIta sA sA teShAMteShAM janapadAnAM manuShyANAmAhAravihAropacAraparicchadAnanuvidhatsveti vAcyA syAt|
ityetat sarvaM putrAshiShAM samRuddhikaraM karma vyAkhyAtaM bhavati||14||

By knowing about the kind of child she desires, the woman should be advised to mentally travel to such places where people having similar dispositions live. Also, she should be advised to take diet, assume behavior, and engage in activities, attire, and social/cultural behooving such places and people.

Thus, the section detailing rituals that couples desirous of a healthy progeny – of the attributes of their liking – has been explained. [14]

Role of mahabhutas in contributing to the complexion of the offspring

न खलु केवलमेतदेव कर्म वर्णवैशेष्यकरं भवति|
अपि तु तेजोधातुरप्युदकान्तरिक्षधातुप्रायोऽवदातवर्णकरो भवति, पृथिवीवायुधातुप्रायः कृष्णवर्णकरः, समसर्वधातुप्रायःश्यामवर्णकरः||१५||

na khalu kēvalamētadēva karma varṇavaiśēṣyakaraṁ bhavati|
api tu tējōdhāturapyudakāntarikṣadhātuprāyō'vadātavarṇakarō bhavati, pr̥thivīvāyudhātuprāyaḥkr̥ṣṇavarṇakaraḥ, samasarvadhātuprāyaḥ śyāmavarṇakaraḥ||15||

na khalu kevalametadeva karma varNavaisheShyakaraM bhavati|
api tu tejodhAturapyudakAntarikShadhAtuprAyo~avadAtavarNakaro bhavati, pRuthivIvAyudhAtuprAyaHkRuShNavarNakaraH, samasarvadhAtuprAyaH shyAmavarNakaraH||15||

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 mahabhuta 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]

Factors determining the psychological disposition of the progeny

सत्त्ववैशेष्यकराणि पुनस्तेषां तेषां प्राणिनां मातापितृसत्त्वान्यन्तर्वत्न्याः श्रुतयश्चाभीक्ष्णं स्वोचितं च कर्मसत्त्वविशेषाभ्यासश्चेति||१६||

sattvavaiśēṣyakarāṇi punastēṣāṁ tēṣāṁ prāṇināṁ mātāpitr̥sattvānyantarvatnyāḥ śrutayaścābhīkṣṇaṁsvōcitaṁ ca karma sattvaviśēṣābhyāsaścēti||16||

sattvavaisheShyakarANi punasteShAM teShAM prANinAM mAtApitRusattvAnyantarvatnyAHshrutayashcAbhIkShNaM svocitaM ca karma sattvavisheShAbhyAsashceti||16||

The factors that determine the psychological disposition of the progeny depends upon the various mental traits of the parents, the impressions received by the pregnant woman, and the influence of past deeds (especially, the psychological makeup of the person in his/her past life). [16]

यथोक्तेन विधिनोपसंस्कृतशरीरयोः स्त्रीपुरुषयोर्मिश्रीभावमापन्नयोः शुक्रं शोणितेन सह संयोगं समेत्याव्यापन्नमव्यापन्नेनयोनावनुपहतायामप्रदुष्टे गर्भाशये गर्भमभिनिर्वर्तयत्येकान्तेन|
यथा-निर्मले वाससि सुपरिकल्पिते रञ्जनं समुदितगुणमुपनिपातादेव रागमभिनिर्वर्तयति, तद्वत्; यथा वाक्षीरंदध्नाऽभिषुतमभिषवणाद्विहाय स्वभावमापद्यते दधिभावं, शुक्रं तद्वत्||१७||

yathōktēna vidhinōpasaṁskr̥taśarīrayōḥ strīpuruṣayōrmiśrībhāvamāpannayōḥ śukraṁ śōṇitēna sahasaṁyōgaṁ samētyāvyāpannamavyāpannēna yōnāvanupahatāyāmapraduṣṭē garbhāśayēgarbhamabhinirvartayatyēkāntēna|
yathā- nirmalē vāsasi suparikalpitē rañjanaṁ samuditaguṇamupanipātādēva rāgamabhinirvartayati,tadvat; yathā vā kṣīraṁ dadhnā'bhiṣutamabhiṣavaṇādvihāya svabhāvamāpadyatē dadhibhāvaṁ, śukraṁtadvat||17||

yathoktena vidhinopasaMskRutasharIrayoH strIpuruShayormishrIbhAvamApannayoH shukraM shoNitenasaha saMyogaM sametyAvyApannamavyApannena yonAvanupahatAyAmapraduShTe garbhAshayegarbhamabhinirvartayatyekAntena|
yathA- nirmale vAsasi suparikalpite ra~jjanaM samuditaguNamupanipAtAdeva rAgamabhinirvartayati,tadvat; yathA vA kShIraM dadhnA~abhiShutamabhiShavaNAdvihAya svabhAvamApadyate dadhibhAvaM,shukraM tadvat||17||

When a couple, whose body and mind are purified by above mentioned methods, engages in sexual intercourse, the undamaged sperm unites with the healthy ovum in a clean genital tract and the healthy uterus is home to an embryo with all the desired characters. Just as a well-washed cloth catches the colour of good dye instantly or milk, when mixed with drops of curd, transforms into curd leaving its original characters, the seeds acquire the positive attributes of the parents and the environment. [17]

एवमभिनिर्वर्तमानस्य गर्भस्य स्त्रीपुरुषत्वे हेतुः पूर्वमुक्तः|
यथा हि बीजमनुपतप्तमुप्तं स्वां स्वां प्रकृतिमनुविधीयते व्रीहिर्वा व्रीहित्वं यवो वा यवत्वं तथा स्त्रीपुरुषावपि यथोक्तंहेतुविभागमनुविधीयेते||१८||

ēvamabhinirvartamānasya garbhasya strīpuruṣatvē hētuḥ pūrvamuktaḥ|
yathā hi bījamanupataptamuptaṁ svāṁ svāṁ prakr̥timanuvidhīyatē vrīhirvā vrīhitvaṁ yavō vā yavatvaṁtathā strīpuruṣāvapi yathōktaṁ hētuvibhāgamanuvidhīyētē||18||

evamabhinirvartamAnasya garbhasya strIpuruShatve hetuH pUrvamuktaH|
yathA hi bIjamanupataptamuptaM svAM svAM prakRutimanuvidhIyate vrIhirvA vrIhitvaM yavo vA yavatvaMtathA strIpuruShAvapi yathoktaM hetuvibhAgamanuvidhIyete||18||

Factors determining the sex of an embryo have already been explained. Just as an undamaged seed when sown reproduces its own kind, such as the paddy seed germinates into paddy and the barley seed produces barley, so too men and women beget children possessing the natural characteristics of their parents. [18]

Factors for healthy progeny

तयोः कर्मणा वेदोक्तेन विवर्तनमुपदिश्यते [१] प्राग्व्यक्तीभावात् प्रयुक्तेन सम्यक्|
कर्मणां हि देशकालसम्पदुपेतानां नियतमिष्टफलत्वं, तथेतरेषामितरत्वम्|
तस्मादापन्नगर्भां स्त्रियमभिसमीक्ष्य प्राग्व्यक्तीभावाद्गर्भस्य पुंसवनमस्यै दद्यात्|
गोष्ठे जातस्य न्यग्रोधस्य प्रागुत्तराभ्यां शाखाभ्यां शुङ्गे अनुपहते आदाय द्वाभ्यां धान्यमाषाभ्यां सम्पदुपेताभ्यांगौरसर्षपाभ्यां वा सह दध्नि प्रक्षिप्य पुष्येण पिबेत्, तथैवापराञ्जीवकर्षभकापामार्गसहचरकल्कांश्च युगपदेकैकशो यथेष्टंवाऽप्युपसंस्कृत्य पयसा, कुड्यकीटकं मत्स्यकं वोदकाञ्जलौ प्रक्षिप्य पुष्येण पिबेत्, तथा कनकमयान् राजतानायसांश्चपुरुषकानग्निवर्णानणुप्रमाणान् दध्नि पयस्युदकाञ्जलौ वा प्रक्षिप्य पिबेदनवशेषतः पुष्येण, पुष्येणैव च शालिपिष्टस्यपच्यमानस्योष्माणमुपाघ्राय तस्यैव च पिष्टस्योदकसंसृष्टस्य रसं देहल्यामुपनिधाय [२] दक्षिणे नासापुटे स्वयमासिञ्चेत्पिचुना|
यच्चान्यदपि ब्राह्मणा ब्रूयुराप्ता वा स्त्रियः पुंसवनमिष्टं तच्चानुष्ठेयम्|
इति पुंसवनानि||१९||

tayōḥ karmaṇā vēdōktēna vivartanamupadiśyatē [1] prāgvyaktībhāvāt prayuktēna samyak|
karmaṇāṁ hi dēśakālasampadupētānāṁ niyatamiṣṭaphalatvaṁ, tathētarēṣāmitaratvam|
tasmādāpannagarbhāṁ striyamabhisamīkṣya prāgvyaktībhāvādgarbhasya puṁsavanamasyai dadyāt|
gōṣṭhē jātasya nyagrōdhasya prāguttarābhyāṁ śākhābhyāṁ śuṅgē anupahatē ādāya dvābhyāṁdhānyamāṣābhyāṁ sampadupētābhyāṁ gaurasarṣapābhyāṁ vā saha dadhni prakṣipya puṣyēṇa pibēt,tathaivāparāñjīvakarṣabhakāpāmārgasahacarakalkāṁśca yugapadēkaikaśō yathēṣṭaṁvā'pyupasaṁskr̥tya payasā, kuḍyakīṭakaṁ matsyakaṁ vōdakāñjalau prakṣipya puṣyēṇa pibēt, tathākanakamayān rājatānāyasāṁśca puruṣakānagnivarṇānaṇupramāṇān dadhni payasyudakāñjalau vāprakṣipya pibēdanavaśēṣataḥ puṣyēṇa, puṣyēṇaiva ca śālipiṣṭasya pacyamānasyōṣmāṇamupāghrāyatasyaiva ca piṣṭasyōdakasaṁsr̥ṣṭasya rasaṁ dēhalyāmupanidhāya [2] dakṣiṇē nāsāpuṭē svayamāsiñcētpicunā|
yaccānyadapi brāhmaṇā brūyurāptā vā striyaḥ puṁsavanamiṣṭaṁ taccānuṣṭhēyam|
iti puṁsavanāni||19||

tayoH karmaNA vedoktena vivartanamupadishyate [1] prAgvyaktIbhAvAt prayuktena samyak|
karmaNAM hi deshakAlasampadupetAnAM niyatamiShTaphalatvaM, tathetareShAmitaratvam|
tasmAdApannagarbhAM striyamabhisamIkShya prAgvyaktIbhAvAdgarbhasya puMsavanamasyai dadyAt|
goShThe jAtasya nyagrodhasya prAguttarAbhyAM shAkhAbhyAM shu~gge anupahate AdAya dvAbhyAMdhAnyamAShAbhyAM sampadupetAbhyAM gaurasarShapAbhyAM vA saha dadhni prakShipya puShyeNapibet, tathaivAparA~jjIvakarShabhakApAmArgasahacarakalkAMshca yugapadekaikasho yatheShTaMvA~apyupasaMskRutya payasA, kuDyakITakaM matsyakaM vodakA~jjalau prakShipya puShyeNa pibet,tathA kanakamayAn rAjatAnAyasAMshca puruShakAnagnivarNAnaNupramANAn dadhnipayasyudakA~jjalau vA prakShipya pibedanavasheShataH puShyeNa, puShyeNaiva ca shAlipiShTasyapacyamAnasyoShmANamupAghrAya tasyaiva ca piShTasyodakasaMsRuShTasya rasaMdehalyAmupanidhAya [2] dakShiNe nAsApuTe svayamAsi~jcet picunA|
yaccAnyadapi brAhmaNA brUyurAptA vA striyaH puMsavanamiShTaM taccAnuShTheyam|
iti puMsavanAni||19||

This verse lays down procedures mentioned in Vedic scriptures that, if administered correctly, could change the sex of an offspring even before its birth. When applied in the best of places and time, these procedures bear the desired fruit invariably always. Therefore, after examining the woman who has conceived recently, before the signs of gestation become apparent, (the physician) should administer pumsavana (procedures to beget a healthy offspring) on her.

On the day of the appearance of the auspicious pushya nakshatra, one should collect two fresh leaf-buds from a banyan tree (Ficus religiosa Linn), growing in a cow-pen (typically, an open ground or range where cows are kept), from its eastern or northern side branches. Then those leaf-buds should be added to curd and blended with either two good grains of masha (Phaseolus radiatus Linn - black gram) or white mustard seeds, and then given to the expectant mother to drink. Or, she may be given milk to drink that has been processed with the paste of jivaka, rishabhaka, apamarga (Achyranthes aspera Linn), and saireyaka (synonym of Sahachara–Barleria cristata Linn) -either all mixed into a paste together or separately, as required. Or else she should be given a handful of water with kudyakitaka (a type of insect) or matsyaka (a type of small fish) on the occasion of pushyanakshatra. Similarly, on the event of pushya nakshatra, she should drink handful of curd milk or water, without leaving any leftover, duly immersed with red hot miniature male statuettes made of gold, silver or and iron. Similarly, on the occasion of pushya nakshatra, she should be made to inhale the steam emanating from steaming dish of powdered shali rice (while it is being cooked) and she herself should daub into her right nostril, using a cotton swab, drops of water from that same cooking pot, by placing (her head) on the daheli (door-sill).

In addition to these rituals, any other measures suggested by brahmanas or well versed (experienced and well-favoring) women as pumsavana, should also be applied.

This concludes the verse on pumsavana. [19]

Measures for the preservation of the embryo

अत ऊर्ध्वं गर्भस्थापनानि व्याख्यास्यामः
ऐन्द्री ब्राह्मी शतवीर्या सहस्रवीर्याऽमोघाऽव्यथा शिवाऽरिष्टा वाट्यपुष्पीविष्वक्सेनकान्ता चेत्यासामोषधीनां शिरसा दक्षिणेन वा पाणिना धारणं, एताभिश्चैव सिद्धस्य पयसः सर्पिषो वा पानम्,एताभिश्चैव पुष्ये पुष्ये स्नानं, सदा च ताः [१] समालभेत|
तथा सर्वासां जीवनीयोक्तानामोषधीनां सदोपयोगस्तैस्तैरुपयोगविधिभिः|
इति गर्भस्थापनानि व्याख्यातानि भवन्ति||२०||

ata ūrdhvaṁ garbhasthāpanāni vyākhyāsyāmaḥ- aindrī brāhmī śatavīryā sahasravīryā'mōghā'vyathāśivā'riṣṭā vāṭyapuṣpī viṣvaksēnakāntā cētyāsāmōṣadhīnāṁ śirasā dakṣiṇēna vā pāṇinā dhāraṇaṁ,ētābhiścaiva siddhasya payasaḥ sarpiṣō vā pānam, ētābhiścaiva puṣyē puṣyē snānaṁ, sadā ca tāḥ [1]samālabhēta|
tathā sarvāsāṁ jīvanīyōktānāmōṣadhīnāṁ sadōpayōgastaistairupayōgavidhibhiḥ|
iti garbhasthāpanāni vyākhyātāni bhavanti||20||

ata UrdhvaM garbhasthApanAni vyAkhyAsyAmaH- aindrI brAhmI shatavIryAsahasravIryA~amoghA~avyathA shivA~ariShTA vATyapuShpI viShvaksenakAntA cetyAsAmoShadhInAMshirasA dakShiNena vA pANinA dhAraNaM, etAbhishcaiva siddhasya payasaH sarpiSho vA pAnam,etAbhishcaiva puShye puShye snAnaM, sadA ca tAH [1] samAlabheta|
tathA sarvAsAM jIvanIyoktAnAmoShadhInAM sadopayogastaistairupayogavidhibhiH|
iti garbhasthApanAni vyAkhyAtAni bhavanti||20||

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]

Factors that could damage or destroy the embryo

गर्भोपघातकरास्त्विमे भावा भवन्ति; तद्यथा उत्कटविषमकठिनासनसेविन्या [१] वातमूत्रपुरीषवेगानुपरुन्धत्यादारुणानुचितव्यायामसेविन्यास्तीक्ष्णोष्णातिमात्रसेविन्याः प्रमिताशनसेविन्या गर्भो म्रियतेऽन्तः कुक्षेः, अकाले वा स्रंसते,शोषी वा भवति; तथाऽभिघातप्रपीडनैः श्वभ्रकूपप्रपातदेशावलोकनैर्वाऽभीक्ष्णं मातुः प्रपतत्यकालेगर्भः,तथाऽतिमात्रसङ्क्षोभिभिर्यानैर्यानेन, अप्रियातिमात्रश्रवणैर्वा|
प्रततोत्तानशायिन्याः पुनर्गर्भस्य नाभ्याश्रया नाडी कण्ठमनुवेष्टयति, विवृतशायिनी नक्तञ्चारिणी चोन्मत्तं जनयति,अपस्मारिणं पुनः कलिकलहशीला, व्यवायशीला दुर्वपुषमह्रीकं स्त्रैणं वा, शोकनित्या भीतमपचितमल्पायुषं वा, अभिध्यात्री [२]परोपतापिनमीर्ष्युं स्त्रैणं वा, स्तेना त्वायासबहुलमतिद्रोहिणमकर्मशीलं वा, अमर्षिणी चण्डमौपधिकमसूयकं वा स्वप्ननित्यातन्द्रालुमबुधमल्पाग्निं वा, मद्यनित्या पिपासालुमल्पस्मृतिमनवस्थितचित्तं वा, गोधामांसप्राया [३] शार्करिणमश्मरिणंशनैर्मेहिणं वा, वराहमांसप्राया रक्ताक्षं क्रथनमतिपरुषरोमाणं वा, मत्स्यमांसनित्या चिरनिमेषं स्तब्धाक्षं वा, मधुरनित्याप्रमेहिणं मूकमतिस्थूलं वा, अम्लनित्या रक्तपित्तिनं त्वगक्षिरोगिणं वा, लवणनित्या शीघ्रवलीपलितं खालित्यरोगिणं वा,कटुकनित्या दुर्बलमल्पशुक्रमनपत्यं वा, तिक्तनित्या शोषिणमबलमनुपचितं वा, कषायनित्या श्यावमानाहिनमुदावर्तिनं वा,यद्यच्च यस्य यस्य व्याधेर्निदानमुक्तं तत्तदासेवमानाऽन्तर्वत्नी तन्निमित्तविकारबहुलमपत्यं जनयति|
पितृजास्तु शुक्रदोषा मातृजैरपचारैर्व्याख्याताः|
इति गर्भोपघातकरा भावा भवन्त्युक्ताः [४] |
तस्मादहितानाहारविहारान् प्रजासम्पदमिच्छन्ती स्त्री विशेषेण वर्जयेत्|
साध्वाचारा चात्मानमुपचरेद्धिताभ्यामाहारविहाराभ्यामिति||२१||

garbhōpaghātakarāstvimē bhāvā bhavanti; tadyathā- utkaṭaviṣamakaṭhināsanasēvinyā [1]vātamūtrapurīṣavēgānuparundhatyā dāruṇānucitavyāyāmasēvinyāstīkṣṇōṣṇātimātrasēvinyāḥpramitāśanasēvinyā garbhō mriyatē'ntaḥ kukṣēḥ, akālē vā sraṁsatē, śōṣī vā bhavati;tathā'bhighātaprapīḍanaiḥ śvabhrakūpaprapātadēśāvalōkanairvā'bhīkṣṇaṁ mātuḥprapatatyakālēgarbhaḥ, tathā'timātrasaṅkṣōbhibhiryānairyānēna, apriyātimātraśravaṇairvā|
pratatōttānaśāyinyāḥ punargarbhasya nābhyāśrayā nāḍī kaṇṭhamanuvēṣṭayati, vivr̥taśāyinī naktañcāriṇīcōnmattaṁ janayati, apasmāriṇaṁ punaḥ kalikalahaśīlā, vyavāyaśīlā durvapuṣamahrīkaṁ straiṇaṁ vā,śōkanityā bhītamapacitamalpāyuṣaṁ vā, abhidhyātrī [2] parōpatāpinamīrṣyuṁ straiṇaṁ vā, stēnātvāyāsabahulamatidrōhiṇamakarmaśīlaṁ vā, amarṣiṇī caṇḍamaupadhikamasūyakaṁ vā svapnanityātandrālumabudhamalpāgniṁ vā, madyanityā pipāsālumalpasmr̥timanavasthitacittaṁ vā,gōdhāmāṁsaprāyā [3] śārkariṇamaśmariṇaṁ śanairmēhiṇaṁ vā, varāhamāṁsaprāyā raktākṣaṁkrathanamatiparuṣarōmāṇaṁ vā, matsyamāṁsanityā ciranimēṣaṁ stabdhākṣaṁ vā, madhuranityāpramēhiṇaṁ mūkamatisthūlaṁ vā, amlanityā raktapittinaṁ tvagakṣirōgiṇaṁ vā, lavaṇanityāśīghravalīpalitaṁ khālityarōgiṇaṁ vā, kaṭukanityā durbalamalpaśukramanapatyaṁ vā, tiktanityāśōṣiṇamabalamanupacitaṁ vā, kaṣāyanityā śyāvamānāhinamudāvartinaṁ vā, yadyacca yasya yasyavyādhērnidānamuktaṁ tattadāsēvamānā'ntarvatnī tannimittavikārabahulamapatyaṁ janayati|
pitr̥jāstu śukradōṣā mātr̥jairapacārairvyākhyātāḥ|
iti garbhōpaghātakarā bhāvā bhavantyuktāḥ [4] |
tasmādahitānāhāravihārān prajāsampadamicchantī strī viśēṣēṇa varjayēt|
sādhvācārā cātmānamupacarēddhitābhyāmāhāravihārābhyāmiti||21||

garbhopaghAtakarAstvime bhAvA bhavanti; tadyathA- utkaTaviShamakaThinAsanasevinyA [1]vAtamUtrapurIShavegAnuparundhatyA dAruNAnucitavyAyAmasevinyAstIkShNoShNAtimAtrasevinyAHpramitAshanasevinyA garbho mriyate~antaH kukSheH, akAle vA sraMsate, shoShI vA bhavati;tathA~abhighAtaprapIDanaiH shvabhrakUpaprapAtadeshAvalokanairvA~abhIkShNaM mAtuHprapatatyakAlegarbhaH, tathA~atimAtrasa~gkShobhibhiryAnairyAnena, apriyAtimAtrashravaNairvA|
pratatottAnashAyinyAH punargarbhasya nAbhyAshrayA nADI kaNThamanuveShTayati, vivRutashAyinInakta~jcAriNI conmattaM janayati, apasmAriNaM punaH kalikalahashIlA, vyavAyashIlAdurvapuShamahrIkaM straiNaM vA, shokanityA bhItamapacitamalpAyuShaM vA, abhidhyAtrI [2]paropatApinamIrShyuM straiNaM vA, stenA tvAyAsabahulamatidrohiNamakarmashIlaM vA, amarShiNIcaNDamaupadhikamasUyakaM vA svapnanityA tandrAlumabudhamalpAgniM vA, madyanityApipAsAlumalpasmRutimanavasthitacittaM vA, godhAmAMsaprAyA [3] shArkariNamashmariNaMshanairmehiNaM vA, varAhamAMsaprAyA raktAkShaM krathanamatiparuSharomANaM vA,matsyamAMsanityA ciranimeShaM stabdhAkShaM vA, madhuranityA pramehiNaM mUkamatisthUlaM vA,amlanityA raktapittinaM tvagakShirogiNaM vA, lavaNanityA shIghravalIpalitaM khAlityarogiNaM vA,kaTukanityA durbalamalpashukramanapatyaM vA, tiktanityA shoShiNamabalamanupacitaM vA,kaShAyanityA shyAvamAnAhinamudAvartinaM vA, yadyacca yasya yasya vyAdhernidAnamuktaMtattadAsevamAnA~antarvatnI tannimittavikArabahulamapatyaM janayati|
pitRujAstu shukradoShA mAtRujairapacArairvyAkhyAtAH|
iti garbhopaghAtakarA bhAvA bhavantyuktAH [4] |
tasmAdahitAnAhAravihArAn prajAsampadamicchantI strI visheSheNa varjayet|
sAdhvAcArA cAtmAnamupacareddhitAbhyAmAhAravihArAbhyAmiti||21||

The following factors may damage or destroy the embryo/fetus: a woman who sits in awkward positions, on uneven and hard seats, or suppresses the urge to pass flatulence, urine and bowel movement, or indulges in intensive or extreme forms of physical activities, or is excessively addicted to consuming pungent and hot things, or eats very sparingly. In such scenarios, her fetus could dry up in the womb or get delivered prematurely, or atrophy.

Similarly, by suffering repeated trauma or similar injuries, or on looking down from heights (e.g., from mountain-tops or cliffs, deep wells, etc.), the expectant mother is liable to miscarry. Similarly, she is liable to miscarry if she travels long distances in excessively jerky carriages, or is exposed to, for prolonged periods of time, loud and unpleasant noise.

By constantly resting or sleeping on her back, the umbilical cord attached to the fetus winds itself round the throat of the fetus, thus tending to strangulate it (so pregnant woman should avoid such posture). Similarly, a woman who sleeps in open air or is used to walking at night is prone to giving birth to a mentally-challenged child. If the woman indulges in too much of quarrels and fights, the child could become epileptic. A woman who indulges in sexual practice excessively (or a nymphomaniac) will give birth to truant with a passion for women. A woman under constant grief would give birth to a timid, or under-developed or short-lived child. A woman who always thinks ill of others will give birth to a delinquent or an anti-social. A woman who is a thief will give birth to a lazy child who is wicked and inept, while an intolerant woman would give birth to a child who is of fierce, deceitful and jealous nature. A woman who sleeps for long hours would give birth to a dull and unwise child with poor digestive powers, while a woman addicted to wines to a child who is ever-thirsty and fickle minded. A woman who consumes flesh and meat of godha (iguana) would give birth to a child afflicted with stones or shanairmeha (a type of urinary disorder where dribbling is seen), while a woman used to consume pork frequently would give birth to a child with red eyes, rough body-hair, and prone to suffering from severe respiratory disorders. A woman used to consume fish excessively would give birth to a child with lagophthalmos and related eye disorders, while a woman used to eating a lot of sweets is prone to giving birth to a dumb or excessively obese child or a child afflicted with diabetes. A woman fond of sour things is prone to giving birth to an offspring suffering from bleeding disorders or diseases of skin and eyes, while a woman addicted to salt or salty food articles may give birth to a child with early onset of wrinkles, grey hair or baldness. A woman used to pungent substances in excess may give birth to a weak child, deficient in semen and impotent, while a woman using bitter substances in excess may give birth to a child with emaciated, weak or undeveloped body. A woman habituated to excessive use of astringents may give birth to a child with blackish complexion, suffering from constipation and udavarta (misperistalsis).

In summary, a pregnant woman indulging in unhealthy dietary and lifestyle activities that could cause certain diseases would increase the risk of her off spring getting afflicted with similar (or more virulent) disorders. From the father’s side, defects in semen could occur due to above mentioned factors for mother. Hence, a woman desirous of a child with excellent qualities should abstain from all forms of addictions as well as unhealthy dietary and lifestyle activities. [21]

Treating pregnant women afflicted with ailments

व्याधींश्चास्या मृदुमधुरशिशिरसुखसुकुमारप्रायैरौषधाहारोपचारैरुपचरेत्, न चास्या वमनविरेचनशिरोविरेचनानि प्रयोजयेत्, नरक्तमवसेचयेत्, सर्वकालं च नास्थापनमनुवासनं वा कुर्यादन्यत्रात्ययिकाद्व्याधेः|
अष्टमं मासमुपादाय वमनादिसाध्येषु पुनर्विकारेष्वात्ययिकेषु मृदुभिर्वमनादिभिस्तदर्थकारिभिर्वोपचारः स्यात्|
पूर्णमिव तैलपात्रमसङ्क्षोभयताऽन्तर्वत्नी [१] भवत्युपचर्या||२२||

vyādhīṁścāsyā mr̥dumadhuraśiśirasukhasukumāraprāyairauṣadhāhārōpacārairupacarēt, na cāsyāvamanavirēcanaśirōvirēcanāni prayōjayēt, na raktamavasēcayēt, sarvakālaṁ ca nāsthāpanamanuvāsanaṁ vākuryādanyatrātyayikādvyādhēḥ|
aṣṭamaṁ māsamupādāya vamanādisādhyēṣu punarvikārēṣvātyayikēṣumr̥dubhirvamanādibhistadarthakāribhirvōpacāraḥ syāt|
pūrṇamiva tailapātramasaṅkṣōbhayatā'ntarvatnī [1] bhavatyupacaryā||22||

vyAdhIMshcAsyA mRudumadhurashishirasukhasukumAraprAyairauShadhAhAropacArairupacaret, na cAsyAvamanavirecanashirovirecanAni prayojayet, na raktamavasecayet, sarvakAlaM ca nAsthApanamanuvAsanaM vAkuryAdanyatrAtyayikAdvyAdheH|
aShTamaM mAsamupAdAya vamanAdisAdhyeShu punarvikAreShvAtyayikeShumRudubhirvamanAdibhistadarthakAribhirvopacAraH syAt|
pUrNamiva tailapAtramasa~gkShobhayatA~antarvatnI [1] bhavatyupacaryA||22||

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]

Occurrences of bleeding during pregnancy

सा चेदपचाराद् द्वयोस्त्रिषु वा मासेषु पुष्पं पश्येन्नास्या गर्भः स्थास्यतीति विद्यात्; अजातसारो हि तस्मिन् काले भवतिगर्भः||२३||

sā cēdapacārād dvayōstriṣu vā māsēṣu puṣpaṁ paśyēnnāsyā garbhaḥ sthāsyatīti vidyāt; ajātasārō hi tasmin kālēbhavati garbhaḥ||23||

sA cedapacArAd dvayostriShu vA mAseShu puShpaM pashyennAsyA garbhaH sthAsyatIti vidyAt; ajAtasAro hi tasmin kAle bhavatigarbhaH||23||

If, as the result of wrongful behavior, bleeding occurs in a pregnant woman either in the second or third month, one should conclude that the conception will not be sustainable, as the embryo during this period is still immature. [23]

सा चेच्चतुष्प्रभृतिषु मासेषुक्रोधशोकासूयेर्ष्याभयत्रासव्यवायव्यायामसङ्क्षोभसन्धारणविषमाशनशयनस्थानक्षुत्पिपासातियोगात् कदाहाराद्वा पुष्पंपश्येत्, तस्या गर्भस्थापनविधिमुपदेक्ष्यामः|
पुष्पदर्शनादेवैनां ब्रूयात्- शयनं तावन्मृदुसुखशिशिरास्तरणसंस्तीर्णमीषदवनतशिरस्कं प्रतिपद्यस्वेति|
ततो यष्टीमधुकसर्पिर्भ्यां परमशिशिरवारिणी संस्थिताभ्यां पिचुमाप्लाव्योपस्थसमीपे स्थापयेत्तस्याः, तथाशतधौतसहस्रधौताभ्यां सर्पिर्भ्यामधोनाभेः सर्वतः प्रदिह्यात्, सर्वतश्च गव्येन चैनां पयसा सुशीतेन मधुकाम्बुना वान्यग्रोधादिकषायेण वा परिषेचयेदधो नाभेः, उदकं वा सुशीतमवगाहयेत्, क्षीरिणां कषायद्रुमाणां च स्वरसपरिपीतानि चेलानि [२]ग्राहयेत्, न्यग्रोधादिशुङ्गासिद्धयोर्वाक्षीरसर्पिषोः पिचुं ग्राहयेत्, अतश्चैवाक्षमात्रं प्राशयेत्, प्राशयेद्वा केवलं क्षीरसर्पिः,पद्मोत्पलकुमुदकिञ्जल्कांश्चास्यै समधुशर्करान् लेहार्थं दद्यात्, शृङ्गाटकपुष्करबीजकशेरुकान् भक्ष्णार्थं,गन्धप्रियङ्ग्वसितोत्पलशालूकोदुम्बरशलाटुन्यग्रोधशुङ्गानि वा पाययेदेनामाजेन पयसा, पयसा चैनांबलातिबलाशालिषष्टिकेक्षुमूलकाकोलीशृतेन समधुशर्करं रक्तशालीनामोदनं मृदुसुरभिशीतलं भोजयेत्,लावकपिञ्जलकुरङ्गशम्बरशशहरिणैणकालपुच्छकरसेन वा घृतसुसंस्कृतेन सुखशिशिरोपवातदेशस्थां भोजयेत्,क्रोधशोकायासव्यवायव्यायामेभ्यश्चाभिरक्षेत्, सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत; तथाऽस्या गर्भस्तिष्ठति||२४||

sā cēccatuṣprabhr̥tiṣu māsēṣukrōdhaśōkāsūyērṣyābhayatrāsavyavāyavyāyāmasaṅkṣōbhasandhāraṇaviṣamāśanaśayanasthānakṣutpipāsātiyōgātkadāhārādvā puṣpaṁ paśyēt, tasyā garbhasthāpanavidhimupadēkṣyāmaḥ|
puṣpadarśanādēvaināṁ brūyāt- śayanaṁ tāvanmr̥dusukhaśiśirāstaraṇasaṁstīrṇamīṣadavanataśiraskaṁpratipadyasvēti|
tatō yaṣṭīmadhukasarpirbhyāṁ paramaśiśiravāriṇī saṁsthitābhyāṁ picumāplāvyōpasthasamīpē sthāpayēttasyāḥ,tathā śatadhautasahasradhautābhyāṁ sarpirbhyāmadhōnābhēḥ sarvataḥ pradihyāt, sarvataśca gavyēna caināṁpayasā suśītēna madhukāmbunā vā nyagrōdhādikaṣāyēṇa vā pariṣēcayēdadhō nābhēḥ, udakaṁ vāsuśītamavagāhayēt, kṣīriṇāṁ kaṣāyadrumāṇāṁ ca svarasaparipītāni cēlāni [2] grāhayēt,nyagrōdhādiśuṅgāsiddhayōrvākṣīrasarpiṣōḥ picuṁ grāhayēt, ataścaivākṣamātraṁ prāśayēt, prāśayēdvā kēvalaṁkṣīrasarpiḥ, padmōtpalakumudakiñjalkāṁścāsyai samadhuśarkarān lēhārthaṁ dadyāt,śr̥ṅgāṭakapuṣkarabījakaśērukān bhakṣṇārthaṁ, gandhapriyaṅgvasitōtpalaśālūkōdumbaraśalāṭunyagrōdhaśuṅgānivā pāyayēdēnāmājēna payasā, payasā caināṁ balātibalāśāliṣaṣṭikēkṣumūlakākōlīśr̥tēna samadhuśarkaraṁraktaśālīnāmōdanaṁ mr̥dusurabhiśītalaṁ bhōjayēt,lāvakapiñjalakuraṅgaśambaraśaśahariṇaiṇakālapucchakarasēna vā ghr̥tasusaṁskr̥tēnasukhaśiśirōpavātadēśasthāṁ bhōjayēt, krōdhaśōkāyāsavyavāyavyāyāmēbhyaścābhirakṣēt, saumyābhiścaināṁkathābhirmanōnukūlābhirupāsīta; tathā'syā garbhastiṣṭhati||24||

sA ceccatuShprabhRutiShu mAseShukrodhashokAsUyerShyAbhayatrAsavyavAyavyAyAmasa~gkShobhasandhAraNaviShamAshanashayanasthAnakShutpipAsAtiyogAtkadAhArAdvA puShpaM pashyet, tasyA garbhasthApanavidhimupadekShyAmaH|
puShpadarshanAdevainAM brUyAt- shayanaM tAvanmRudusukhashishirAstaraNasaMstIrNamIShadavanatashiraskaMpratipadyasveti|
tato yaShTImadhukasarpirbhyAM paramashishiravAriNI saMsthitAbhyAM picumAplAvyopasthasamIpe sthApayettasyAH, tathAshatadhautasahasradhautAbhyAM sarpirbhyAmadhonAbheH sarvataH pradihyAt, sarvatashca gavyena cainAM payasA sushItenamadhukAmbunA vA nyagrodhAdikaShAyeNa vA pariShecayedadho nAbheH, udakaM vA sushItamavagAhayet, kShIriNAMkaShAyadrumANAM ca svarasaparipItAni celAni [2] grAhayet, nyagrodhAdishu~ggAsiddhayorvAkShIrasarpiShoH picuM grAhayet,atashcaivAkShamAtraM prAshayet, prAshayedvA kevalaM kShIrasarpiH, padmotpalakumudaki~jjalkAMshcAsyaisamadhusharkarAn lehArthaM dadyAt, shRu~ggATakapuShkarabIjakasherukAn bhakShNArthaM,gandhapriya~ggvasitotpalashAlUkodumbarashalATunyagrodhashu~ggAni vA pAyayedenAmAjena payasA, payasA cainAMbalAtibalAshAliShaShTikekShumUlakAkolIshRutena samadhusharkaraM raktashAlInAmodanaM mRudusurabhishItalaM bhojayet,lAvakapi~jjalakura~ggashambarashashahariNaiNakAlapucchakarasena vA ghRutasusaMskRutenasukhashishiropavAtadeshasthAM bhojayet, krodhashokAyAsavyavAyavyAyAmebhyashcAbhirakShet, saumyAbhishcainAMkathAbhirmanonukUlAbhirupAsIta; tathA~asyA garbhastiShThati||24||

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 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 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]

यस्याः पुनरामान्वयात् पुष्पदर्शनं स्यात्, प्रायस्तस्यास्तद्गर्भोपघातकरं भवति,
विरुद्धोपक्रमत्वात्तयोः||२५||

yasyāḥ punarāmānvayāt puṣpadarśanaṁ syāt, prāyastasyāstadgarbhōpaghātakaraṁ bhavati,
viruddhōpakramatvāttayōḥ||25||

yasyAH punarAmAnvayAt puShpadarshanaM syAt, prAyastasyAstadgarbhopaghAtakaraM bhavati,
viruddhopakramatvAttayoH||25||

If vaginal bleeding occurs as the result of ama (indigestion), there is a very high probability of miscarriage and abortion of the foetus and it may not be avoidable, because the two disorders (vaginal bleeding and indigestion) require mutually opposite treatments. [25]

यस्याः पुनरुष्णतीक्ष्णोपयोगाद्गर्भिण्या महति सञ्जातसारे गर्भे पुष्पदर्शनं स्यादन्यो वा योनिस्रावस्तस्या गर्भो वृद्धिं नप्राप्नोति निःस्रुतत्वात्; स कालमवतिष्ठतेऽतिमात्रं, तमुपविष्टकमित्याचक्षते केचित्|
उपवासव्रतकर्मपरायाः पुनः कदाहारायाः स्नेहद्वेषिण्या वातप्रकोपणोक्तान्यासेवमानाया गर्भो वृद्धिं न प्राप्नोतिपरिशुष्कत्वात्; स चापि कालमवतिष्ठतेऽतिमात्रम् [१] , अस्पन्दनश्च भवति, तं तु नागोदरमित्याचक्षते||२६||

yasyāḥ punaruṣṇatīkṣṇōpayōgādgarbhiṇyā mahati sañjātasārē garbhē puṣpadarśanaṁ syādanyō vāyōnisrāvastasyā garbhō vr̥ddhiṁ na prāpnōti niḥsrutatvāt; sa kālamavatiṣṭhatē'timātraṁ,tamupaviṣṭakamityācakṣatē kēcit|
upavāsavratakarmaparāyāḥ punaḥ kadāhārāyāḥ snēhadvēṣiṇyā vātaprakōpaṇōktānyāsēvamānāyāgarbhō vr̥ddhiṁ na prāpnōti pariśuṣkatvāt; sa cāpi kālamavatiṣṭhatē'timātram [1] , aspandanaśca bhavati,taṁ tu nāgōdaramityācakṣatē||26||

yasyAH punaruShNatIkShNopayogAdgarbhiNyA mahati sa~jjAtasAre garbhe puShpadarshanaM syAdanyovA yonisrAvastasyA garbho vRuddhiM na prApnoti niHsrutatvAt; sa kAlamavatiShThate~atimAtraM,tamupaviShTakamityAcakShate kecit|
upavAsavratakarmaparAyAH punaH kadAhArAyAH snehadveShiNyA vAtaprakopaNoktAnyAsevamAnAyAgarbho vRuddhiM na prApnoti parishuShkatvAt; sa cApi kAlamavatiShThate~atimAtram [1] , aspandanashcabhavati, taM tu nAgodaramityAcakShate||26||

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]

Specific Therapeutic courses for the management of Intrauterine Growth Retardation

नार्योस्तयोरुभयोरपि चिकित्सितविशेषमुपदेक्ष्यामः- भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धानां सर्पिषां पयसामामगर्भाणांचोपयोगो गर्भवृद्धिकरः; तथा सम्भोजनमेतैरेव सिद्धैश्च घृतादिभिः सुभिक्षायाः [१] ,
अभीक्ष्णंयानवाहनापमार्जनावजृम्भणैरुपपादनमिति||२७||

nāryōstayōrubhayōrapi cikitsitaviśēṣamupadēkṣyāmaḥ-bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhānāṁ sarpiṣāṁ payasāmāmagarbhāṇāṁ cōpayōgōgarbhavr̥ddhikaraḥ; tathā sambhōjanamētairēva siddhaiśca ghr̥tādibhiḥ subhikṣāyāḥ [1] ,
abhīkṣṇaṁyānavāhanāpamārjanāvajr̥mbhaṇairupapādanamiti||27|

nAryostayorubhayorapi cikitsitavisheShamupadekShyAmaH-bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhAnAM sarpiShAM payasAmAmagarbhANAM copayogogarbhavRuddhikaraH; tathA sambhojanametaireva siddhaishca ghRutAdibhiH subhikShAyAH [1] ,
abhIkShNaM yAnavAhanApamArjanAvajRumbhaNairupapAdanamiti||27||

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]

यस्याः पुनर्गर्भः प्रसुप्तो न स्पन्दते तां श्येनमत्स्यगवयशिखिताम्रचूडतित्तिरीणामन्यतमस्य सर्पिष्मता रसेन माषयूषेण वाप्रभूतसर्पिषा मूलकयूषेण वा रक्तशालीनामोदनं मृदुमधुरशीतलं भोजयेत्|
तैलाभ्यङ्गेन चास्या अभीक्ष्णमुदरबस्तिवङ्क्षणोरुकटीपार्श्वपृष्ठप्रदेशानीषदुष्णेनोपचरेत्||२८||

yasyāḥ punargarbhaḥ prasuptō na spandatē tāṁśyēnamatsyagavayaśikhitāmracūḍatittirīṇāmanyatamasya sarpiṣmatā rasēna māṣayūṣēṇa vāprabhūtasarpiṣā mūlakayūṣēṇa vā raktaśālīnāmōdanaṁ mr̥dumadhuraśītalaṁ bhōjayēt|
tailābhyaṅgēna cāsyā abhīkṣṇamudarabastivaṅkṣaṇōrukaṭīpārśvapr̥ṣṭhapradēśānīṣaduṣṇēnōpacarēt||28||

yasyAH punargarbhaH prasupto na spandate tAMshyenamatsyagavayashikhitAmracUDatittirINAmanyatamasya sarpiShmatA rasena mAShayUSheNa vAprabhUtasarpiShA mUlakayUSheNa vA raktashAlInAmodanaM mRudumadhurashItalaM bhojayet|
tailAbhya~ggena cAsyAabhIkShNamudarabastiva~gkShaNorukaTIpArshvapRuShThapradeshAnIShaduShNenopacaret||28||

If the fetal development has stalled or is slowed (for various reasons), then the pregnant woman should be advised to take shali rice (cooked Oriza sativa Linn.) which is soft, sweet and cool, with meat juices (seasoned with ghee), of one or more of the following animals- the hawk, fish, gayal, peacock, rooster, or partridge - or with gruel of masha (Phaseolusradiates Linn - black gram) or with the soup of radish, with plenty of ghee. She also should be massaged with lukewarm oil (tila taila-gingilly oil) over her abdomen, pelvic region, groin, thigh, waist, sides and back. [28]

Constipation during third trimester

यस्याः पुनरुदावर्तविबन्धः स्यादष्टमे मासे न चानुवासनसाध्यं मन्येत ततस्तस्यास्तद्विकारप्रशमनमुपकल्पयेन्निरूहम्|
उदावर्तो ह्युपेक्षितः सहसा सगर्भां [२] गर्भिणीं गर्भमथवाऽतिपातयेत्|

तत्र वीरणशालिषष्टिककुशकाशेक्षुवालिकावेतसपरिव्याधमूलानां भूतीकानन्ताकाश्मर्यपरूषकमधुकमृद्वीकानां चपयसाऽर्धोदकेनोद्गमय्य रसं प्रियालबिभीतकमज्जतिलकल्कसम्प्रयुक्तमीषल्लवणमनत्युष्णं च निरूहं दद्यात्|
व्यपगतविबन्धां चैनां सुखसलिलपरिषिक्ताङ्गीं स्थैर्यकरमविदाहिनमाहारं भुक्तवतीं सायं मधुरकसिद्धेन तैलेनानुवासयेत्|
न्युब्जां त्वेनामास्थापनानुवासनाभ्यामुपचरेत्||२९||

yasyāḥ punarudāvartavibandhaḥ syādaṣṭamē māsē na cānuvāsanasādhyaṁ manyētatatastasyāstadvikārapraśamanamupakalpayēnnirūham|
udāvartō hyupēkṣitaḥ sahasā sagarbhāṁ [2] garbhiṇīṁ garbhamathavā'tipātayēt|

tatra vīraṇaśāliṣaṣṭikakuśakāśēkṣuvālikāvētasaparivyādhamūlānāṁbhūtīkānantākāśmaryaparūṣakamadhukamr̥dvīkānāṁ ca payasā'rdhōdakēnōdgamayya rasaṁpriyālabibhītakamajjatilakalkasamprayuktamīṣallavaṇamanatyuṣṇaṁ ca nirūhaṁ dadyāt|
vyapagatavibandhāṁ caināṁ sukhasalilapariṣiktāṅgīṁ sthairyakaramavidāhinamāhāraṁ bhuktavatīṁsāyaṁ madhurakasiddhēna tailēnānuvāsayēt| nyubjāṁ tvēnāmāsthāpanānuvāsanābhyāmupacarēt||29||

yasyAH punarudAvartavibandhaH syAdaShTame mAse na cAnuvAsanasAdhyaM manyetatatastasyAstadvikAraprashamanamupakalpayennirUham|
udAvarto hyupekShitaH sahasA sagarbhAM [2] garbhiNIM garbhamathavA~atipAtayet|

tatra vIraNashAliShaShTikakushakAshekShuvAlikAvetasaparivyAdhamUlAnAMbhUtIkAnantAkAshmaryaparUShakamadhukamRudvIkAnAM ca payasA~ardhodakenodgamayya rasaMpriyAlabibhItakamajjatilakalkasamprayuktamIShallavaNamanatyuShNaM ca nirUhaM dadyAt|
vyapagatavibandhAM cainAM sukhasalilapariShiktA~ggIM sthairyakaramavidAhinamAhAraM bhuktavatIMsAyaM madhurakasiddhena tailenAnuvAsayet| nyubjAM tvenAmAsthApanAnuvAsanAbhyAmupacaret||29||

In case the pregnant woman develops constipation due to udavarta (misperistalsis) in the eighth month and if it cannot be treated with unctuous enema, then the physician should treat her with non-unctuous enema that may relieve her condition. If the disorder of misperistalsis is neglected, it may abruptly turn fatal for both the mother and the fetus or for the fetus alone. In such conditions, a decoction prepared with the roots of virana (Veriveriazizanoides Nash), shali (Oryzasativa Linn), sashtika (a variety of Oryza species), kusha (Desmostachya bipinnata Staf), kasha (Saccharum spontaneum Linn.), ikshuvalika (Asteracanthalongifolia Nees), vetasa (Salixcaprea Linn.), parivyadha (type of Vetasa, Salix species) bhutika (Trachyspermumammi Sprague), ananta (Hemidesmus indicusR. B.), kashmarya (Gmelinaarborea Linn.), parushaka (Grewiaasiatica Linn.), madhuka (Glycyrrhizaglabra Linn) and mridwika (Vitisvinifera Linn.), prepared with milk and mixed with half that volume of water containing paste of priyala (Buchananialanzan Spreng), bibhitakamajja (the seed pulp of Terminaliabelerica Roxb.), tila (Sesamumindicum Linn.) and salt (Saindhava – rock salt) should be used for non-unctuous enema. Once the constipation is relieved, she should be sprinkled with lukewarm water and then given food having stabilizing properties and which will not cause any burning sensation.

In the evening, she should be treated with unctuous enema of oil prepared with sweet drugs. The enema should be administered to her in a bent-down position (fetal, knee-to-the-chest position). [29]

Symptoms of intra-uterine death

यस्याः पुनरतिमात्रदोषोपचयाद्वा तीक्ष्णोष्णातिमात्रसेवनाद्वा वातमूत्रपुरीषवेगविधारणैर्वा विषमाश(स)नशयनस्थानसम्पीडनाभिघातैर्वा क्रोधशोकेर्ष्याभयत्रासादिभिर्वा साहसैर्वाऽपरैः कर्मभिरन्तःकुक्षेर्गर्भो [१] म्रियते, तस्याःस्तिमितं स्तब्धमुदरमाततं शीतमश्मान्तर्गतमिव भवत्यस्पन्दनो गर्भः, शूलमधिकमुपजायते, न चाव्यः प्रादुर्भवन्ति, योनिर्नप्रस्रवति, अक्षिणी चास्याः स्रस्ते भवतः, ताम्यति, व्यथते, भ्रमते, श्वसिति, अरतिबहुला च भवति, न चास्या वेगप्रादुर्भावोयथावदुपलभ्यते; इत्येवंलक्षणां स्त्रियं मृतगर्भेयमिति विद्यात्||३०||

yasyāḥ punaratimātradōṣōpacayādvā tīkṣṇōṣṇātimātrasēvanādvā vātamūtrapurīṣavēgavidhāraṇairvāviṣamāśa(sa)naśayanasthānasampīḍanābhighātairvā krōdhaśōkērṣyābhayatrāsādibhirvāsāhasairvā'paraiḥ karmabhirantaḥkukṣērgarbhō [1] mriyatē, tasyāḥ stimitaṁ stabdhamudaramātataṁśītamaśmāntargatamiva bhavatyaspandanō garbhaḥ, śūlamadhikamupajāyatē, na cāvyaḥ prādurbhavanti,yōnirna prasravati, akṣiṇī cāsyāḥ srastē bhavataḥ, tāmyati, vyathatē, bhramatē, śvasiti, aratibahulā cabhavati, na cāsyā vēgaprādurbhāvō yathāvadupalabhyatē; ityēvaṁlakṣaṇāṁ striyaṁ mr̥tagarbhēyamitividyāt||30||

yasyAH punaratimAtradoShopacayAdvA tIkShNoShNAtimAtrasevanAdvAvAtamUtrapurIShavegavidhAraNairvA viShamAsha(sa)nashayanasthAnasampIDanAbhighAtairvAkrodhashokerShyAbhayatrAsAdibhirvA sAhasairvA~aparaiH karmabhirantaHkukShergarbho [1] mriyate,tasyAH stimitaM stabdhamudaramAtataM shItamashmAntargatamiva bhavatyaspandano garbhaH,shUlamadhikamupajAyate, na cAvyaH prAdurbhavanti, yonirna prasravati, akShiNI cAsyAH srastebhavataH, tAmyati, vyathate, bhramate, shvasiti, aratibahulA ca bhavati, na cAsyA vegaprAdurbhAvoyathAvadupalabhyate; ityevaMlakShaNAM striyaM mRutagarbheyamiti vidyAt||30||

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]

Treatment of intra-uterine death

तस्य गर्भशल्यस्य जरायुप्रपातनं कर्म संशमनमित्याहुरेके, मन्त्रादिकमथर्ववेदविहितमित्येके, परिदृष्टकर्मणा शल्यहर्त्राहरणमित्येके|
व्यपगतगर्भशल्यां तु स्त्रियमामगर्भां सुरासीध्वरिष्टमधुमदिरासवानामन्यतममग्रे सामर्थ्यतःपाययेद्गर्भकोष्ठशुद्ध्यर्थमर्तिविस्मरणार्थं प्रहर्षणार्थं च, अतः परं सम्प्रीणनैर्बलानुरक्षिभिरस्नेहसम्प्रयुक्तैर्यवाग्वादिभिर्वा [१]तत्कालयोगिभिराहारैरुपचरेद्दोषधातुक्लेदविशोषणमात्रं कालम्|
अतः परं स्नेहपानैर्बस्तिभिराहारविधिभिश्च दीपनीयजीवनीयबृंहणीयमधुरवातहरसमाख्यातैरुपचरेत्| परिपक्वगर्भशल्यायाः पुनर्विमुक्तगर्भशल्यायास्तदहरेव स्नेहोपचारः स्यात्||३१||

tasya garbhaśalyasya jarāyuprapātanaṁ karma saṁśamanamityāhurēkē,mantrādikamatharvavēdavihitamityēkē, paridr̥ṣṭakarmaṇā śalyahartrā haraṇamityēkē|
vyapagatagarbhaśalyāṁ tu striyamāmagarbhāṁ surāsīdhvariṣṭamadhumadirāsavānāmanyatamamagrēsāmarthyataḥ pāyayēdgarbhakōṣṭhaśuddhyarthamartivismaraṇārthaṁ praharṣaṇārthaṁ ca, ataḥ paraṁsamprīṇanairbalānurakṣibhirasnēhasamprayuktairyavāgvādibhirvā [1]tatkālayōgibhirāhārairupacarēddōṣadhātuklēdaviśōṣaṇamātraṁ kālam|
ataḥ paraṁ snēhapānairbastibhirāhāravidhibhiścadīpanīyajīvanīyabr̥ṁhaṇīyamadhuravātaharasamākhyātairupacarēt| paripakvagarbhaśalyāyāḥ punarvimuktagarbhaśalyāyāstadaharēva snēhōpacāraḥ syāt||31||

tasya garbhashalyasya jarAyuprapAtanaM karma saMshamanamityAhureke,mantrAdikamatharvavedavihitamityeke, paridRuShTakarmaNA shalyahartrA haraNamityeke|
vyapagatagarbhashalyAM tu striyamAmagarbhAMsurAsIdhvariShTamadhumadirAsavAnAmanyatamamagre sAmarthyataHpAyayedgarbhakoShThashuddhyarthamartivismaraNArthaM praharShaNArthaM ca, ataH paraMsamprINanairbalAnurakShibhirasnehasamprayuktairyavAgvAdibhirvA [1]tatkAlayogibhirAhArairupacareddoShadhAtukledavishoShaNamAtraM kAlam|
ataH paraM snehapAnairbastibhirAhAravidhibhishcadIpanIyajIvanIyabRuMhaNIyamadhuravAtaharasamAkhyAtairupacaret| paripakvagarbhashalyAyAH punarvimuktagarbhashalyAyAstadahareva snehopacAraH syAt||31||

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]

Monthly regimen to be adopted during normal pregnancy

परमतो निर्विकारमाप्याय्यमानस्य गर्भस्य मासे मासे कर्मोपदेक्ष्यामः|
प्रथमे मासे शङ्किता चेद्गर्भमापन्ना क्षीरमनुपस्कृतं मात्रावच्छीतं काले काले पिबेत्, सात्म्यमेव च भोजनं सायं प्रातश्चभुञ्जीत; द्वितीये मासे क्षीरमेव च मधुरौषधसिद्धं; तृतीये मासे क्षीरं मधुसर्पिर्भ्यामुपसंसृज्य; चतुर्थे मासेक्षीरनवनीतमक्षमात्रमश्नीयात्; पञ्चमे मासे क्षीरसर्पिः; षष्ठे मासे क्षीरसर्पिर्मधुरौषधसिद्धं; तदेव सप्तमे मासे|
तत्र गर्भस्य केशा जायमाना मातुर्विदाहं जनयन्तीति स्त्रियो भाषन्ते; तन्नेति भगवानात्रेयः, किन्तुगर्भोत्पीडनाद्वातपित्तश्लेष्माण उरः प्राप्य विदाहं जनयन्ति, ततः कण्डूरुपजायते, कण्डूमूला च किक्किसावाप्तिर्भवति|
तत्र कोलोदकेन नवनीतस्य मधुरौषधसिद्धस्य पाणितलमात्रं काले कालेऽस्यै पानार्थं दद्यात्, चन्दनमृणालकल्कैश्चास्याःस्तनोदरं विमृद्गीयात्, शिरीषधातकीसर्षपमधुकचूर्णैर्वा, कुटजार्जकबीजमुस्तहरिद्राकल्कैर्वा,निम्बकोलसुरसमञ्जिष्ठाकल्कैर्वा, पृषतहरिणशशरुधिरयुतया त्रिफलया वा; करवीरपत्रसिद्धेन तैलेनाभ्यङ्गः; परिषेकःपुनर्मालतीमधुकसिद्धेनाम्भसा; जातकण्डूश्च कण्डूयनं वर्जयेत्त्वग्भेदवैरूप्यपरिहारार्थम्, असह्यायां तुकण्ड्वामुन्मर्दनोद्धर्षणाभ्यां परिहारः स्यात्; मधुरमाहारजातं वातहरमल्पमस्नेहलवणमल्पोदकानुपानं च भुञ्जीत|
अष्टमे तु मासे क्षीरयवागूं सर्पिष्मतीं काले काले पिबेत्; तन्नेति भद्रकाप्यः, पैङ्गल्याबाधो ह्यस्या गर्भमागच्छेदिति; अस्त्वत्रपैङ्गल्याबाध इत्याह भगवान् पुनर्वसुरात्रेयः, न त्वेवैतन्न कार्यम्; एवं कुर्वती ह्यरोगाऽऽरोग्यबलवर्णस्वरसंहननसम्पदुपेतंज्ञातीनामपि श्रेष्ठमपत्यं जनयति|
नवमे तु खल्वेनां मासे मधुरौषधसिद्धेन तैलेनानुवासयेत्|
अतश्चैवास्यास्तैलात् पिचुं योनौ प्रणयेद्गर्भस्थानमार्गस्नेहनार्थम्|
यदिदं कर्म प्रथमं मासं समुपादायोपदिष्टमानवमान्मासात्तेन गर्भिण्या गर्भसमये गर्भधारिणीकुक्षिकटीपार्श्वपृष्ठं [१] मृदूभवति,वातश्चानुलोमः सम्पद्यते, मूत्रपुरीषे च प्रकृतिभूते सुखेन मार्गमनुपद्येते, चर्मनखानि च मार्दवमुपयान्ति, बलवर्णौचोपचीयेते; पुत्रं चेष्टं सम्पदुपेतं सुखिनं सुखेनैषा काले प्रजायत इति||३२||

paramatō nirvikāramāpyāyyamānasya garbhasya māsē māsē karmōpadēkṣyāmaḥ|
prathamē māsē śaṅkitā cēdgarbhamāpannā kṣīramanupaskr̥taṁ mātrāvacchītaṁ kālē kālē pibēt,sātmyamēva ca bhōjanaṁ sāyaṁ prātaśca bhuñjīta; dvitīyē māsē kṣīramēva ca madhurauṣadhasiddhaṁ;tr̥tīyē māsē kṣīraṁ madhusarpirbhyāmupasaṁsr̥jya; caturthē māsē kṣīranavanītamakṣamātramaśnīyāt;pañcamē māsē kṣīrasarpiḥ; ṣaṣṭhē māsē kṣīrasarpirmadhurauṣadhasiddhaṁ; tadēva saptamē māsē|
tatra garbhasya kēśā jāyamānā māturvidāhaṁ janayantīti striyō bhāṣantē; tannēti bhagavānātrēyaḥ, kintugarbhōtpīḍanādvātapittaślēṣmāṇa uraḥ prāpya vidāhaṁ janayanti, tataḥ kaṇḍūrupajāyatē, kaṇḍūmūlā cakikkisāvāptirbhavati|
tatra kōlōdakēna navanītasya madhurauṣadhasiddhasya pāṇitalamātraṁ kālē kālē'syai pānārthaṁ dadyāt,candanamr̥ṇālakalkaiścāsyāḥ stanōdaraṁ vimr̥dgīyāt, śirīṣadhātakīsarṣapamadhukacūrṇairvā,kuṭajārjakabījamustaharidrākalkairvā, nimbakōlasurasamañjiṣṭhākalkairvā,pr̥ṣatahariṇaśaśarudhirayutayā triphalayā vā; karavīrapatrasiddhēna tailēnābhyaṅgaḥ; pariṣēkaḥpunarmālatīmadhukasiddhēnāmbhasā; jātakaṇḍūśca kaṇḍūyanaṁvarjayēttvagbhēdavairūpyaparihārārtham, asahyāyāṁ tu kaṇḍvāmunmardanōddharṣaṇābhyāṁ parihāraḥsyāt; madhuramāhārajātaṁ vātaharamalpamasnēhalavaṇamalpōdakānupānaṁ ca bhuñjīta|
aṣṭamē tu māsē kṣīrayavāgūṁ sarpiṣmatīṁ kālē kālē pibēt; tannēti bhadrakāpyaḥ, paiṅgalyābādhō hyasyāgarbhamāgacchēditi; astvatra paiṅgalyābādha ityāha bhagavān punarvasurātrēyaḥ, na tvēvaitannakāryam; ēvaṁ kurvatī hyarōgārōgyabalavarṇasvarasaṁhananasampadupētaṁ jñātīnāmapiśrēṣṭhamapatyaṁ janayati|
navamē tu khalvēnāṁ māsē madhurauṣadhasiddhēna tailēnānuvāsayēt|
ataścaivāsyāstailāt picuṁ yōnau praṇayēdgarbhasthānamārgasnēhanārtham|
yadidaṁ karma prathamaṁ māsaṁ samupādāyōpadiṣṭamānavamānmāsāttēna garbhiṇyā garbhasamayēgarbhadhāriṇīkukṣikaṭīpārśvapr̥ṣṭhaṁ [1] mr̥dūbhavati, vātaścānulōmaḥ sampadyatē, mūtrapurīṣē caprakr̥tibhūtē sukhēna mārgamanupadyētē, carmanakhāni ca mārdavamupayānti, balavarṇau cōpacīyētē;putraṁ cēṣṭaṁ sampadupētaṁ sukhinaṁ sukhēnaiṣā kālē prajāyata iti||32||

paramato nirvikAramApyAyyamAnasya garbhasya mAse mAse karmopadekShyAmaH|
prathame mAse sha~gkitA cedgarbhamApannA kShIramanupaskRutaM mAtrAvacchItaM kAle kAle pibet,sAtmyameva ca bhojanaM sAyaM prAtashca bhu~jjIta; dvitIye mAse kShIrameva camadhurauShadhasiddhaM; tRutIye mAse kShIraM madhusarpirbhyAmupasaMsRujya; caturthe mAsekShIranavanItamakShamAtramashnIyAt; pa~jcame mAse kShIrasarpiH; ShaShThe mAsekShIrasarpirmadhurauShadhasiddhaM; tadeva saptame mAse|
tatra garbhasya keshA jAyamAnA mAturvidAhaM janayantIti striyo bhAShante; tanneti bhagavAnAtreyaH,kintu garbhotpIDanAdvAtapittashleShmANa uraH prApya vidAhaM janayanti, tataH kaNDUrupajAyate,kaNDUmUlA ca kikkisAvAptirbhavati|
tatra kolodakena navanItasya madhurauShadhasiddhasya pANitalamAtraM kAle kAle~asyai pAnArthaMdadyAt, candanamRuNAlakalkaishcAsyAH stanodaraM vimRudgIyAt,shirIShadhAtakIsarShapamadhukacUrNairvA, kuTajArjakabIjamustaharidrAkalkairvA,nimbakolasurasama~jjiShThAkalkairvA, pRuShatahariNashasharudhirayutayA triphalayA vA;karavIrapatrasiddhena tailenAbhya~ggaH; pariShekaH punarmAlatImadhukasiddhenAmbhasA;jAtakaNDUshca kaNDUyanaM varjayettvagbhedavairUpyaparihArArtham, asahyAyAM tukaNDvAmunmardanoddharShaNAbhyAM parihAraH syAt; madhuramAhArajAtaMvAtaharamalpamasnehalavaNamalpodakAnupAnaM ca bhu~jjIta|
aShTame tu mAse kShIrayavAgUM sarpiShmatIM kAle kAle pibet; tanneti bhadrakApyaH, pai~ggalyAbAdhohyasyA garbhamAgacchediti; astvatra pai~ggalyAbAdha ityAha bhagavAn punarvasurAtreyaH, natvevaitanna kAryam; evaM kurvatI hyarogA~a~arogyabalavarNasvarasaMhananasampadupetaMj~jAtInAmapi shreShThamapatyaM janayati|
navame tu khalvenAM mAse madhurauShadhasiddhena tailenAnuvAsayet|
atashcaivAsyAstailAt picuM yonau praNayedgarbhasthAnamArgasnehanArtham|
yadidaM karma prathamaM mAsaM samupAdAyopadiShTamAnavamAnmAsAttena garbhiNyAgarbhasamaye garbhadhAriNIkukShikaTIpArshvapRuShThaM [1] mRudUbhavati, vAtashcAnulomaHsampadyate, mUtrapurIShe ca prakRutibhUte sukhena mArgamanupadyete, carmanakhAni camArdavamupayAnti, balavarNau copacIyete; putraM ceShTaM sampadupetaM sukhinaM sukhenaiShA kAleprajAyata iti||32||

In this verse, we shall explain the monthly regimen to be adopted in a steadily developing, normal pregnancy:

  • In the first month when pregnancy is suspected, cold and unmedicated milk (that has not been processed with any drug) should be taken in adequate quantity at regular intervals, and nourishing food should be eaten twice a day.
  • In the second month of pregnancy, milk processed with sweet-tasting drugs should be taken, as needed.
  • In the third month of pregnancy, milk along with honey and ghee should be given to drink.
  • In the fourth month of pregnancy, milk along with one aksha (10 – 12 g) butter should be consumed.
  • 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 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 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.

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]

Infra structure of maternity home

प्राक् चैवास्या नवमान्मासात् सूतिकागारं कारयेदपहृतास्थिशर्कराकपाले देशे प्रशस्तरूपरसगन्धायां भूमौ प्राग्द्वारमुदग्द्वारं वाबैल्वानां काष्ठानां तैन्दुकैङ्गुदकानां भाल्लातकानां वार(रु)णानां खादिराणां वा; यानि चान्यान्यपि ब्राह्मणाःशंसेयुरथर्ववेदविदस्तेषां; वसनालेपनाच्छादनापिधानसम्पदुपेतंवास्तुविद्याहृदययोगाग्निसलिलोदूखलवर्चःस्थानस्नानभूमिमहानसमृतुसुखं च||३३||

prāk caivāsyā navamānmāsāt sūtikāgāraṁ kārayēdapahr̥tāsthiśarkarākapālē dēśēpraśastarūparasagandhāyāṁ bhūmau prāgdvāramudagdvāraṁ vā bailvānāṁ kāṣṭhānāṁtaindukaiṅgudakānāṁ bhāllātakānāṁ vāra(ru)ṇānāṁ khādirāṇāṁ vā; yāni cānyānyapi brāhmaṇāḥśaṁsēyuratharvavēdavidastēṣāṁ; vasanālēpanācchādanāpidhānasampadupētaṁvāstuvidyāhr̥dayayōgāgnisalilōdūkhalavarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁ ca||33||

prAk caivAsyA navamAnmAsAt sUtikAgAraM kArayedapahRutAsthisharkarAkapAle desheprashastarUparasagandhAyAM bhUmau prAgdvAramudagdvAraM vA bailvAnAM kAShThAnAMtaindukai~ggudakAnAM bhAllAtakAnAM vAra(ru)NAnAM khAdirANAM vA; yAni cAnyAnyapi brAhmaNAHshaMseyuratharvavedavidasteShAM; vasanAlepanAcchAdanApidhAnasampadupetaMvAstuvidyAhRudayayogAgnisalilodUkhalavarcaHsthAnasnAnabhUmimahAnasamRutusukhaM ca||33||

Well before the ninth month of pregnancy, a maternity home should be constructed in a place that is free from bones, gravels and broken pieces of baked earthen utensils, the soil of which should have excellent color, taste and odour, the door of which should be facing the east or north and made of bilwa wood (Aeglemarmelos Corr.) or tinduka (Diospyrosperegrine Gurke), ingudi (Balanitesaegyptica Delile.), bhallataka (Semecarpusanacardium Linn.), varuna (Creteva religiosa) or khadira (Acaciacatechu willd.), or those woods recommended by brahmins who are well versed in Atharva Veda. The maternity home should be well built, spacious, well painted, have adequate doors and windows, well furnished with appliances, furnishings, water storage, lavatories, toiletries, etc. - built in accordance with the principles of Vastuvidya (science of architecture). The house should be comfortable for all seasons. [33]

Requirements in the maternity home

तत्र सर्पिस्तैलमधुसैन्धवसौवर्चलकालविड्लवणविडङ्गकुष्ठकिलिमनागर-पिप्पलीपिप्पलीमूलहस्तिपिप्पलीमण्डूकपर्ण्येलालाङ्गलीवचाचव्यचित्रकचिरबिल्व-हिङ्गुसर्षपलशुनकतककणकणिकानीपातसीबल्वजभूर्जकुलत्थमैरेयसुरासवाः सन्निहिताः स्युः; तथाऽश्मानौ द्वौ, द्वे कु(च)ण्डमुसले, द्वे उदूखले, खरवृषभश्च [१] , द्वौ च तीक्ष्णौ सूचीपिप्पलकौ सौवर्णराजतौ, शस्त्राणि च तीक्ष्णायसानि, द्वौ चबिल्वमयौ पर्यङ्कौ, तैन्दुकैङ्गुदानि च काष्ठान्यग्निसन्धुक्षणानि, स्त्रियश्च बह्व्यो बहुशः प्रजाताः सौहार्दयुक्ताःसततमनुरक्ताः प्रदक्षिणाचाराः प्रतिपत्तिकुशलाः प्रकृतिवत्सलास्त्यक्तविषादाः क्लेशसहिन्योऽभिमताः,ब्राह्मणाश्चाथर्ववेदविदः; यच्चान्यदपि तत्र समर्थं मन्येत, यच्चान्यच्च ब्राह्मणा ब्रूयुः स्त्रियश्च वृद्धास्तत् कार्यम्||३४||

tatra sarpistailamadhusaindhavasauvarcalakālaviḍlavaṇaviḍaṅgakuṣṭhakilimanāgara-pippalīpippalīmūlahastipippalīmaṇḍūkaparṇyēlālāṅgalīvacācavyacitrakacirabilva-hiṅgusarṣapalaśunakatakakaṇakaṇikānīpātasībalvajabhūrjakulatthamairēyasurāsavāḥ sannihitāḥ syuḥ;tathā'śmānau dvau, dvē ku(ca)ṇḍamusalē, dvē udūkhalē, kharavr̥ṣabhaśca [1] , dvau ca tīkṣṇausūcīpippalakau sauvarṇarājatau, śastrāṇi ca tīkṣṇāyasāni, dvau ca bilvamayau paryaṅkau,taindukaiṅgudāni ca kāṣṭhānyagnisandhukṣaṇāni, striyaśca bahvyō bahuśaḥ prajātāḥ sauhārdayuktāḥsatatamanuraktāḥ pradakṣiṇācārāḥ pratipattikuśalāḥ prakr̥tivatsalāstyaktaviṣādāḥ klēśasahinyō'bhimatāḥ,brāhmaṇāścātharvavēdavidaḥ; yaccānyadapi tatra samarthaṁ manyēta, yaccānyacca brāhmaṇā brūyuḥstriyaśca vr̥ddhāstat kāryam||34||

tatra sarpistailamadhusaindhavasauvarcalakAlaviDlavaNaviDa~ggakuShThakilimanAgara-pippalIpippalImUlahastipippalImaNDUkaparNyelAlA~ggalIvacAcavyacitrakacirabilva-hi~ggusarShapalashunakatakakaNakaNikAnIpAtasIbalvajabhUrjakulatthamaireyasurAsavAH sannihitAHsyuH; tathA~ashmAnau dvau, dve ku(ca)NDamusale, dve udUkhale, kharavRuShabhashca [1] , dvau catIkShNau sUcIpippalakau sauvarNarAjatau, shastrANi ca tIkShNAyasAni, dvau ca bilvamayau parya~gkau,taindukai~ggudAni ca kAShThAnyagnisandhukShaNAni, striyashca bahvyo bahushaH prajAtAHsauhArdayuktAH satatamanuraktAH pradakShiNAcArAH pratipattikushalAHprakRutivatsalAstyaktaviShAdAH kleshasahinyo~abhimatAH, brAhmaNAshcAtharvavedavidaH;yaccAnyadapi tatra samarthaM manyeta, yaccAnyacca brAhmaNA brUyuH striyashca vRuddhAstatkAryam||34||

The following items should be made available in that maternity home: Ghee, honey, saindhava (rock salt), sauvarchala, kala, bida salts, vidanga (Emblelia ribes Burm. f.), kushta (Saussurea lappaC. B. Clarke.), kilima (Cedrus deodara Loud.), nagara (Zingiber officinale Rosc.), pippali (Piper longum Linn), pippali moola (root of Piper longum Linn.), hasti pippali (Scindapsus officinalis Schott), mandukaparni (Centella asiatica urban.), ela (Elettaria cadamomum Maton.), langali (Gloriosa superba Linn.), vacha (Acorus calamus Linn.), chavya (Piper cheba Hunter.), chitraka (Plumbago zeylanica Linn.), chirabilva (Pongamia pinnata Merr.), hingu (Ferula narthex Boiss.), sarshapa (Brassica nigra Koch.), lashuna (Alium sativum Linn.), kataka (Strychnos potatorum Linn. f.), kana (Pippali – piper longum Linn), kundaka, kanika (a variety of kana with bigger grains), neepa (Anthocephalus indicus A. Rich.), atasi (Linum usitatissumum Linn.), balvaja (--), bhurja (Betula utilis D. Don.), kulatha (Dolichos biflorus Linn.), maireya, and alcoholic beverages (sura, and asava). In addition to the above, the following items too should be kept available there – two grinding stones, two small pestles, two mortars, one untamed bull, two gold and silver cases for keeping needles, various surgical instruments that are sharp and prepared of metals, two bedsteads made of bilva (Aeglemarmelos Corr.), wood of tinduka (Diospyrosperegrine Gurke) and ingudi (Balanitesaegyptica Delile.) as fire wood, good number of female attendants who are multiskilled, who are affectionate and attached to the lady, well mannered, resourceful, pleasant to talk to, free from grief, tolerant of hardship and agreeable, and brahmins well versed in the Atharva Veda.

Above all, whatever prescribed by brahmins and experienced old ladies and found necessary are to be kept handy in this maternity home. [34]

Rituals for the expecting woman before entering the maternity home

ततः प्रवृत्ते नवमे मासे पुण्येऽहनि प्रशस्तनक्षत्रयोगमुपगते प्रशस्ते भगवति शशिनि कल्याणे कल्याणे च करणे मैत्रे मुहूर्ते शान्तिंहुत्वा गोब्राह्मणमग्निमुदकं चादौ प्रवेश्य गोभ्यस्तृणोदकं मधुलाजांश्च प्रदाय ब्राह्मणेभ्योऽक्षतान् सुमनसो नान्दीमुखानि चफलानीष्टानि दत्त्वोदकपूर्वमासनस्थेभ्योऽभिवाद्य पुनराचम्य स्वस्ति वाचयेत्|
ततः पुण्याहशब्देन गोब्राह्मणं समनुवर्तमाना [१] प्रदक्षिणं प्रविशेत् सूतिकागारम्|
तत्रस्था च प्रसवकालं प्रतीक्षेत||३५||

tataḥ pravr̥ttē navamē māsē puṇyē'hani praśastanakṣatrayōgamupagatē praśastē bhagavati śaśini kalyāṇēkalyāṇē ca karaṇē maitrē muhūrtē śāntiṁ hutvā gōbrāhmaṇamagnimudakaṁ cādau pravēśyagōbhyastr̥ṇōdakaṁ madhulājāṁśca pradāya brāhmaṇēbhyō'kṣatān sumanasō nāndīmukhāni caphalānīṣṭāni dattvōdakapūrvamāsanasthēbhyō'bhivādya punarācamya svasti vācayēt|
tataḥ puṇyāhaśabdēna gōbrāhmaṇaṁ samanuvartamānā [1] pradakṣiṇaṁ praviśēt sūtikāgāram|
tatrasthā ca prasavakālaṁ pratīkṣēta||35||

tataH pravRutte navame mAse puNye~ahani prashastanakShatrayogamupagate prashaste bhagavatishashini kalyANe kalyANe ca karaNe maitre muhUrte shAntiM hutvA gobrAhmaNamagnimudakaM cAdaupraveshya gobhyastRuNodakaM madhulAjAMshca pradAya brAhmaNebhyo~akShatAn sumanasonAndImukhAni ca phalAnIShTAni dattvodakapUrvamAsanasthebhyo~abhivAdya punarAcamya svastivAcayet|
tataH puNyAhashabdena gobrAhmaNaM samanuvartamAnA [1] pradakShiNaM pravishet sUtikAgAram|
tatrasthA ca prasavakAlaM pratIkSheta||35||

After furnishing the maternity home, in the beginning of the ninth month, on an auspicious day, when moon is in the auspicious nakshatra (constellation), with an auspicious karana and at an auspicious muhurta (astrological unit of time), with priests offering oblations and rites to holy fire, first of all the cow, the brahmana, fire and water should be made to enter the maternity home. Then grass, water, honey and laja (parched rice) should be offered to the cows, and akshata (rice grains prepared exclusively for worship), fragrant flowers and sweet fruits (such as khajura, date), which are indicative of good fortune, should be offered to the brahmanas. Blessings should then be sought from the brahmanas, after taking sips of water (achamana is taking sips of water after chanting mantra). With auspicious mantras being chanted by the priests, the expecting woman should enter the maternity home, following the cow and the brahmanas to her right side. Then she should stay there until she delivers her child. [35]

Premonitory signs and symptoms of labor

तस्यास्तु खल्विमानि लिङ्गानि प्रजननकालमभितो भवन्ति; तद्यथा- क्लमो गात्राणां, ग्लानिराननस्य, अक्ष्णोः शैथिल्यं,विमुक्तबन्धनत्वमिव [१] वक्षसः, कुक्षेरवस्रंसनम्, अधोगुरुत्वं, वङ्क्षणबस्तिकटीकुक्षिपार्श्वपृष्ठनिस्तोदः, योनेः प्रस्रवणम्,अनन्नाभिलाषश्चेति; ततोऽनन्तरमावीनां प्रादुर्भावः, प्रसेकश्च गर्भोदकस्य||३६||

tasyāstu khalvimāni liṅgāni prajananakālamabhitō bhavanti; tadyathā- klamō gātrāṇāṁ, glānirānanasya,akṣṇōḥ śaithilyaṁ, vimuktabandhanatvamiva [1] vakṣasaḥ, kukṣēravasraṁsanam, adhōgurutvaṁ,vaṅkṣaṇabastikaṭīkukṣipārśvapr̥ṣṭhanistōdaḥ, yōnēḥ prasravaṇam, anannābhilāṣaścēti;tatō'nantaramāvīnāṁ prādurbhāvaḥ, prasēkaśca garbhōdakasya||36||

tasyAstu khalvimAni li~ggAni prajananakAlamabhito bhavanti; tadyathA- klamo gAtrANAM,glAnirAnanasya, akShNoH shaithilyaM, vimuktabandhanatvamiva [1] vakShasaH, kukSheravasraMsanam,adhogurutvaM, va~gkShaNabastikaTIkukShipArshvapRuShThanistodaH, yoneH prasravaNam,anannAbhilAShashceti; tato~anantaramAvInAM prAdurbhAvaH, prasekashca garbhodakasya||36||

The premonitory signs and symptoms of labor include tiredness, pallor, laxity of eyes (drooping of eyelids), feeling of getting freed from constrictions around the chest, bearing down pressure sensation in pelvis because of fetus, heaviness of lower abdomen, and pain in the groin, bladder area perineum, pelvis, belly, sides and the back, discharge from the vagina, lack of desire for food. These are typically followed by the appearance of garbhodaka (amniotic fluid) and initiation of aavee (labor pain). [36]

Commencement of aavee (labor)

आवीप्रादुर्भावे तु भूमौ शयनं विदध्यान्मृद्वास्तरणोपपन्नम्|
तदध्यासीत [२] सा|
तां ततः समन्ततः परिवार्य यथोक्तगुणाः स्त्रियः पर्युपासीरन्नाश्वासयन्त्यो वाग्भिर्ग्राहिणीयाभिः [३] सान्त्वनीयाभिश्च||३७||

āvīprādurbhāvē tu bhūmau śayanaṁ vidadhyānmr̥dvāstaraṇōpapannam|
tadadhyāsīta [2] sā|
tāṁ tataḥ samantataḥ parivārya yathōktaguṇāḥ striyaḥ paryupāsīrannāśvāsayantyō vāgbhirgrāhiṇīyābhiḥ[3] sāntvanīyābhiśca||37||

AvIprAdurbhAve tu bhUmau shayanaM vidadhyAnmRudvAstaraNopapannam|
tadadhyAsIta [2] sA|
tAM tataH samantataH parivArya yathoktaguNAH striyaH paryupAsIrannAshvAsayantyovAgbhirgrAhiNIyAbhiH [3] sAntvanIyAbhishca||37||

With the commencement of aavee, the parturient woman should be made to sit on a bed prepared with soft materials spread over the ground. Then, the female attendants with qualities mentioned in the preceding verses should surround her from all sides and encourage her by comforting words and touch. [37]

Issues with delivery despite labor pains

सा चेदावीभिः सङ्क्लिश्यमाना न प्रजायेताथैनां ब्रूयात्-उत्तिष्ठ, मुसलमन्यतरं गृहीष्व, अनेनैतदुलूखलं धान्यपूर्णंमुहुर्मुहुरभिजहि मुहुर्मुहुरवजृम्भस्व चङ्क्रमस्व चान्तराऽन्तरेति; एवमुपदिशन्त्येके|
तन्नेत्याह भगवानात्रेयः|
दारुणव्यायामवर्जनं हि गर्भिण्याः सततमुपदिश्यते, विशेषतश्च प्रजननकाले प्रचलितसर्वधातुदोषायाःसुकुमार्या नार्यामुसलव्यायामसमीरितो वायुरन्तरं लब्ध्वा प्राणान् हिंस्यात्, दुष्प्रतीकारतमा हि तस्मिन् काले विशेषेण भवति गर्भिणी;तस्मान्मुसलग्रहणं परिहार्यमृषयो मन्यन्ते, जृम्भणं चङ्क्रमणं च पुनरनुष्ठेयमिति|
अथास्यै दद्यात् कुष्ठैलालाङ्गलिकीवचाचित्रकचिरबिल्वचव्यचूर्णमुपघ्रातुं, सा तन्मुहुर्मुहुरुपजिघ्रेत्, तथा भूर्जपत्रधूमंशिंशपासारधूमं वा|
तस्याश्चान्तराऽन्तरा कटीपार्श्वपृष्ठसक्थिदेशानीषदुष्णेन तैलेनाभ्यज्यानुसुखमवमृद्नीयात् [४] |
अनेन कर्मणा गर्भोऽवाक् [५] प्रतिपद्यते||३८||

sā cēdāvībhiḥ saṅkliśyamānā na prajāyētāthaināṁ brūyāt- uttiṣṭha, musalamanyataraṁ gr̥hīṣva,anēnaitadulūkhalaṁ dhānyapūrṇaṁ muhurmuhurabhijahi muhurmuhuravajr̥mbhasva caṅkramasvacāntarā'ntarēti; ēvamupadiśantyēkē|
tannētyāha bhagavānātrēyaḥ|
dāruṇavyāyāmavarjanaṁ hi garbhiṇyāḥ satatamupadiśyatē, viśēṣataśca prajananakālēpracalitasarvadhātudōṣāyāḥ sukumāryā nāryā musalavyāyāmasamīritō vāyurantaraṁ labdhvā prāṇānhiṁsyāt, duṣpratīkāratamā hi tasmin kālē viśēṣēṇa bhavati garbhiṇī; tasmānmusalagrahaṇaṁparihāryamr̥ṣayō manyantē, jr̥mbhaṇaṁ caṅkramaṇaṁ ca punaranuṣṭhēyamiti|
athāsyai dadyāt kuṣṭhailālāṅgalikīvacācitrakacirabilvacavyacūrṇamupaghrātuṁ, sātanmuhurmuhurupajighrēt, tathā bhūrjapatradhūmaṁ śiṁśapāsāradhūmaṁ vā|
tasyāścāntarā'ntarā kaṭīpārśvapr̥ṣṭhasakthidēśānīṣaduṣṇēna tailēnābhyajyānusukhamavamr̥dnīyāt [4] |
anēna karmaṇā garbhō'vāk [5] pratipadyatē||38||

sA cedAvIbhiH sa~gklishyamAnA na prajAyetAthainAM brUyAt- uttiShTha, musalamanyataraM gRuhIShva,anenaitadulUkhalaM dhAnyapUrNaM muhurmuhurabhijahi muhurmuhuravajRumbhasva ca~gkramasvacAntarA~antareti; evamupadishantyeke|
tannetyAha bhagavAnAtreyaH|
dAruNavyAyAmavarjanaM hi garbhiNyAH satatamupadishyate, visheShatashca prajananakAlepracalitasarvadhAtudoShAyAH sukumAryA nAryA musalavyAyAmasamIrito vAyurantaraM labdhvA prANAnhiMsyAt, duShpratIkAratamA hi tasmin kAle visheSheNa bhavati garbhiNI; tasmAnmusalagrahaNaMparihAryamRuShayo manyante, jRumbhaNaM ca~gkramaNaM ca punaranuShTheyamiti|
athAsyai dadyAt kuShThailAlA~ggalikIvacAcitrakacirabilvacavyacUrNamupaghrAtuM, sAtanmuhurmuhurupajighret, tathA bhUrjapatradhUmaM shiMshapAsAradhUmaM vA|
tasyAshcAntarA~antarA kaTIpArshvapRuShThasakthideshAnIShaduShNenatailenAbhyajyAnusukhamavamRudnIyAt [4] |
anena karmaNA garbho~avAk [5] pratipadyate||38||

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]

Mantra to be recited when labor pain increases

स यदा जानीयाद्विमुच्य हृदयमुदरमस्यास्त्वाविशति, बस्तिशिरोऽवगृह्णाति, त्वरयन्त्येनामाव्यः, परिवर्ततेऽधो [६] गर्भइति; अस्यामवस्थायां पर्यङ्कमेनामारोप्य प्रवाहयितुमुपक्रमेत|
कर्णे चास्या मन्त्रमिममनुकूला स्त्री जपेत्-
‘क्षितिर्जलं वियत्तेजो वायुर्विष्णुः [७] प्रजापतिः|
सगर्भां त्वां सदा पान्तु वैशल्यं च दिशन्तु ते|
प्रसूष्व त्वमविक्लिष्टमविक्लिष्टा शुभानने!|
कार्तिकेयद्युतिं पुत्रं कार्तिकेयाभिरक्षितम्’ इति||३९||

sa yadā jānīyādvimucya hr̥dayamudaramasyāstvāviśati, bastiśirō'vagr̥hṇāti, tvarayantyēnāmāvyaḥ,parivartatē'dhō [6] garbha iti; asyāmavasthāyāṁ paryaṅkamēnāmārōpya pravāhayitumupakramēta|
karṇē cāsyā mantramimamanukūlā strī japēt-
‘kṣitirjalaṁ viyattējō vāyurviṣṇuḥ [7] prajāpatiḥ|
sagarbhāṁ tvāṁ sadā pāntu vaiśalyaṁ ca diśantu tē|
prasūṣva tvamavikliṣṭamavikliṣṭā śubhānanē!|
kārtikēyadyutiṁ putraṁ kārtikēyābhirakṣitam’ iti||39||

sa yadA jAnIyAdvimucya hRudayamudaramasyAstvAvishati, bastishiro~avagRuhNAti,tvarayantyenAmAvyaH, parivartate~adho [6] garbha iti; asyAmavasthAyAM parya~gkamenAmAropyapravAhayitumupakrameta|
karNe cAsyA mantramimamanukUlA strI japet-
‘kShitirjalaM viyattejo vAyurviShNuH [7] prajApatiH|
sagarbhAM tvAM sadA pAntu vaishalyaM ca dishantu te|
prasUShva tvamavikliShTamavikliShTA shubhAnane!|
kArtikeyadyutiM putraM kArtikeyAbhirakShitam’ iti||39||

When the feeling of fetus descending into the lower abdomen getting separated from heart (upper part) is felt by mother, and fetal head has turned which gets caught in the pelvic cavity, also the labour pain becomes more frequent. At this stage she should be made to lie down on the delivery cot and urged to bear down. One of her favourite lady attendants should recite the following mantra in her ears “May the Earth, the water, the heaven, the light, the wind, Visnu and Prajapati ever protect you and the child and may they guide the delivery. O, auspicious faced one! Bring forth, without distress to yourself or to him, a son who will possess the lustre of Kartikeya and will have the protection of Kartikeya.’’ [39]

ताश्चैनां यथोक्तगुणाः स्त्रियोऽनुशिष्युः-अनागतावीर्मा प्रवाहिष्ठाः; या ह्यनागतावीः [८] प्रवाहते व्यर्थमेवास्यास्तत् कर्मभवति, प्रजा चास्या विकृता विकृतिमापन्ना च, श्वासकासशोषप्लीहप्रसक्ता वा भवति|
यथा हि क्षवथूद्गारवातमूत्रपुरीषवेगान् प्रयतमानोऽप्यप्राप्तकालान्न लभते कृच्छ्रेण वाऽप्यवाप्नोति [९] ,तथाऽनागतकालंगर्भमपि प्रवाहमाणा; यथा चैषामेव क्षवथ्वादीनां सन्धारणमुपघातायोपपद्यते, तथा प्राप्तकालस्य गर्भस्याप्रवाहणमिति|
सा यथानिर्देशं कुरुष्वेति वक्तव्या स्यात्|
तथा च कुर्वती शनैः पूर्वं प्रवाहेत, ततोऽनन्तरं बलवत्तरम्|
तस्यां च प्रवाहमाणायां स्त्रियः शब्दं कुर्युः- ‘प्रजाता प्रजाता धन्यं धन्यं पुत्रम्’ इति|
तथाऽस्या हर्षेणाप्याय्यन्ते प्राणाः||४०||

tāścaināṁ yathōktaguṇāḥ striyō'nuśiṣyuḥ- anāgatāvīrmā pravāhiṣṭhāḥ; yā hyanāgatāvīḥ [8] pravāhatēvyarthamēvāsyāstat karma bhavati, prajā cāsyā vikr̥tā vikr̥timāpannā ca, śvāsakāsaśōṣaplīhaprasaktā vābhavati|
yathā hi kṣavathūdgāravātamūtrapurīṣavēgān prayatamānō'pyaprāptakālānna labhatē kr̥cchrēṇavā'pyavāpnōti [9] , tathā'nāgatakālaṁ garbhamapi pravāhamāṇā; yathā caiṣāmēva kṣavathvādīnāṁsandhāraṇamupaghātāyōpapadyatē, tathā prāptakālasya garbhasyāpravāhaṇamiti|
sā yathānirdēśaṁ kuruṣvēti vaktavyā syāt|
tathā ca kurvatī śanaiḥ pūrvaṁ pravāhēta, tatō'nantaraṁ balavattaram|
tasyāṁ ca pravāhamāṇāyāṁ striyaḥ śabdaṁ kuryuḥ- ‘prajātā prajātā dhanyaṁ dhanyaṁ putram’ iti|
tathā'syā harṣēṇāpyāyyantē prāṇāḥ||40||

tAshcainAM yathoktaguNAH striyo~anushiShyuH- anAgatAvIrmA pravAhiShThAH; yA hyanAgatAvIH [8]pravAhate vyarthamevAsyAstat karma bhavati, prajA cAsyA vikRutA vikRutimApannA ca,shvAsakAsashoShaplIhaprasaktA vA bhavati|
yathA hi kShavathUdgAravAtamUtrapurIShavegAn prayatamAno~apyaprAptakAlAnna labhate kRucchreNavA~apyavApnoti [9] , tathA~anAgatakAlaM garbhamapi pravAhamANA; yathA caiShAmevakShavathvAdInAM sandhAraNamupaghAtAyopapadyate, tathA prAptakAlasya garbhasyApravAhaNamiti|
sA yathAnirdeshaM kuruShveti vaktavyA syAt|
tathA ca kurvatI shanaiH pUrvaM pravAheta, tato~anantaraM balavattaram|
tasyAM ca pravAhamANAyAM striyaH shabdaM kuryuH- ‘prajAtA prajAtA dhanyaM dhanyaM putram’ iti|
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]

Procedure to remove placenta post-delivery

यदा च प्रजाता स्यात्तदैवैनामवेक्षेत- काचिदस्या अपरा प्रपन्ना न वेति|
तस्याश्चेदपरा न प्रपन्ना स्यादथैनामन्यतमा स्त्री दक्षिणेन पाणिना नाभेरुपरिष्टाद्बलवन्निपीड्य सव्येन पाणिना पृष्ठतउपसङ्गृह्य तां सुनिर्धूतं निर्धुनुयात्|
अथास्याः पार्ष्ण्या श्रोणीमाकोटयेत्|
अस्याः स्फिचावुपसङ्गृह्य सुपीडितं पीडयेत्|
अथास्या बालवेण्या कण्ठतालु परिमृशेत्|
भूर्जपत्रकाचमणिसर्पनिर्मोकैश्चास्या योनिं धूपयेत्|
कुष्ठतालीसकल्कं बल्वजयूषे [१] मैरेयसुरामण्डे तीक्ष्णे कौलत्थे व यूषे मण्डूकपर्णीपिप्पलीसम्पाके वा सम्प्लाव्य पाययेदेनाम्|
तथा सूक्ष्मैलाकिलिमकुष्ठनागर विडङ्गपिप्पलीकालागुरुचव्यचित्रकोपकुञ्चिकाकल्कं खरवृषभस्य वा जीवतो [२] दक्षिणंकर्णमुत्कृत्य दृषदि जर्जरीकृत्य बल्वजक्वाथादीनामाप्लावनानामन्यतमे [३] प्रक्षिप्याप्लाव्य मुहूर्तस्थितमुद्धृत्य तदाप्लावनंपाययेदेनाम्|
शतपुष्पाकुष्ठमदनहिङ्गुसिद्धस्य चैनां तैलस्य पिचुं ग्राहयेत्|
अतश्चैवानुवासयेत्|
एतैरेव चाप्लावनैः फलजीमूतेक्ष्वाकुधामार्गवकुटजकृतवेधनहस्तिपिप्पल्युपहितैरास्थापयेत्|
तदास्थापनमस्याः सह वातमूत्रपुरीषैर्निर्हरत्यपरामासक्तां वायोरेवाप्रतिलोमगत्वात् [४] |
अपरां हि वातमूत्रपुरीषाण्यन्यानि चान्तर्बहिर्मार्गाणि [५] सज्जन्ति||४१||

yadā ca prajātā syāttadaivaināmavēkṣēta- kācidasyā aparā prapannā na vēti|
tasyāścēdaparā na prapannā syādathaināmanyatamā strī dakṣiṇēna pāṇinānābhērupariṣṭādbalavannipīḍya savyēna pāṇinā pr̥ṣṭhata upasaṅgr̥hya tāṁ sunirdhūtaṁ nirdhunuyāt|
athāsyāḥ pārṣṇyā śrōṇīmākōṭayēt|
asyāḥ sphicāvupasaṅgr̥hya supīḍitaṁ pīḍayēt|
athāsyā bālavēṇyā kaṇṭhatālu parimr̥śēt|
bhūrjapatrakācamaṇisarpanirmōkaiścāsyā yōniṁ dhūpayēt|
kuṣṭhatālīsakalkaṁ balvajayūṣē [1] mairēyasurāmaṇḍē tīkṣṇē kaulatthē va yūṣēmaṇḍūkaparṇīpippalīsampākē vā samplāvya pāyayēdēnām| tathā sūkṣmailākilimakuṣṭhanāgara viḍaṅgapippalīkālāgurucavyacitrakōpakuñcikākalkaṁ kharavr̥ṣabhasyavā jīvatō [2] dakṣiṇaṁ karṇamutkr̥tya dr̥ṣadi jarjarīkr̥tya balvajakvāthādīnāmāplāvanānāmanyatamē [3]prakṣipyāplāvya muhūrtasthitamuddhr̥tya tadāplāvanaṁ pāyayēdēnām|
śatapuṣpākuṣṭhamadanahiṅgusiddhasya caināṁ tailasya picuṁ grāhayēt|
ataścaivānuvāsayēt|
ētairēva cāplāvanaiḥ phalajīmūtēkṣvākudhāmārgavakuṭajakr̥tavēdhanahastipippalyupahitairāsthāpayēt|
tadāsthāpanamasyāḥ saha vātamūtrapurīṣairnirharatyaparāmāsaktāṁ vāyōrēvāpratilōmagatvāt [4] |
aparāṁ hi vātamūtrapurīṣāṇyanyāni cāntarbahirmārgāṇi [5] sajjanti||41||

yadA ca prajAtA syAttadaivainAmavekSheta- kAcidasyA aparA prapannA na veti|
tasyAshcedaparA na prapannA syAdathainAmanyatamA strI dakShiNena pANinAnAbherupariShTAdbalavannipIDya savyena pANinA pRuShThata upasa~ggRuhya tAM sunirdhUtaMnirdhunuyAt|
athAsyAH pArShNyA shroNImAkoTayet|
asyAH sphicAvupasa~ggRuhya supIDitaM pIDayet|
athAsyA bAlaveNyA kaNThatAlu parimRushet|
bhUrjapatrakAcamaNisarpanirmokaishcAsyA yoniM dhUpayet|
kuShThatAlIsakalkaM balvajayUShe [1] maireyasurAmaNDe tIkShNe kaulatthe va yUShemaNDUkaparNIpippalIsampAke vA samplAvya pAyayedenAm| tathA sUkShmailAkilimakuShThanAgara viDa~ggapippalIkAlAgurucavyacitrakopaku~jcikAkalkaMkharavRuShabhasya vA jIvato [2] dakShiNaM karNamutkRutya dRuShadi jarjarIkRutyabalvajakvAthAdInAmAplAvanAnAmanyatame [3] prakShipyAplAvya muhUrtasthitamuddhRutyatadAplAvanaM pAyayedenAm|
shatapuShpAkuShThamadanahi~ggusiddhasya cainAM tailasya picuM grAhayet|
atashcaivAnuvAsayet|
etaireva cAplAvanaiHphalajImUtekShvAkudhAmArgavakuTajakRutavedhanahastipippalyupahitairAsthApayet|
tadAsthApanamasyAH saha vAtamUtrapurIShairnirharatyaparAmAsaktAM vAyorevApratilomagatvAt [4] |
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.) 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|
कृष्णकपालिकाशूर्पेण चैनमभिनिष्पुणीयुर्यद्यचेष्टः स्याद् यावत् प्राणानां प्रत्यागमनम् (तत्तत् [२] सर्वमेव कार्यम्)|
ततः प्रत्यागतप्राणं प्रकृतिभूतमभिसमीक्ष्य स्नानोदकग्रहणाभ्यामुपपादयेत्||४२||

tasyāstu khalvaparāyāḥ prapatanārthē karmaṇi kriyamāṇē jātamātrasyaiva kumārasya kāryāṇyētānikarmāṇi bhavanti; tadyathā- aśmanōḥ saṅghaṭṭanaṁ karṇayōrmūlē, śītōdakēnōṣṇōdakēna vāmukhapariṣēkaḥ [1] , tathā sa klēśavihatān prāṇān punarlabhēta|
kr̥ṣṇakapālikāśūrpēṇa cainamabhiniṣpuṇīyuryadyacēṣṭaḥ syād yāvat prāṇānāṁ pratyāgamanam (tattat [2]sarvamēva kāryam)|
tataḥ pratyāgataprāṇaṁ prakr̥tibhūtamabhisamīkṣya snānōdakagrahaṇābhyāmupapādayēt||42||

tasyAstu khalvaparAyAH prapatanArthe karmaNi kriyamANe jAtamAtrasyaiva kumArasya kAryANyetAnikarmANi bhavanti; tadyathA- ashmanoH sa~gghaTTanaM karNayormUle, shItodakenoShNodakena vAmukhapariShekaH [1] , tathA sa kleshavihatAn prANAn punarlabheta|
kRuShNakapAlikAshUrpeNa cainamabhiniShpuNIyuryadyaceShTaH syAd yAvat prANAnAMpratyAgamanam (tattat [2] sarvameva kAryam)|
tataH pratyAgataprANaM prakRutibhUtamabhisamIkShya snAnodakagrahaNAbhyAmupapAdayet||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]

Procedure for cleaning the baby after birth

अथास्य ताल्वोष्ठकण्ठजिह्वाप्रमार्जनमारभेताङ्गुल्या सुपरिलिखितनखया सुप्रक्षालितोपधानकार्पाससपिचुमत्या|
प्रथमं प्रमार्जितास्यस्य चास्य शिरस्तालु कार्पासपिचुना स्नेहगर्भेण प्रतिसञ्छादयेत्|
ततोऽस्यानन्तरं सैन्धवोपहितेन सर्पिषा कार्यं प्रच्छर्दनम्||४३||

athāsya tālvōṣṭhakaṇṭhajihvāpramārjanamārabhētāṅgulyā suparilikhitanakhayāsuprakṣālitōpadhānakārpāsasapicumatyā|
prathamaṁ pramārjitāsyasya cāsya śirastālu kārpāsapicunā snēhagarbhēṇa pratisañchādayēt|
tatō'syānantaraṁ saindhavōpahitēna sarpiṣā kāryaṁ pracchardanam||43||

athAsya tAlvoShThakaNThajihvApramArjanamArabhetA~ggulyA suparilikhitanakhayAsuprakShAlitopadhAnakArpAsasapicumatyA|
prathamaM pramArjitAsyasya cAsya shirastAlu kArpAsapicunA snehagarbheNa pratisa~jchAdayet|
tato~asyAnantaraM saindhavopahitena sarpiShA kAryaM pracchardanam||43||

Thereafter, the palate, lips, throat and tongue of the child should be cleaned with a clean cotton swab using a finger of the attendant, whose nails have been well manicured. After cleaning the mouth, a cotton swab well soaked in oil should be placed over the shirastalu (anterior fontanel) and then a procedure to provoke vomiting should be administered using ghee with saindhava (rock salt). [43]

Measuring the umbilical cord

ततः कल्पनं नाड्याः|
अतस्तस्याः कल्पनविधिमुपदेक्ष्यामः-नाभिबन्धनात् प्रभृत्यष्टाङ्गुलमभिज्ञानं कृत्वा छेदनावकाशस्य द्वयोरन्तरयोःशनैर्गृहीत्वा तीक्ष्णेन रौक्मराजतायसानां छेदनानामन्यतमेनार्धधारेण [१] छेदयेत्|
तामग्रे सूत्रेणोपनिबध्य कण्ठेऽस्य शिथिलमवसृजेत्|
तस्य चेन्नाभिः पच्येत, तां लोध्रमधुकप्रियङ्गुसुरदारुहरिद्राकल्कसिद्धेन तैलेनाभ्यज्यात्, एषामेव तैलौषधानांचूर्णेनावचूर्णयेत्|
इति नाडीकल्पनविधिरुक्तः सम्यक्||४४||

tataḥ kalpanaṁ nāḍyāḥ|
atastasyāḥ kalpanavidhimupadēkṣyāmaḥ- nābhibandhanāt prabhr̥tyaṣṭāṅgulamabhijñānaṁ kr̥tvāchēdanāvakāśasya dvayōrantarayōḥ śanairgr̥hītvā tīkṣṇēna raukmarājatāyasānāṁchēdanānāmanyatamēnārdhadhārēṇa [1] chēdayēt|
tāmagrē sūtrēṇōpanibadhya kaṇṭhē'sya śithilamavasr̥jēt|
tasya cēnnābhiḥ pacyēta, tāṁ lōdhramadhukapriyaṅgusuradāruharidrākalkasiddhēna tailēnābhyajyāt,ēṣāmēva tailauṣadhānāṁ cūrṇēnāvacūrṇayēt|
iti nāḍīkalpanavidhiruktaḥ samyak||44||

tataH kalpanaM nADyAH|
atastasyAH kalpanavidhimupadekShyAmaH- nAbhibandhanAt prabhRutyaShTA~ggulamabhij~jAnaMkRutvA chedanAvakAshasya dvayorantarayoH shanairgRuhItvA tIkShNena raukmarAjatAyasAnAMchedanAnAmanyatamenArdhadhAreNa [1] chedayet|
tAmagre sUtreNopanibadhya kaNThe~asya shithilamavasRujet|
tasya cennAbhiH pacyeta, tAM lodhramadhukapriya~ggusuradAruharidrAkalkasiddhena tailenAbhyajyAt,eShAmeva tailauShadhAnAM cUrNenAvacUrNayet|
iti nADIkalpanavidhiruktaH samyak||44||

Thereafter, the umbilical cord is measured. The cord should be marked at a distance of eight angula (thumb-length) from its base where it is attached at the navel of the child, and then holding the cord gently and firmly on both the ends, it should be cut with a sharp half-edged instrument made of gold, silver or iron (steel). The portion of the cord at the navel side should be tied with a thread and then loosely tied to the neck of the child. If the umbilicus end gets suppurated, then it should be anointed with oil prepared with paste of lodhra (Symplocos racemosa Roxb.), madhuka (Glycyrrhiza glabra Linn.), priyangu (Callicarpa macrophylla Vahl.), devadaru (Cedrus deodara Loud.) and haridra (Curcuma longa Linn.), and the powder of the same drugs should be sprinkled over the cut surface. This concludes the verse on the “measurement of the cord”. [44]

Complications arising due to improper cutting of the umbilical cord

असम्यक्कल्पने हि नाड्या आयामव्यायामोत्तुण्डिता-पिण्डलिका-विनामिका-विजृम्भिकाबाधेभ्यो भयम्|
तत्राविदाहिभिर्वातपित्तप्रशमनैरभ्यङ्गोत्सादनपरिषेकैः सर्पिर्भिश्चोपक्रमेत गुरुलाघवमभिसमीक्ष्य||४५||

asamyakkalpanē hi nāḍyā āyāmavyāyāmōttuṇḍitā-piṇḍalikā-vināmikā-vijr̥mbhikābādhēbhyō bhayam|
tatrāvidāhibhirvātapittapraśamanairabhyaṅgōtsādanapariṣēkaiḥ sarpirbhiścōpakramētagurulāghavamabhisamīkṣya||45||

asamyakkalpane hi nADyA AyAmavyAyAmottuNDitA-piNDalikA-vinAmikA-vijRumbhikAbAdhebhyo bhayam|
tatrAvidAhibhirvAtapittaprashamanairabhya~ggotsAdanapariShekaiH sarpirbhishcopakrametagurulAghavamabhisamIkShya||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 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]

Birth-rites per Vedic rituals

अतोऽनन्तरं जातकर्म कुमारस्य कार्यम्|
तद्यथा- मधुसर्पिषी मन्त्रोपमन्त्रिते यथाम्नायं प्रथमं प्राशितुं दद्यात्|
स्तनमत ऊर्ध्वमेतेनैव विधिना दक्षिणं पातुं पुरस्तात् प्रयच्छेत्|
अथातः [१] शीर्षतः स्थापयेदुदकुम्भं मन्त्रोपमन्त्रितम्||४६||

atō'nantaraṁ jātakarma kumārasya kāryam|
tadyathā- madhusarpiṣī mantrōpamantritē yathāmnāyaṁ prathamaṁ prāśituṁ dadyāt|
stanamata ūrdhvamētēnaiva vidhinā dakṣiṇaṁ pātuṁ purastāt prayacchēt|
athātaḥ [1] śīrṣataḥ sthāpayēdudakumbhaṁ mantrōpamantritam||46||

ato~anantaraM jAtakarma kumArasya kAryam|
tadyathA- madhusarpiShI mantropamantrite yathAmnAyaM prathamaM prAshituM dadyAt|
stanamata Urdhvametenaiva vidhinA dakShiNaM pAtuM purastAt prayacchet|
athAtaH [1] shIrShataH sthApayedudakumbhaM mantropamantritam||46||

Thereafter, birth-rites of the child should be performed per vedic rituals, which are as follows: first of all, honey and ghee duly “consecrated” with vedic mantras (chanted by brahmanas or priests) should be anointed to the child. Breast milk should first be fed from the right breast, and should be done so after performing the rituals mentioned above. An earthen pot filled with water should be consecrated with mantras and kept near the head of the child. [46]

Measures to protect the newborn

अथास्य रक्षां विदध्यात्- आदानीखदिरकर्कन्धुपीलुपरूषकशाखाभिरस्या गृहं समन्ततः परिवारयेत्|
सर्वतश्च सूतिकागारस्य सर्षपातसीतण्डुलकणकणिकाः प्रकिरेयुः|
तथा तण्डुलबलिहोमः सततमुभयकालं [१] क्रियेतानामकर्मणः [२] |
द्वारे च मुसलं देहलीमनु तिरश्चीनं न्यसेत्|
वचाकुष्ठक्षौमकहिङ्गुसर्षपातसीलशुनकणकणिकानां रक्षोघ्नसमाख्यातानां चौषधीनां पोट्टलिकां बद्ध्वासूतिकागारस्योत्तरदेहल्यामवसृजेत्, तथा सूतिकायाः कण्ठे सपुत्रायाः, स्थाल्युदककुम्भपर्यङ्केष्वपि, तथैव चद्वयोर्द्वारपक्षयोः|
कणककण्टकेन्धनवानग्निस्तिन्दुककाष्ठेन्धनश्चाग्निः सूतिकागारस्याभ्यन्तरतो नित्यं स्यात्|
स्त्रियश्चैनां यथोक्तगुणाः सुहृदश्चानुश्चानुजागृयुर्दशाहं द्वादशाहं वा|
अनुपरतप्रदानमङ्गलाशीःस्तुतिगीतवादित्रमन्नपानविशदमनुरक्तप्रहृष्टजनसम्पूर्णं च तद्वेश्म कार्यम्|
ब्राह्मणश्चाथर्ववेदवित् सततमुभयकालं शान्तिं जुहुयात् स्वस्त्ययनार्थं कुमारस्य तथा सूतिकायाः|
इत्येतद्रक्षाविधानमुक्तम्||४७||

athāsya rakṣāṁ vidadhyāt- ādānīkhadirakarkandhupīluparūṣakaśākhābhirasyā gr̥haṁ samantataḥparivārayēt|
sarvataśca sūtikāgārasya sarṣapātasītaṇḍulakaṇakaṇikāḥ prakirēyuḥ|
tathā taṇḍulabalihōmaḥ satatamubhayakālaṁ [1] kriyētānāmakarmaṇaḥ [2] |
dvārē ca musalaṁ dēhalīmanu tiraścīnaṁ nyasēt|
vacākuṣṭhakṣaumakahiṅgusarṣapātasīlaśunakaṇakaṇikānāṁ rakṣōghnasamākhyātānāṁ cauṣadhīnāṁpōṭṭalikāṁ baddhvā sūtikāgārasyōttaradēhalyāmavasr̥jēt, tathā sūtikāyāḥ kaṇṭhē saputrāyāḥ,sthālyudakakumbhaparyaṅkēṣvapi, tathaiva ca dvayōrdvārapakṣayōḥ|
kaṇakakaṇṭakēndhanavānagnistindukakāṣṭhēndhanaścāgniḥ sūtikāgārasyābhyantaratō nityaṁ syāt|
striyaścaināṁ yathōktaguṇāḥ suhr̥daścānuścānujāgr̥yurdaśāhaṁ dvādaśāhaṁ vā|
anuparatapradānamaṅgalāśīḥstutigītavāditramannapānaviśadamanuraktaprahr̥ṣṭajanasampūrṇaṁ catadvēśma kāryam|
brāhmaṇaścātharvavēdavit satatamubhayakālaṁ śāntiṁ juhuyāt svastyayanārthaṁ kumārasya tathāsūtikāyāḥ|
ityētadrakṣāvidhānamuktam||47||

athAsya rakShAM vidadhyAt- AdAnIkhadirakarkandhupIluparUShakashAkhAbhirasyA gRuhaM samantataHparivArayet|
sarvatashca sUtikAgArasya sarShapAtasItaNDulakaNakaNikAH prakireyuH|
tathA taNDulabalihomaH satatamubhayakAlaM [1] kriyetAnAmakarmaNaH [2] |
dvAre ca musalaM dehalImanu tirashcInaM nyaset|
vacAkuShThakShaumakahi~ggusarShapAtasIlashunakaNakaNikAnAM rakShoghnasamAkhyAtAnAMcauShadhInAM poTTalikAM baddhvA sUtikAgArasyottaradehalyAmavasRujet, tathA sUtikAyAH kaNThesaputrAyAH, sthAlyudakakumbhaparya~gkeShvapi, tathaiva ca dvayordvArapakShayoH| kaNakakaNTakendhanavAnagnistindukakAShThendhanashcAgniH sUtikAgArasyAbhyantarato nityaM syAt|
striyashcainAM yathoktaguNAH suhRudashcAnushcAnujAgRuyurdashAhaM dvAdashAhaM vA|
anuparatapradAnama~ggalAshIHstutigItavAditramannapAnavishadamanuraktaprahRuShTajanasampUrNaMca tadveshma kAryam|
brAhmaNashcAtharvavedavit satatamubhayakAlaM shAntiM juhuyAt svastyayanArthaM kumArasya tathAsUtikAyAH|
ityetadrakShAvidhAnamuktam||47||

This verse describes measures to protect the newborn. To start with, the maternity home should be surrounded by the branches of adani (-?-),khadira (Acacia catechu Willd.), karkandhu (Zyzyphus nummularia W.&A.), pilu (Salvadora persica Linn.), and parushaka (Grewiaasiatica Linn.).Sarshapa (Brassica nigra Linn - mustard seeds), atasi (Linum ustatissimum Linn.), and tandula kanakanika (pieces of broken rice) should be spread all over the floors in the maternity home. The sacrificial ritual of offering rice to fire should be performed every morning and evening till the naming ceremony for the child is complete. At the door-sill, a wooden pestle should be kept obliquely. A potli (bag) containing vacha (Acorus calamus Linn.), kushtha (Saussurea lappa C.B. Clarke.), choraka (Ksaumaka -?-), hingu (Ferula narthex Boiss.), sarshapa (Brassica nigra Koch.), atasi (Linum usitatissimum Linn.), lashuna (Alium sativum Linn.), kanakanika (-?-) and other drugs known to be repellents of evil spirits should be tied to the door-sill, and to the necks of the mother and the child , and should also be put into cooking utensils, water jars, bed, and on either side of the door panels. There should be a fire lighted constantly with the fire woods of kanakanika (-?-), and tinduka (Diospyros peregrine Gurke.) at the fireplace within the maternity home. The attending women (of the qualities mentioned earlier) should keep vigilance of the maternity home for ten to twelve days. The whole house should be kept busy with people who are pious, affectionate and happy, and kept engaged with gifts, encouraging blessings, praise, song, music food and drinks. In order to bestow auspicious blessings on the mother and the child, brahmins well versed in Atharva Veda should perform ritual sacrifices in the sacred fire two times a day. These are, rituals and measures that need to be put in place to protect the mother and the child. [47]

Post-partum care of the mother

सूतिकां तु खलु बुभुक्षितां विदित्वा स्नेहं पाययेत परमया शक्त्या सर्पिस्तैलं वसां मज्जानं वा सात्म्यीभावमभिसमीक्ष्यपिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरचूर्णसहितम्|
स्नेहं पीतवत्याश्च सर्पिस्तैलाभ्यामभ्यज्य वेष्टयेदुदरं महताऽच्छेन वाससा; तथा तस्या न वायुरुदरेविकृतिमुत्पादयत्यनवकाशत्वात्|
जीर्णे तु स्नेहे पिप्पल्यादिभिरेव सिद्धां यवागूं सुस्निग्धां द्रवां मात्रशः [१] पाययेत्|
उभयतःकालं चोष्णोदकेन च परिषेचयेत् प्राक् स्नेहयवागूपानाभ्याम्|
एवं पञ्चरात्रं सप्तरात्रं वाऽनुपाल्य क्रमेणाप्याययेत्|
स्वस्थवृत्तमेतावत् सूतिकायाः||४८||

sūtikāṁ tu khalu bubhukṣitāṁ viditvā snēhaṁ pāyayēta paramayā śaktyā sarpistailaṁ vasāṁ majjānaṁ vāsātmyībhāvamabhisamīkṣya pippalīpippalīmūlacavyacitrakaśr̥ṅgavēracūrṇasahitam|
snēhaṁ pītavatyāśca sarpistailābhyāmabhyajya vēṣṭayēdudaraṁ mahatā'cchēna vāsasā; tathā tasyā navāyurudarē vikr̥timutpādayatyanavakāśatvāt|
jīrṇē tu snēhē pippalyādibhirēva siddhāṁ yavāgūṁ susnigdhāṁ dravāṁ mātraśaḥ [1] pāyayēt|
ubhayataḥkālaṁ cōṣṇōdakēna ca pariṣēcayēt prāk snēhayavāgūpānābhyām|
ēvaṁ pañcarātraṁ saptarātraṁ vā'nupālya kramēṇāpyāyayēt|
svasthavr̥ttamētāvat sūtikāyāḥ||48||

sUtikAM tu khalu bubhukShitAM viditvA snehaM pAyayeta paramayA shaktyA sarpistailaM vasAM majjAnaMvA sAtmyIbhAvamabhisamIkShya pippalIpippalImUlacavyacitrakashRu~ggaveracUrNasahitam|
snehaM pItavatyAshca sarpistailAbhyAmabhyajya veShTayedudaraM mahatA~acchena vAsasA; tathAtasyA na vAyurudare vikRutimutpAdayatyanavakAshatvAt|
jIrNe tu snehe pippalyAdibhireva siddhAM yavAgUM susnigdhAM dravAM mAtrashaH [1] pAyayet|
ubhayataHkAlaM coShNodakena ca pariShecayet prAk snehayavAgUpAnAbhyAm|
evaM pa~jcarAtraM saptarAtraM vA~anupAlya krameNApyAyayet|
svasthavRuttametAvat sUtikAyAH||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]

तस्यास्तु खलु यो व्याधिरुत्पद्यते स कृच्छ्रसाध्यो भवत्यसाध्यो वा,
गर्भवृद्धिक्षयितशिथिलसर्वधातुत्वात्,प्रवाहणवेदनाक्लेदनरक्तनिःस्रुतिविशेषशून्यशरीरत्वाच्च; तस्मात्तां यथोक्तेन विधिनोपचरेत्;भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धैरभ्यङ्गोत्सादनपरिषेकावगाहनान्नपानविधिभिर्विशेषतश्चोपचरेत्; विशेषतो हिशून्यशरीराः स्त्रियः प्रजाता भवन्ति||४९||

tasyāstu khalu yō vyādhirutpadyatē sa kr̥cchrasādhyō bhavatyasādhyō vā,
garbhavr̥ddhikṣayitaśithilasarvadhātutvāt,pravāhaṇavēdanāklēdanaraktaniḥsrutiviśēṣaśūnyaśarīratvācca; tasmāttāṁ yathōktēna vidhinōpacarēt;bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhairabhyaṅgōtsādanapariṣēkāvagāhanānnapānavidhibhirviśēṣataścōpacarēt;viśēṣatō hi śūnyaśarīrāḥ striyaḥ prajātā bhavanti||49||

tasyAstu khalu yo vyAdhirutpadyate sa kRucchrasAdhyo bhavatyasAdhyo vA,
garbhavRuddhikShayitashithilasarvadhAtutvAt,pravAhaNavedanAkledanaraktaniHsrutivisheShashUnyasharIratvAcca; tasmAttAM yathoktena vidhinopacaret;bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhairabhya~ggotsAdanapariShekAvagAhanAnnapAnavidhibhirvisheShatashcopacaret;visheShato hi shUnyasharIrAH striyaH prajAtA bhavanti||49||

If the mother is afflicted with any disease at this puerperal stage, then the condition becomes either difficult to cure or incurable because her body has suffered throughout pregnancy and parturition; because of providing nourishment for growth and development of fetus as well as discharges of blood and kleda during parturition she is vulnerable to doshic afflictions and various diseases.It is therefore important for a weak mother, or a mother afflicted with sickness to be specifically treated with massages, oil anointments, warm baths, food and drink prepared with drugs that are bhautika (alleviators of evil spirits), and of jivaniya, brimhaniya, madhura and vatahar classes of medications. [49]

दशमे त्वहनि [१] सपुत्रा स्त्री सर्वगन्धौषधैर्गौरसर्षपलोध्रैश्च स्नाता लघ्वहतशुचिवस्त्रं परिधाय [२] पवित्रेष्टलघुविचित्रभूषणवतीच संस्पृश्य मङ्गलान्युचितामर्चयित्वा च देवतां शिखिनः शुक्लवाससोऽव्यङ्गांश्च ब्राह्मणान् स्वस्ति वाचयित्वाकुमारमहतानां [३] च वाससां सञ्चये प्राक्शिरसमुदक्शिरसं वा संवेश्य देवतापूर्वं द्विजातिभ्यः प्रणमतीत्युक्त्वा कुमारस्य पिताद्वे नामनी कारयेन्नाक्षत्रिकं नामाभिप्रायिकं च|
तत्राभिप्रायिकं घोषवदाद्यन्तस्थान्तमूष्मान्तं वाऽवृद्धं [४] त्रिपुरुषानूकमनवप्रतिष्ठितं, नाक्षात्रिकं तु नक्षत्रदेवतासमानाख्यं [५]द्व्यक्षरं चतुरक्षरं वा||५०||

daśamē tvaha ni [1] saputrā strī sarvagandhauṣadhairgaurasarṣapalōdhraiśca snātā laghvahataśucivastraṁparidhāya [2] pavitrēṣṭalaghuvicitrabhūṣaṇavatī ca saṁspr̥śya maṅgalānyucitāmarcayitvā ca dēvatāṁśikhinaḥ śuklavāsasō'vyaṅgāṁśca brāhmaṇān svasti vācayitvā kumāramahatānāṁ [3] ca vāsasāṁ sañcayēprākśirasamudakśirasaṁ vā saṁvēśya dēvatāpūrvaṁ dvijātibhyaḥ praṇamatītyuktvā kumārasya pitā dvēnāmanī kārayēnnākṣatrikaṁ nāmābhiprāyikaṁ ca|
tatrābhiprāyikaṁ ghōṣavadādyantasthāntamūṣmāntaṁ vā'vr̥ddhaṁ [4] tripuruṣānūkamanavapratiṣṭhitaṁ,nākṣātrikaṁ tu nakṣatradēvatāsamānākhyaṁ [5] dvyakṣaraṁ caturakṣaraṁ vā||50||

dashame tvahani [1] saputrA strI sarvagandhauShadhairgaurasarShapalodhraishca snAtAlaghvahatashucivastraM paridhAya [2] pavitreShTalaghuvicitrabhUShaNavatI ca saMspRushyama~ggalAnyucitAmarcayitvA ca devatAM shikhinaH shuklavAsaso~avya~ggAMshca brAhmaNAn svastivAcayitvA kumAramahatAnAM [3] ca vAsasAM sa~jcaye prAkshirasamudakshirasaM vA saMveshyadevatApUrvaM dvijAtibhyaH praNamatItyuktvA kumArasya pitA dve nAmanI kArayennAkShatrikaMnAmAbhiprAyikaM ca|
tatrAbhiprAyikaM ghoShavadAdyantasthAntamUShmAntaM vA~avRuddhaM [4]tripuruShAnUkamanavapratiShThitaM, nAkShAtrikaM tu nakShatradevatAsamAnAkhyaM [5] dvyakSharaMcaturakSharaM vA||50||

On the tenth day of delivery, the woman, along with her child, should take bath in water treated with fragrant herbs, shveta sarshapa (white variety of mustard – Brassica nigra Koch.) and lodhra (Symplocos recemosa Roxb.). They should be dressed in light, new and clean garments, while the woman should also be adorned in pure, light and variegated ornaments. The garments and ornaments should have been consecrated using Vedic rituals, and blessed by priests wearing white garments and without any physical deformities. Then the child, having been wrapped in a new garment, should be placed with his head facing the east or the north. The father of the child should pay obeisance to the Gods and Brahmins on behalf of the child and then give it two names: one denoting the nakshatra under which it was born and the other intended for social interactions. The name for social purpose should have a Ghosha (sonant) for its first letter and for its last a Antastha (semi-vowel) or usman (sibilants and aspirate), should be free of Vriddhi(diphthongs), indicative of one of the three ancestors (father, grandfather and great grandfather) and not a new created The constellar name should be identical to that of the diety of the nakshatra and should be made up of two or four (Sanskrit) syllables. [50]

Assessment of life-span of the baby

वृत्ते [१] च नामकर्मणि कुमारं परीक्षितुमुपक्रमेतायुषः प्रमाणज्ञानहेतोः|
तत्रेमान्यायुष्मतां कुमाराणां लक्षणानि भवन्ति|
तद्यथा- एकैकजा मृदवोऽल्पाः स्निग्धाः सुबद्धमूलाः कृष्णाः केशाः प्रशस्यन्ते, स्थिरा बहला त्वक्,प्रकृत्याऽतिसम्पन्नमीषत्प्रमाणातिवृत्तमनुरूपमातपत्रोपमं [२] शिरः, व्यूढं दृढं समंसुश्लिष्टशङ्खसन्ध्यूर्ध्वव्यञ्जनसम्पन्नमुपचितं वलिभमर्धचन्द्राकृति ललाटं, बहलौ विपुलसमपीठौ समौ नीचैर्वृद्धौपृष्ठतोऽवनतौ सुश्लिष्टकर्णपुत्रकौ महाच्छिद्रौ कर्णौ, ईषत्प्रलम्बिन्यावसङ्गते समे संहते महत्यौ भ्रुवौ, समे समाहितदर्शनेव्यक्तभागविभागे बलवती तेजसोपपन्ने स्वङ्गापाङ्गे चक्षुषी, ऋज्वी महोच्छ्वासा वंशसम्पन्नेषदवनताग्रा नासिका,महदृजुसुनिविष्टदन्तमास्यम्, आयामविस्तारोपपन्ना श्लक्ष्णा तन्वी प्रकृतिवर्णयुक्ता [३] जिह्वा, श्लक्ष्णंयुक्तोपचयमूष्मोपपन्नं रक्तं तालु, महानदीनः स्निग्धोऽनुनादी गम्भीरसमुत्थो धीरः स्वरः, नातिस्थूलौ नातिकृशौविस्तारोपपन्नावास्यप्रच्छादनौ रक्तावोष्ठौ, महत्यौ हनू, वृत्ता नातिमहती ग्रीवा, व्यूढमुपचितमुरः, गूढं जत्रु पृष्ठवंशश्च,विप्रकृष्टान्तरौ स्तनौ, असम्पातिनी स्थिरे पार्श्वे, वृत्तपरिपूर्णायतौ बाहू सक्थिनी अङ्गुलयश्च, महदुपचितं पाणिपादं, स्थिरावृत्ताः स्निग्धास्ताम्रास्तुङ्गाः कूर्माकाराः करजाः, प्रदक्षिणावर्ता सोत्सङ्गा च नाभिः, उरस्त्रिभागहीना समा समुपचितमांसाकटी, वृत्तौ स्थिरोपचितमांसौ नात्युन्नतौ नात्यवनतौ स्फिचौ, अनुपूर्वं वृत्तावुपचययुक्तावूरू, नात्युपचिते नात्यपचिते एणीपदेप्रगूढसिरास्थिसन्धी जङ्घे, नात्युपचितौ नात्यपचितौ गुल्फौ, पूर्वोपदिष्टगुणौ पादौ कूर्माकारौ, प्रकृतियुक्तानिवातमूत्रपुरीषगुह्यानि तथा स्वप्रजागरणायासस्मितरुदितस्तनग्रहणानि, यच्च किञ्चिदन्यदप्यनुक्तमस्ति तदपि सर्वंप्रकृतिसम्पन्नमिष्टं, विपरीतं पुनरनिष्टम्|
इति दीर्घायुर्लक्षणानि||५१||

vr̥ttē [1] ca nāmakarmaṇi kumāraṁ parīkṣitumupakramētāyuṣaḥ pramāṇajñānahētōḥ|
tatrēmānyāyuṣmatāṁ kumārāṇāṁ lakṣaṇāni bhavanti|
tadyathā- ēkaikajā mr̥davō'lpāḥ snigdhāḥ subaddhamūlāḥ kr̥ṣṇāḥ kēśāḥ praśasyantē, sthirā bahalā tvak,prakr̥tyā'tisampannamīṣatpramāṇātivr̥ttamanurūpamātapatrōpamaṁ [2] śiraḥ, vyūḍhaṁ dr̥ḍhaṁ samaṁsuśliṣṭaśaṅkhasandhyūrdhvavyañjanasampannamupacitaṁ valibhamardhacandrākr̥ti lalāṭaṁ, bahalauvipulasamapīṭhau samau nīcairvr̥ddhau pr̥ṣṭhatō'vanatau suśliṣṭakarṇaputrakau mahācchidrau karṇau,īṣatpralambinyāvasaṅgatē samē saṁhatē mahatyau bhruvau, samē samāhitadarśanē vyaktabhāgavibhāgēbalavatī tējasōpapannē svaṅgāpāṅgē cakṣuṣī, r̥jvī mahōcchvāsā vaṁśasampannēṣadavanatāgrā nāsikā,mahadr̥jusuniviṣṭadantamāsyam, āyāmavistārōpapannā ślakṣṇā tanvī prakr̥tivarṇayuktā [3] jihvā, ślakṣṇaṁyuktōpacayamūṣmōpapannaṁ raktaṁ tālu, mahānadīnaḥ snigdhō'nunādī gambhīrasamutthō dhīraḥsvaraḥ, nātisthūlau nātikr̥śau vistārōpapannāvāsyapracchādanau raktāvōṣṭhau, mahatyau hanū, vr̥ttānātimahatī grīvā, vyūḍhamupacitamuraḥ, gūḍhaṁ jatru pr̥ṣṭhavaṁśaśca, viprakr̥ṣṭāntarau stanau,asampātinī sthirē pārśvē, vr̥ttaparipūrṇāyatau bāhū sakthinī aṅgulayaśca, mahadupacitaṁ pāṇipādaṁ,sthirā vr̥ttāḥ snigdhāstāmrāstuṅgāḥ kūrmākārāḥ karajāḥ, pradakṣiṇāvartā sōtsaṅgā ca nābhiḥ,urastribhāgahīnā samā samupacitamāṁsā kaṭī, vr̥ttau sthirōpacitamāṁsau nātyunnatau nātyavanatausphicau, anupūrvaṁ vr̥ttāvupacayayuktāvūrū, nātyupacitē nātyapacitē ēṇīpadē pragūḍhasirāsthisandhījaṅghē, nātyupacitau nātyapacitau gulphau, pūrvōpadiṣṭaguṇau pādau kūrmākārau, prakr̥tiyuktānivātamūtrapurīṣaguhyāni tathā svaprajāgaraṇāyāsasmitaruditastanagrahaṇāni, yaccakiñcidanyadapyanuktamasti tadapi sarvaṁ prakr̥tisampannamiṣṭaṁ, viparītaṁ punaraniṣṭam|
iti dīrghāyurlakṣaṇāni||51||

vRutte [1] ca nAmakarmaNi kumAraM parIkShitumupakrametAyuShaH pramANaj~jAnahetoH|
tatremAnyAyuShmatAM kumArANAM lakShaNAni bhavanti|
tadyathA- ekaikajA mRudavo~alpAH snigdhAH subaddhamUlAH kRuShNAH keshAH prashasyante, sthirAbahalA tvak, prakRutyA~atisampannamIShatpramANAtivRuttamanurUpamAtapatropamaM [2] shiraH,vyUDhaM dRuDhaM samaM sushliShTasha~gkhasandhyUrdhvavya~jjanasampannamupacitaMvalibhamardhacandrAkRuti lalATaM, bahalau vipulasamapIThau samau nIcairvRuddhaupRuShThato~avanatau sushliShTakarNaputrakau mahAcchidrau karNau, IShatpralambinyAvasa~ggatesame saMhate mahatyau bhruvau, same samAhitadarshane vyaktabhAgavibhAge balavatI tejasopapannesva~ggApA~gge cakShuShI, RujvI mahocchvAsA vaMshasampanneShadavanatAgrA nAsikA,mahadRujusuniviShTadantamAsyam, AyAmavistAropapannA shlakShNA tanvI prakRutivarNayuktA [3] jihvA,shlakShNaM yuktopacayamUShmopapannaM raktaM tAlu, mahAnadInaH snigdho~anunAdIgambhIrasamuttho dhIraH svaraH, nAtisthUlau nAtikRushau vistAropapannAvAsyapracchAdanauraktAvoShThau, mahatyau hanU, vRuttA nAtimahatI grIvA, vyUDhamupacitamuraH, gUDhaM jatrupRuShThavaMshashca, viprakRuShTAntarau stanau, asampAtinI sthire pArshve, vRuttaparipUrNAyataubAhU sakthinI a~ggulayashca, mahadupacitaM pANipAdaM, sthirA vRuttAH snigdhAstAmrAstu~ggAHkUrmAkArAH karajAH, pradakShiNAvartA sotsa~ggA ca nAbhiH, urastribhAgahInA samAsamupacitamAMsA kaTI, vRuttau sthiropacitamAMsau nAtyunnatau nAtyavanatau sphicau, anupUrvaMvRuttAvupacayayuktAvUrU, nAtyupacite nAtyapacite eNIpade pragUDhasirAsthisandhI ja~gghe,nAtyupacitau nAtyapacitau gulphau, pUrvopadiShTaguNau pAdau kUrmAkArau, prakRutiyuktAnivAtamUtrapurIShaguhyAni tathA svaprajAgaraNAyAsasmitaruditastanagrahaNAni, yaccaki~jcidanyadapyanuktamasti tadapi sarvaM prakRutisampannamiShTaM, viparItaM punaraniShTam|
iti dIrghAyurlakShaNAni||51||

Once the naming ceremony is over, the life-span of the child is assessed by the priests. The children that live long, according to this verse, have discrete, soft, sparse, oily, firm-rooted and black hair, firm and thick skin, naturally well-endowed, slightly bigger in size, umbrella-like head; broad, firm, even, united well with the temporal bone, endowed with three transverse lines, plump, having wrinkles and half moon-shaped forehead; thick, large, symmetrical ears with even flaps, equal elongated and downwardly depressed at the back, having compact tragus and big meatus; eyebrows that are slightly hanging downwards, disjoined (i.e., separate brows and not a uni-brow), even, compact and large; symmetrical eyes that have sharp vision, have beautiful shape (when viewed from the front and the sides); straight nose, with large nostrils, well ridged and slightly depressed at the tip; mouth big and straight, with good gums (and when the child grows up, a healthy set of teeth); tongue of sufficient length and breadth, smooth in texture and of normal colour; palate smooth, well developed, hot and red; voice sweet, echoing, and tempered; reddish lips that are neither too thick nor thin; large jaws; round, but not very long (or craning) or thick neck; broad and well developed chest; hidden xiphisternum and vertebral column; unbending and stable sides; arms, legs and fingers that are round, developed and long; hands and feet that are big and developed; unafflicted nails, round, unctuous, coppery, high and tortoise shaped; navel that is whirled clockwise and deep; waist 1/3rd less than chest (in breadth), even, having well developed muscles; buttocks round, not too elevated, with firm and developed muscles; thighs tapering downwards, round and well developed; shanks neither too stout nor too thin, but resembling that of deer’s foot, with hidden blood vessels, bones and joints; ankles neither too broad nor too thin; feet possessing the above features and tortoise shaped; and normal functions associated with passing bodily wastes, sexual organs, sleep, abilities to express emotions by smiling, weeping, and appetite through suckling. Other aspects of the child’s body or bodily functions, if with normal features, are desirable. This sums up the verse on physical features used to assess the longevity of the newborn. [51]

Qualities of the wet-nurse attending the newborn

अतो धात्रीपरीक्षामुपदेक्ष्यामः|
अथ ब्रूयात्-धात्रीमानय समानवर्णां यौवनस्थां निभृतामनातुरामव्यङ्गामव्यसनामविरूपामजुगुप्सितां [१]देशजातीयामक्षुद्रामक्षुद्रकर्मिणीं कुले जातां वत्सलामरोगां जीवद्वत्सां पुंवत्सांदोग्ध्रीमप्रमत्तामनुच्चारशायिनीमनन्त्यावसायिनीं कुशलोपचारां शुचिमशुचिद्वेषिणीं स्तनस्तन्यसम्पदुपेतामिति||५२||

atō dhātrīparīkṣāmupadēkṣyāmaḥ|
atha brūyāt- dhātrīmānaya samānavarṇāṁ yauvanasthāṁnibhr̥tāmanāturāmavyaṅgāmavyasanāmavirūpāmajugupsitāṁ [1] dēśajātīyāmakṣudrāmakṣudrakarmiṇīṁkulē jātāṁ vatsalāmarōgāṁ jīvadvatsāṁ puṁvatsāṁdōgdhrīmapramattāmanuccāraśāyinīmanantyāvasāyinīṁ kuśalōpacārāṁ śucimaśucidvēṣiṇīṁstanastanyasampadupētāmiti||52||

ato dhAtrIparIkShAmupadekShyAmaH|
atha brUyAtdhAtrImAnaya samAnavarNAM yauvanasthAMnibhRutAmanAturAmavya~ggAmavyasanAmavirUpAmajugupsitAM [1]deshajAtIyAmakShudrAmakShudrakarmiNIM kule jAtAM vatsalAmarogAM jIvadvatsAM puMvatsAMdogdhrImapramattAmanuccArashAyinImanantyAvasAyinIM kushalopacArAM shucimashucidveShiNIMstanastanyasampadupetAmiti||52||

This verse describes the qualities of the wet nurse attending the baby. The attending physician should ask of the parents to hire a wet nurse who belongs to the same caste as the child’s mother, who is in her youth, is submissive, free from diseases, not deficient in any limb, not given to unwholesome pursuits, not ugly, not ill- disposed, is native to the country, is not mean or does not indulge in mean acts, affectionate towards children, whose children have not died, who is a mother to a male child, who is never careless, not sleeping in beds soiled with excrement, not married to man of lower caste, skillful in attendance, hygienic and is endowed with plenty of milk in her breasts. [52]

Qualities of an ideal breast

तत्रेयं स्तनसम्पत्- नात्यूर्ध्वौ नातिलम्बावनतिकृशावनतिपीनौ युक्तपिप्पलकौ सुखप्रपानौ चेति (स्तनसम्पत्)||५३||

tatrēyaṁ stanasampat- nātyūrdhvau nātilambāvanatikr̥śāvanatipīnau yuktapippalakau sukhaprapānau cēti(stanasampat)||53||

tatreyaM stanasampat- nAtyUrdhvau nAtilambAvanatikRushAvanatipInau yuktapippalakau sukhaprapAnauceti (stanasampat)||53||

These are the features of ideal breasts: they should be neither be very high nor very loose and sagging, neither very lean nor massive. They should have proportionate nipples and be easy to suck. [53]

Qualities of the ideal breastmilk

स्तन्यसम्पत्तु प्रकृतिवर्णगन्धरसस्पर्शम्, उदपात्रे च दुह्यमानमुदकं व्येति प्रकृतिभूतत्वात्; तत् पुष्टिकरमारोग्यकरं चेति(स्तन्यसम्पत्)||५४||

stanyasampattu prakr̥tivarṇagandharasasparśam, udapātrē ca duhyamānamudakaṁ vyētiprakr̥tibhūtatvāt; tat puṣṭikaramārōgyakaraṁ cēti (stanyasampat)||54||

stanyasampattu prakRutivarNagandharasasparsham, udapAtre ca duhyamAnamudakaM vyetiprakRutibhUtatvAt; tat puShTikaramArogyakaraM ceti (stanyasampat)||54||

Ideal breast milk for the baby has properties such as natural color, smell, taste and touch and when poured into a pot of water, it should mix at once perfectly with the water. Such milk is nourishing and health giving to the child. [54]

अतोऽन्यथा व्यापन्नं ज्ञेयम्|
तस्य विशेषाः श्यावारुणवर्णं कषायानुरसं विशदमनालक्ष्यगन्धं रूक्षं द्रवं फेनिलं लघ्वतृप्तिकरं कर्शनं वातविकाराणां कर्तृवातोपसृष्टं क्षीरमभिज्ञेयं [१] ; कृष्णनीलपीतताम्रावभासं तिक्ताम्लकटुकानुरसं कुणपरुधिरगन्धि भृशोष्णं पित्तविकाराणां कर्तृच पित्तोपसृष्टं क्षीरमभिज्ञेयम्, अत्यर्थशुक्लमतिमाधुर्योपपन्नं लवणानुरसं घृततैलवसामज्जगन्धि पिच्छिलंतन्तुमदुकपात्रेऽवसीदछ्लेष्मविकाराणां कर्तृ श्लेष्मोपसृष्टं क्षीरमभिज्ञेयम्||५५||

atō'nyathā vyāpannaṁ jñēyam|
tasya viśēṣāḥ- śyāvāruṇavarṇaṁ kaṣāyānurasaṁ viśadamanālakṣyagandhaṁ rūkṣaṁ dravaṁ phēnilaṁlaghvatr̥ptikaraṁ karśanaṁ vātavikārāṇāṁ kartr̥ vātōpasr̥ṣṭaṁ kṣīramabhijñēyaṁ [1] ;kr̥ṣṇanīlapītatāmrāvabhāsaṁ tiktāmlakaṭukānurasaṁ kuṇaparudhiragandhi bhr̥śōṣṇaṁ pittavikārāṇāṁkartr̥ ca pittōpasr̥ṣṭaṁ kṣīramabhijñēyam, atyarthaśuklamatimādhuryōpapannaṁ lavaṇānurasaṁghr̥tatailavasāmajjagandhi picchilaṁ tantumadukapātrē'vasīdachlēṣmavikārāṇāṁ kartr̥ ślēṣmōpasr̥ṣṭaṁkṣīramabhijñēyam||55||

ato~anyathA vyApannaM j~jeyam|
tasya visheShAH- shyAvAruNavarNaM kaShAyAnurasaM vishadamanAlakShyagandhaM rUkShaM dravaMphenilaM laghvatRuptikaraM karshanaM vAtavikArANAM kartRu vAtopasRuShTaM kShIramabhij~jeyaM [1] ;kRuShNanIlapItatAmrAvabhAsaM tiktAmlakaTukAnurasaM kuNaparudhiragandhi bhRushoShNaMpittavikArANAM kartRu ca pittopasRuShTaM kShIramabhij~jeyam, atyarthashuklamatimAdhuryopapannaMlavaNAnurasaM ghRutatailavasAmajjagandhi picchilaM tantumadukapAtre~avasIdachleShmavikArANAMkartRu shleShmopasRuShTaM kShIramabhij~jeyam||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]

तेषां तु त्रयाणामपि क्षीरदोषाणां प्रतिविशेषमभिसमीक्ष्य यथास्वं यथादोषं च वमनविरेचनास्थापनानुवासनानि विभज्य कृतानिप्रशमनाय भवन्ति|
पानाशनविधिस्तु दुष्टक्षीराया यवगोधूमशालिषष्टिकमुद्गहरेणुककुलत्थसुरासौवीरकमैरेयमेदकलशुनकरञ्जप्रायः स्यात्|
क्षीरदोषविशेषांश्चावेक्ष्यावेक्ष्य तत्तद्विधानं कार्यं स्यात्|
पाठामहौषधसुरदारुमुस्तमूर्वागुडूचीवत्सकफलकिराततिक्तककटुकरोहिणीसारिवाकषायाणां च पानं प्रशस्यते, तथाऽन्येषांतिक्तकषायकटुकमधुराणां [१] द्रव्याणां प्रयोगः क्षीरविकारविशेषानभिसमीक्ष्य मात्रां कालं च|
इति क्षीरविशोधनानि||५६||

tēṣāṁ tu trayāṇāmapi kṣīradōṣāṇāṁ prativiśēṣamabhisamīkṣya yathāsvaṁ yathādōṣaṁ cavamanavirēcanāsthāpanānuvāsanāni vibhajya kr̥tāni praśamanāya bhavanti|
pānāśanavidhistu duṣṭakṣīrāyāyavagōdhūmaśāliṣaṣṭikamudgaharēṇukakulatthasurāsauvīrakamairēyamēdakalaśunakarañjaprāyaḥ syāt|
kṣīradōṣaviśēṣāṁścāvēkṣyāvēkṣya tattadvidhānaṁ kāryaṁ syāt|
pāṭhāmahauṣadhasuradārumustamūrvāguḍūcīvatsakaphalakirātatiktakakaṭukarōhiṇīsārivākaṣāyāṇāṁ capānaṁ praśasyatē, tathā'nyēṣāṁ tiktakaṣāyakaṭukamadhurāṇāṁ [1] dravyāṇāṁ prayōgaḥkṣīravikāraviśēṣānabhisamīkṣya mātrāṁ kālaṁ ca|
iti kṣīraviśōdhanāni||56||

teShAM tu trayANAmapi kShIradoShANAM prativisheShamabhisamIkShya yathAsvaM yathAdoShaM cavamanavirecanAsthApanAnuvAsanAni vibhajya kRutAni prashamanAya bhavanti|
pAnAshanavidhistu duShTakShIrAyAyavagodhUmashAliShaShTikamudgahareNukakulatthasurAsauvIrakamaireyamedakalashunakara~jjaprAyaHsyAt|
kShIradoShavisheShAMshcAvekShyAvekShya tattadvidhAnaM kAryaM syAt|
pAThAmahauShadhasuradArumustamUrvAguDUcIvatsakaphalakirAtatiktakakaTukarohiNIsArivAkaShAyANAMca pAnaM prashasyate, tathA~anyeShAM tiktakaShAyakaTukamadhurANAM [1] dravyANAM prayogaHkShIravikAravisheShAnabhisamIkShya mAtrAM kAlaM ca|
iti kShIravishodhanAni||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]

Lactation-stimulants (or galactogogues)

क्षीरजननानि तु मद्यानि सीधुवर्ज्यानि, ग्राम्यानूपौदकानि च शाकधान्यमांसानि, द्रवमधुराम्ललवणभूयिष्ठाश्चाहाराः,क्षीरिण्यश्चौषधयः, क्षीरपानमनायासश्च, वीरणषष्टिकशालीक्षुवालिकादर्भकुशकाशगुन्द्रेत्कटमूलकषायाणां च पानमिति(क्षीरजननानि)||५७||

kṣīrajananāni tu madyāni sīdhuvarjyāni, grāmyānūpaudakāni ca śākadhānyamāṁsāni,dravamadhurāmlalavaṇabhūyiṣṭhāścāhārāḥ, kṣīriṇyaścauṣadhayaḥ, kṣīrapānamanāyāsaśca,vīraṇaṣaṣṭikaśālīkṣuvālikādarbhakuśakāśagundrētkaṭamūlakaṣāyāṇāṁ ca pānamiti (kṣīrajananāni)||57||

kShIrajananAni tu madyAni sIdhuvarjyAni, grAmyAnUpaudakAni ca shAkadhAnyamAMsAni,dravamadhurAmlalavaNabhUyiShThAshcAhArAH, kShIriNyashcauShadhayaH, kShIrapAnamanAyAsashca,vIraNaShaShTikashAlIkShuvAlikAdarbhakushakAshagundretkaTamUlakaShAyANAM ca pAnamiti(kShIrajananAni)||57||

Galactogogues (lactation-stimulants) include the following food articles and habits: all wines with the exception of sidhu, vegetables, cereals and meat of domestic, marshy and aquatic origins; food articles and liquids that have predominantly sweet, sour or salty taste; herbs containing milky juices; cow’s milk; avoidance of laborious tasks, and; drinking of the decoctions of roots of virana (Vetiveria zizanoides Nash.), shashtika (a variety of shali – Oryza sativa Linn.), shali (Oryza sativa Linn.), ikshuvalika (Astercantha longifolia Nees.), darbha (Desmostachya bipinnata Stapf), kusha (Desmostachya bipinnata Stapf), kasha (Saccharum spontaneum Linn.), gundra (Saccharum sara)and Itkata (-?-)(are galactogogues). [57]

Procedure to be followed by the wet-nurse in order to feed the baby

धात्री तु यदा स्वादुबहुलशुद्धदुग्धा स्यात्तदास्नातानुलिप्ता शुक्लवस्त्रं परिधायैन्द्रीं ब्राह्मीं शतवीर्यां सहस्रवीर्याममोघामव्यथांशिवामरिष्टां वाट्यपुष्पीं विष्वक्सेनकान्तां [१] वा बिभ्रत्योषधिं कुमारं प्राङ्मुखंप्रथमं दक्षिणं स्तनं पाययेत्|
इति धात्रीकर्म||५८||

dhātrī tu yadā svādubahulaśuddhadugdhā syāttadāsnātānuliptā śuklavastraṁ paridhāyaindrīṁ brāhmīṁśatavīryāṁ sahasravīryāmamōghāmavyathāṁ śivāmariṣṭāṁ vāṭyapuṣpīṁ viṣvaksēnakāntāṁ [1] vābibhratyōṣadhiṁ kumāraṁ prāṅmukhaṁ prathamaṁ dakṣiṇaṁ stanaṁ pāyayēt|
iti dhātrīkarma||58||

dhAtrI tu yadA svAdubahulashuddhadugdhA syAttadAsnAtAnuliptA shuklavastraM paridhAyaindrIMbrAhmIM shatavIryAM sahasravIryAmamoghAmavyathAM shivAmariShTAM vATyapuShpIMviShvaksenakAntAM [1] vA bibhratyoShadhiM kumAraM prA~gmukhaM prathamaM dakShiNaM stanaMpAyayet|
iti dhAtrIkarma||58||

When the wet nurse, having sweet, copious and pure milk, has bathed and anointed herself with fragrant pastes, dressed in white garments and adorned with herbs such as aindri (Citrullus colocynthis Schrad), brahmi (Bacopa monnieri Pennel), shatavirya (Cynodon dactylon Pers.), sahasravirya (a type of Shatavirya), amogha (Emblica officinalis Gaertn.), avyatha (Tinospora cordifolia Miers.)shiva (Terminalia chebula Linn.), vatyapushpi (Sida rhombifolia Linn.) and viswaksenakanta (Callicarpa macrophyla Vahl.), then she should take hold of the baby and, while facing east , feed the baby from the right breast first. These are prescribed duties of dhatri, or the wet nurse attending the baby. [58]

Procedure of construction of nursery

अतोऽनन्तरं कुमारागारविधिमनुव्याख्यास्यामः-वास्तुविद्याकुशलः प्रशस्तं रम्यमतमस्कं निवातं प्रवातैकदेशंदृढमपगतश्वापदपशुदंष्ट्रिमूषिकपतङ्गं सुविभक्तसलिलोलूखलमूत्रवर्चःस्थानस्नानभूमिमहानसमृतुसुखंयथर्तुशयनासनास्तरणसम्पन्नं कुर्यात्; तथा सुविहितरक्षाविधानबलिमङ्गलहोमप्रायश्चित्तंशुचिवृद्धवैद्यानुरक्तजनसम्पूर्णम्|
इति कुमारागारविधिः||५९||

atō'nantaraṁ kumārāgāravidhimanuvyākhyāsyāmaḥ- vāstuvidyākuśalaḥ praśastaṁ ramyamatamaskaṁnivātaṁ pravātaikadēśaṁ dr̥ḍhamapagataśvāpadapaśudaṁṣṭrimūṣikapataṅgaṁsuvibhaktasalilōlūkhalamūtravarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁyathartuśayanāsanāstaraṇasampannaṁ kuryāt;tathā suvihitarakṣāvidhānabalimaṅgalahōmaprāyaścittaṁśucivr̥ddhavaidyānuraktajanasampūrṇam|
iti kumārāgāravidhiḥ||59||

ato~anantaraM kumArAgAravidhimanuvyAkhyAsyAmaH- vAstuvidyAkushalaH prashastaMramyamatamaskaM nivAtaM pravAtaikadeshaMdRuDhamapagatashvApadapashudaMShTrimUShikapata~ggaMsuvibhaktasalilolUkhalamUtravarcaHsthAnasnAnabhUmimahAnasamRutusukhaMya
thartushayanAsanAstaraNasampannaM kuryAt; tathAsuvihitarakShAvidhAnabalima~ggalahomaprAyashcittaM shucivRuddhavaidyAnuraktajanasampUrNam|
iti kumArAgAravidhiH||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]

शयनासनास्तरणप्रावरणानि कुमारस्य मृदुलघुशुचिसुगन्धीनि स्युः; स्वेदमलजन्तुमन्ति मूत्रपुरीषोपसृष्टानि च वर्ज्यानि स्युः;असति सम्भवेऽन्येषां तान्येव च सुप्रक्षालितोपधानानि सुधूपितानि शुद्धशुष्काण्युपयोगं गच्छेयुः||६०||

śayanāsanāstaraṇaprāvaraṇāni kumārasya mr̥dulaghuśucisugandhīni syuḥ; svēdamalajantumantimūtrapurīṣōpasr̥ṣṭāni ca varjyāni syuḥ; asati sambhavē'nyēṣāṁ tānyēva ca suprakṣālitōpadhānānisudhūpitāni śuddhaśuṣkāṇyupayōgaṁ gacchēyuḥ||60||

shayanAsanAstaraNaprAvaraNAni kumArasya mRudulaghushucisugandhIni syuH; svedamalajantumantimUtrapurIShopasRuShTAni ca varjyAni syuH; asati sambhave~anyeShAM tAnyeva casuprakShAlitopadhAnAni sudhUpitAni shuddhashuShkANyupayogaM gaccheyuH||60||

The bed, seats, spreads and covers meant for the child should be soft, light, clean and perfumed. Sweat and/or excrement-stained or pestilence-infested articles should be disposed off immediately, and if fresh ones are not available the same may be used again only after they have been washed and fumigated thoroughly and rendered perfectly clean and dry. [60]

धूपनानि पुनर्वाससां शयनास्तरणप्रावरणानां चयवसर्षपातसीहिङ्गुगुग्गुलुवचाचोरकवयःस्थागोलोमीजटिलापलङ्कषाशोकरोहिणीसर्पनिर्मोकाणि घृतयुक्तानि स्युः||६१||

dhūpanāni punarvāsasāṁ śayanāstaraṇaprāvaraṇānāṁ cayavasarṣapātasīhiṅgugugguluvacācōrakavayaḥsthāgōlōmījaṭilāpalaṅkaṣāśōkarōhiṇīsarpanirmōkāṇighr̥tayuktāni syuḥ||61||

dhUpanAni punarvAsasAM shayanAstaraNaprAvaraNAnAM cayavasarShapAtasIhi~ggugugguluvacAcorakavayaHsthAgolomIjaTilApala~gkaShAshokarohiNIsarpanirmokANighRutayuktAni syuH||61||

For fumigation of the garments, bed, and furnishings the following articles smeared with ghee may be used- barley, mustard, atasi (Linumusitaissimum Linn.), hingu (Ferulanarthex Boiss.), guggulu (Commiforamukul Engl.), vacha (Acoruscalamus Linn.), choraka (Angelicaglauca Edgw), vayahstha (Bacopamonnieri Pennel.), golomi (type of Vacha), jatila (Nardostachysjatamansi D. C.), palankasha (type of Guggulu), ashoka (Saracaindica Linn.), rohini (Picrorhizakurroa royle ex Benth.)and sarpa nirmoka(sloughs of snakes). [61]

Measures for ensuring the child's well-being

मणयश्च धारणीयाः कुमारस्य खड्गरुरुगवयवृषभाणां जीवतामेव दक्षिणेभ्यो विषाणेभ्योऽग्राणि गृहीतानि स्युः;ऐन्द्र्याद्याश्चौषधयो जीवकर्षभकौ च, यानि चान्यान्यपि ब्राह्मणाः प्रशंसेयुरथर्ववेदविदः||६२||

maṇayaśca dhāraṇīyāḥ kumārasya khaḍgarurugavayavr̥ṣabhāṇāṁ jīvatāmēva dakṣiṇēbhyōviṣāṇēbhyō'grāṇi gr̥hītāni syuḥ; aindryādyāścauṣadhayō jīvakarṣabhakau ca, yāni cānyānyapi brāhmaṇāḥpraśaṁsēyuratharvavēdavidaḥ||62||

maNayashca dhAraNIyAH kumArasya khaDgarurugavayavRuShabhANAM jIvatAmeva dakShiNebhyoviShANebhyo~agrANi gRuhItAni syuH; aindryAdyAshcauShadhayo jIvakarShabhakau ca, yAni cAnyAnyapibrAhmaNAH prashaMseyuratharvavedavidaH||62||

The following articles should be worn as talismans or amulets by the child: gems, tip of the right horn of a live rhinoceros, deer, gayal or a bull; herbs like aindri, jivaka, rusabhaka, etc., and also all such articles as the brahmins well versed in Atharva Veda may recommend. [62]

क्रीडनकानि खलु कुमारस्य विचित्राणि घोषवन्त्यभिरामाणि चागुरूणि चातीक्ष्णाग्राणि चानास्य प्रवेशीनि चाप्राणहराणिचावित्रासनानि स्युः||६३||

krīḍanakāni khalu kumārasya vicitrāṇi ghōṣavantyabhirāmāṇi cāgurūṇi cātīkṣṇāgrāṇi cānāsya pravēśīnicāprāṇaharāṇi cāvitrāsanāni syuḥ||63||

krIDanakAni khalu kumArasya vicitrANi ghoShavantyabhirAmANi cAgurUNi cAtIkShNAgrANi cAnAsyapraveshIni cAprANaharANi cAvitrAsanAni syuH||63||

The toys of the child should be multicolored, attractive, light, without sharp edges, and incapable of being swallowed. These should make pleasing sounds (i.e., should not be making screechy, loud or disturbing sounds), and should not be fatal to life or disturbing. [63]

न ह्यस्य वित्रासनं साधु|
तस्मात्तस्मिन् रुदत्यभुञ्जाने वाऽन्यत्र विधेयतामगच्छति राक्षसपिशाचपूतनाद्यानां नामान्याह्वयता कुमारस्य वित्रासनार्थंनामग्रहणं न कार्यं स्यात्||६४||

na hyasya vitrāsanaṁ sādhu|
tasmāttasmin rudatyabhuñjānē vā'nyatra vidhēyatāmagacchati rākṣasapiśācapūtanādyānāṁnāmānyāhvayatā kumārasya vitrāsanārthaṁ nāmagrahaṇaṁ na kāryaṁ syāt||64||

na hyasya vitrAsanaM sAdhu|
tasmAttasmin rudatyabhu~jjAne vA~anyatra vidheyatAmagacchati rAkShasapishAcapUtanAdyAnAMnAmAnyAhvayatA kumArasya vitrAsanArthaM nAmagrahaNaM na kAryaM syAt||64||

It is never good to frighten a child. So, if he is found weeping, refusing to eat his meals, or in any other way becoming disobedient, it is not good to take the name of rakshasas (goblins), pishacha (ghost) or putana (harpy) with a purpose of scaring him further. [64]

यदि त्वातुर्यं किञ्चित् कुमारमागच्छेत् तत् प्रकृतिनिमित्तपूर्वरूपलिङ्गोपशयविशेषैस्तत्त्वतोऽनुबुध्यसर्वविशेषानातुरौषधदेशकालाश्रयानवेक्षमाणश्चिकित्सितुमारभेतैनं मधुरमृदुलघुसुरभिशीतशङ्करं कर्म प्रवर्तयन्|
एवंसात्म्या हि कुमारा भवन्ति|
तथा ते शर्म लभन्ते चिराय|
अरोगे त्वरोगवृत्तमातिष्ठेद्देशकालात्मगुणविपर्ययेण वर्तमानः, क्रमेणासात्म्यानि परिवर्त्योपयुञ्जानः सर्वाण्यहितानिवर्जयेत्|
तथा बलवर्णशरीरायुषां सम्पदमवाप्नोतीति||६५||

yadi tvāturyaṁ kiñcit kumāramāgacchēt tat prakr̥tinimittapūrvarūpaliṅgōpaśayaviśēṣaistattvatō'nubudhyasarvaviśēṣānāturauṣadhadēśakālāśrayānavēkṣamāṇaścikitsitumārabhētainaṁmadhu
ramr̥dulaghusurabhiśītaś
aṅkaraṁ karma pravartayan| ēvaṁsātmyā hi kumārā bhavanti| tathā tē śarma labhantē cirāya| arōgē tvarōgavr̥ttamātiṣṭhēddēśakālātmaguṇaviparyayēṇa vartamānaḥ, kramēṇāsātmyāniparivartyōpayuñjānaḥ sarvāṇyahitāni varjayēt| tathā balavarṇaśarīrāyuṣāṁ sampadamavāpnōtīti||65||

yadi tvAturyaM ki~jcit kumAramAgacchet tatprakRutinimittapUrvarUpali~ggopashayavisheShaistattvato~anubudhyasarvavisheShAnAturauShadhadeshakAlAshrayAnavekShamANashcikitsitumArabhetainaMmadhu
ramRudulaghusurabhishItasha~gkaraM karma pravartayan|
evaMsAtmyA hi kumArA bhavanti|
tathA te sharma labhante cirAya|
aroge tvarogavRuttamAtiShTheddeshakAlAtmaguNaviparyayeNa vartamAnaH, krameNAsAtmyAniparivartyopayu~jjAnaH sarvANyahitAni varjayet|
tathA balavarNasharIrAyuShAM sampadamavApnotIti||65||

If some illness affects the child, then the physician, after cautiously examining the child, should thoroughly analyze his constitution, etiological factors, premonitory signs and symptoms, and all other factors concerned such as time and place, and then should proceed to treat him by medication that is sweet in taste and smell, soft, light, cold and pleasant. Such measures suit the palate of the children and make the administering of drugs that much easier. As regards a healthy child, the regimen prescribed for regular consumption is the same as that mentioned as code of conduct for the healthy. Following these ensures that the child attains the excellence of strength, healthy complexion, bodily growth and longevity. [65]

एवमेनं कुमारमायौवनप्राप्तेर्धर्मार्थकौशलागमनाच्चानुपालयेत्||६६||

ēvamēnaṁ kumāramāyauvanaprāptērdharmārthakauśalāgamanāccānupālayēt||66||

evamenaM kumAramAyauvanaprApterdharmArthakaushalAgamanAccAnupAlayet||66||

In this manner the child should be nurtured, from his childhood to his youth, i.e., till he acquires the knowledge and skills necessary for conducting religious activities and leading his livelihood. [66]

इति पुत्राशिषां समृद्धिकरं कर्म व्याख्यातम्|
तदाचरन् यथोक्तैर्विधिभिः पूजां यथेष्टं लभतेऽनसूयक इति||६७||

iti putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātam|
tadācaran yathōktairvidhibhiḥ pūjāṁ yathēṣṭaṁ labhatē'nasūyaka iti||67||

iti putrAshiShAM samRuddhikaraM karma vyAkhyAtam|
tadAcaran yathoktairvidhibhiH pUjAM yatheShTaM labhate~anasUyaka iti||67||

Thus all measures that promote the life of one’s progeny have been described for those who aspire to have children. By adopting these measures in the prescribed manner, one who is free from envy and ill-will attains his wishes with regard and honour. [67]

Summary

तत्र श्लोकौ-
पुत्राशिषां कर्म समृद्धिकारकं यदुक्तमेतन्महदर्थसंहितम्|
तदाचरन् ज्ञो विधिभिर्यथातथं पूजां यथेष्टं लभतेऽनसूयकः||६८||

tatra ślōkau-
putrāśiṣāṁ karma samr̥ddhikārakaṁ yaduktamētanmahadarthasaṁhitam|
tadācaran jñō vidhibhiryathātathaṁ pūjāṁ yathēṣṭaṁ labhatē'nasūyakaḥ||68||

tatra shlokau-
putrAshiShAM karma samRuddhikArakaM yaduktametanmahadarthasaMhitam|
tadAcaran j~jo vidhibhiryathAtathaM pUjAM yatheShTaM labhate~anasUyakaH||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]

शरीरं चिन्त्यते सर्वं दैवमानुषसम्पदा|
सर्वभावैर्यतस्तस्माच्छारीरं स्थानमुच्यते||६९||

śarīraṁ cintyatē sarvaṁ daivamānuṣasampadā|
sarvabhāvairyatastasmācchārīraṁ sthānamucyatē||69||

sharIraM cintyate sarvaM daivamAnuShasampadA|
sarvabhAvairyatastasmAcchArIraM sthAnamucyate||69||

This section is known as Sharira Sthana because it consists of a body of knowledge consisting of all the godly and human aspects of the various phenomena taking place in an individual’s body.

Thus, ends the eight chapter of the Sharira Sthana of Agnivesha’s work as redacted by Charaka, and also marks the end of the Sharira Sthana itself. [69]

Tattva Vimarsha (Fundamental Principles)

  • 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]
  • 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]
  • 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]
  • To beget a good progeny, healthy male and female reproductive systems, proper ovulatory cycles and potent seeds are essential. [17]
  • Even if all factors and conditions for obtaining a desired progeny are met, the influence of the child’s past (due to the deeds in his previous life) are said to play a critical role in deciding the final outcome. [18] Pumsavana is a measure of begetting a child of desired sex, literally meaning a male child. However, some authors refer to this as a procedure not only for sex selection but for proper implantation, intra uterine growth and development of the foetus as well. [19]
  • The herbs indicated for the Pumsavana karma will provide nutritional support to the pregnant woman and thus benefit the mother as well as her growing foetus. [20]
  • The principle behind do’s and don’ts advocated during pregnancy is to lead an unaltered normal life with adequate rest, care and good nutrition to attain a healthy progeny. [21]
  • Chances of survival of the fetus are less and even if it survives, chances of congenital anomaly are more if bleeding appears during the second or third month. [23]
  • 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]
  • 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)

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.

                                        
Under effect of progesterone preventing sperm penetration              Cervical mucus under estrogenic effect 

Source : http://www.naturalfamilyplanning.ie/mucus/gls-p-mucus/

The possible mechanism of sex selection can be understood by knowing the swimming behavior of spermatozoa bearing X and Y chromosome in the female genital tract, as well as evidence suggesting selective penetration of spermatozoa in cervical mucus. The factors affecting the motility of sperms in genital tract are pH, temperature, viscosity, osmolarity, elements and ions. All these evidence suggest that the sex selection may depend on the female genital environment which changes throughout the cycle and hence the specific days of coitus mentioned in text may contribute to the selection of the desired offspring. The concentration of sperm in semen increases if the coitus is performed during alternate days. More the number of Y-bearing spermatozoa, more probability of procuring a male progeny[1].

Selection of Suitable partner for conception

In Ayurveda classics, the preparation of procuring healthy progeny begins with the selection of a partner. For a healthy progeny with longevity and desired traits, both partners should be of reproductive age without any physical or mental disease or chronic illness. Conception in older age is associated with genetic abnormalities like Down’s syndrome and rare chromosomal abnormalities like Patau's syndrome and Edward's syndrome in the offspring. Increased maternal age may also lead to the poor outcome of pregnancy. Conception during illness may result in congenital anomalies or growth retarded fetus. Research has shown risks of low birth weight, premature labor, anemia, and pre-eclampsia are related to the biological age[2].

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.

Ambiance for coitus

The importance of ambiance in stimulating desire in a couple to perform sex, and thus, conceive a healthy child, is expressly mentioned in this chapter. Articles or experiences pleasant to the sensory organs (such as using fragrant objects, pleasing or arousing music or sound, articles pleasant in taste or touch) in a stimulating environment play a very important role in arousal and act as aphrodisiacs, per Ayurvedic texts.

Effect of chanting mantras

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.

Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis[3]. 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.

Do’s and Dont’s before coitus

This chapter provides a detailed list of Do’s and Don’ts that could help a couple conceive a healthy child. These rules or guidelines address various aspects of the couple’s lifestyle – including their diet, their environment – and their health. Traditional rituals and guidelines such as staying pious (and not indulging in immoral thoughts or actions) and being in the company of spiritual or virtuous individuals have been adviced, especially for the expecting mother.

Preparation for putreshthi yajna and its benefits

Cultures around the world, especially in the eastern countries, practice various rituals to get a healthy offspring. While these rituals and customs are considered essential, their validity from the standpoint of scientific studies have not yet been established. Cultural traditions, however, do provide some much-needed assurance during this period of anxiety and should be continued according to tradition. The physical, psychological, social and spiritual wellbeing of the couple desirous of having progeny is very important - and this is facilitated through rituals. All the regimen and rituals also favor a planned pregnancy instead of an accidental pregnancy. A planned pregnancy ensures a proper physical, psychological, financial and social status.

Regimens and factors affecting desired progeny

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.[4]' 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

Researchers have been studying the effect of external sensory experiences on the brain activities of infants. In one instance, researchers found enhanced brain activity in infants exposed to “novel word sounds” played everyday during the third trimester.[5]

Effects of karma of the progeny’s prior birth

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

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

Stha or tishthati means to stay or remain in position. For sustaining a pregnancy, proper nourishment with adequate hormone status is essential. As mentioned in verse 20 of this chapter, herbs such as aindra, brahmi, satavirya, etc. help nourish the fetus, while Jivaniya herbs used regularly by the mother help achieve a healthy outcome of pregnancy.

Factors causing harm to the embryo

Numerous factors that may hamper sustaining the pregnancy or cause abnormalities in the progeny have been described in this chapter. These factors can be classified as dietary, lifestyle, traumatic, psychological and spiritual factors. Observance of these avoidable factors leads to growth retardation, the death of the fetus, premature birth, illness or congenital malformations to the offspring. Research seems to indicate that emotional stress to the mother can lead to prenatal or postnatal complications of various types[6] . Dietary habits and lifestyle may lead to neurohormonal changes which affect pregnancy and its outcome[7] . Similar faulty habits by the father can also cause abnormalities of spermatozoa which in turn leads to congenital anomalies in offspring.

Precaution for the treatment of disorders in pregnant females

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. 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 [8]. 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

Following are the common disorder of fetus, abortion, followed by intrauterine growth retardation and intrauterine death:

Factors responsible for abortion and its treatment

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. 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.

Growth retardation of fetus and its treatment

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. 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

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.

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]

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

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[9]. 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.

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.

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.

Care during 9th month of pregnancy: Instead of suitiikagara, what special care of pregnant lady is advised by Ayurvedic obstretian at home before she goes into labor should be described. What instructions are given when labor pain starts?

Management of Labor

Instead of moving the mother after the labor pain starts, she is shifted to the delivery abode (sutikagara) at the onset of the ninth month. The entry is a ritual and done on auspicious day and timing to ensure the successful and uneventful outcome of pregnancy and parturition without any untoward complications. Symptoms and signs which signify formation of the lower segment with uterine contractions and cervical dilation indicate the onset of labor. As soon as the onset of labor is determined, the counseling and observation of mother are to be with while she is lying down.

To ensure proper progress of labor or when the uterine contractions are not strong, to favor descent of presenting part of the fetus, the mother is advised to walk around. She is also given herbs which are known to have the property of enhancing uterine contractions, in inhalation or fumigation form for quick absorption. Application of lepa made of pippali and vacha churna on abdominal area enhances the intensity of contractions. They are also helpful in prolonged labor caused by weak contractions. Langali, though not abundantly available, tying its roots or applying its lepa also gives such desired effects.

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 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.

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

Resuscitation of a newborn is the initial step and is called Pranapratyagaman Vidhi. There is a prescribed sequence for the clearing of mucous secretions from the oral cavity. First the palate, then the inner aspect of lips, kantha (pharynx), and the Jivha (tongue) should be cleaned. Once the secretion is cleared from the palate, it facilitates the air entry in the pharynx easily. Clearing of pharynx clears the air passage and finally clearing of tongue removes the amniotic fluid and mucous which sticks to the tongue. Nowadays, a neonatal care practice is to clear up the secretion with a suction apparatus first from the mouth and then through the nose. The reason for removing secretions from the mouth first is to prevent the aspiration of more copious oral secretions than nasal secretions. Emesis with ghee and rock salt prescribed in the past is not done. Modern practice is to do gastric suction. Once the baby is breathing well next step is to cut the umbilical cord under aseptic conditions to prevent serious complication of stump infection. This is followed by application of oil and dry powders with antiseptic and drying property. All these measures are to prevent infection in the umbilical stump, early fall of the umbilical cord, healthy healing of the wound after the fall of the cord stump and for prevention of complications like omphalocele, etc. Lodhra, madhuka, priyamgu, suradaru, and Haridra, etc. are drugs that have kashaya and astringent properties to remove excessive moisture and prevent infection, since dry conditions favor the early separation of stump. Oil made up of the same drugs has antimicrobial and wound healing properties and prevents moisture and microbes. The wrong method of cutting of cord and improper care of the cord leads to complications.

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 there any special ayurvedic ways being used now?

Prescribed post-partum measures for women

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.

Within ten days of childbirth, the uterus returns to its normal size and shape, the lochia (serous and water discharge from uterine bed through the vagina) becomes minimum or nil, and the physiology of the woman is restored to her normal stage. The mother also lactates in this phase. However, since she is still weak and vulnerable to diseases, while her body (and life) returns to a state of normalcy, she should be kept under strict vigil and care.

Orally decoction of dashmoola for garbhashaya shodhana as well as relieving backache is given, trikatu churna, vasa churna, bharangi churna, pippali churna, parsik yavani churna in combination with honey or warm water is administered for sufficient uterine contractions ensuring proper drainage of lochia, for agnideepana and for relieving pain. Shatavari churna with milk (Kshirpaka) for proper lactation, tablet triphala guggulu as the antiseptic measure is also given to the mother. At many Ayurveda hospitals, the mother is massaged with bala oil followed by steam; yonidhupana is done by sitting on a chair with herbs for fumigation kept below. (fig) A blanket is wrapped around the body covering legs after mother sits on it. The abdomen is wrapped with a big cloth to prevent distention and ensure proper involution.

                                                     Fig: Chair for yoni dhupana
Source: http://www.jennsutkowski.com/blog-du-moment/steam-that-yonisteam-that-yoni-for-me-or-i-mean-you

Naming Ceremony

The naming ceremony is also advised to be done on the tenth day of childbirth. Although the family is free to keep a name of their choosing, guidelines for selection of the name are given here - one that is auspicious and derived through rituals, and the other for social identity.

Naming the baby is a very important event. A person’s name always leaves a very deep impact on his/her personality and behavior. Psychologically, what one hears and reacts is very important for the mental wellbeing of the person. Therefore, one should be given a good name having an auspicious meaning and that which instills confidence in the individual. Vedic cultures have formal naming ceremonies, as do some other cultures around the world. [50]

Examination of Newborn

All the morphological features of the newborn should be examined thoroughly to rule out any features of congenital anomalies and life-threatening conditions as early as possible. With the help of such findings, one can prevent further complications and consequences of these congenital issues. Therefore, on the tenth day of the child’s delivery, the physician should examine the baby thoroughly. The newborn is grossly examined at birth, but thorough examination is recommended on the tenth day because many minute observations might get missed just after birth and will become obvious by the tenth day.

Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..

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.

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.

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 Sthana4]

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.

According to today's obstetrics and neonatology practice, the mother should feed the baby with the comfort of both mother and baby, keeping both in proper positions and with positive and loving thoughts for the baby. The concept of examination of breast milk is not practically applied in today's era. The diet, lifestyle, and psyche of the mother affect the quality and quantity of breast milk. The characteristic and quantity of breast milk affects the growth and development of the newborn.

Designing and care of the child’s room

The kumaragara (or day care facility) should be prepared in such a manner as to prevent accidents and to protect the child from agantuja vyadhi (diseases due to external/extrinsic factors). In such healthy, emotionally stable and protected environment, children grow very healthy. Antimicrobial properties of all these drugs have been proven in different researches, and hence their use in newborn care and the neonatal nursery is quite evident. Till date, there is no evidence-based scientific explanation available for wearing stones and animal-based jewelry or ornaments. Most of these practices have passed down as customs or rituals since time immemorial.

Toys for children

Toys are very fundamental constituents for the proper growth and development of creative and logical thoughts in babies. Toys play a crucial role as sensory stimuli. Acharya Charaka was well aware of this aspect of child development and therefore described toys in detail. All societies and cultures have toys, and their role in child development is universally accepted.

The upbringing of the child

According to Artha Shastra of Chanakya (Vishnugupta), a child till the age of five years needs a lot of care and affection, while the next ten years require inculcating him/her with discipline and education and once he/she reaches 16 years of age, he/she should be treated as a friend. Children of 16 years of age are mature, physically and sexually, and by then are ready to acquire skills of work for earning.

Related articles

Congenital disorders, Neonatal care, Garbha‎‎, Prenatal care (garbhini paricharya), Sutika Paricharya

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References

  1. Skandhan KP, Japee Jasmine: Hypothesis: Who is responsible for the sex of the offspring, Trends in Medical Research; 2011
  2. CM Gibbs et al, The Impact of Early Age at First Childbirth on Maternal and Infant Health, 2012, PMID:22742615
  3. Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing
  4. 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
  5. Partanen, Eino et al, Prenatal Music Exposure Induces Long-Term Neural Effects, 2013, PLoS One, doi: 10.1371/journal.pone.0078946
  6. Stephen Maret, Introduction to Prenatal Psychology, 2011, Church Gate Books ISBN: 9780578089980
  7. Calvin Hobel, Jennifer Culhane, Role of Pyschosocial and Nutritional Stress on Poor Pregnancy Outcome, 2003, J.Nutr., vol 133 no. 5 1709S-1717S
  8. 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
  9. Meharban Singh – Care Of the New Born, 7thed. New Delhi. Sagar Publications, 2010.