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The Ayurvedic Perspective and Treatment of Birth Complications Research paper submitted by requirement of the CCA Ayurvedic Health Practitioner Certification in Grass Valley, CA Ayurveda, directly translated, means the knowledge or science of life. In this ancient, traditional medicine of India, the concept of life and how to find balance and harmony throughout it is key. That is why pregnancy is so vitally important. It is a subject that is applicable to all health care practitioners, anyone wishing to become pregnant one day, or even the simply curious student of life. This is the process through which life itself begins. As defined by a recent Thieme Medical Publishers article, "Pregnancy is a period when biomechanical and physiological changes occur rapidly as the body adapts to support the growing fetus. Every woman experiences pregnancy differently and there can be a variety of physical and emotional symptoms that coincide with it." [1] Two beings share the same vessel for approximately nine months, and during this time, a woman can learn how to care for herself while also caring for another. It is truly a miracle how pregnancy develops from conception to full term and eventually to a human being. Along the way, many factors contribute to the health of both the mother and baby. "Expectant mothers should be provided with support, tools, resources, and appropriate types and amounts of exercise during pregnancy to reduce the risk of complications and increase the chances of healthy pregnancies and deliveries." [2] By exploring current medical articles and classical Ayurvedic texts, the history of pregnancy and the practices behind it will be uncovered as either myth, rumor, or fact. In sanskrit, yoga translates into 'the act of yoking'. This refers to the union of the body and the mind through asanas, or physical postures, and breath. There are eight limbs of yoga, those being yama: morality, niyama: personal observances, asana: body postures, pranayama: exercises of the breath, pratyahara: control of the senses, dharana: concentration and inner awareness, dhyana: meditation and devotion to the divine, and samadhi: union with the divine. Most people of western culture are introduced to yoga through the asanas in a hour-long yoga class and that can be as far as they choose to delve into the practice. It can often take some time to cultivate dedication to the other limbs of yoga, though as a whole the eight limbs are the core of a true yoga practice. "Yoga and Ayurveda are sister sciences that have been connected for thousands of years. … They promote a healthy, natural lifestyle through diet, herbs, physical postures, and breathing techniques. … Self- knowledge and self-care are central principles of Ayurveda and are key to real, deep, and lasting healing and health." [3] Ayurveda aims to treat not only the illness of a particular organ or body system,
but also the whole lifestyle of the individual, all while prolonging life and decreasing suffering. Only now is it becoming increasingly popular in western societies. As we dissect thousand-year-old vedic literature, we are are able to shed more and more light on this system of mind-body healing. In the times that these texts were written, people did not have access to technology and so they recorded only what they observed. These limitations being so, there are several statements in the Caraka Samhita that might not sit well with today's traditional western doctors and scientists. For example, it is stated that "If a male child is desired, they should meet on the even days and if a female child is desired, they should meet on the odd days." [4] In addition, it was believed that if a couple wished their child to develop the physical characteristics of a certain ethnicity, they could manipulate this by "Whatever colours she desires to have in her child, she should use apparel of the same color … She should also be asked to adopt the food, regimen, manners and apparel of the people of those countries whom she wishes her son to resemble." [5] Western scientists would leap to argue that genetics decide upon the skin color of a child, not the articles of clothing or styles of food taken on by the mother. However, Dr. Marc Halpern makes a good point in that, "While some beliefs were clearly inaccurate, there was also a vast amount of accurate knowledge and hence we should not discount the whole due to inaccuracy of parts." [6] During growth of the fetus, "A pregnant woman is to be treated very cautiously as if one is walking with a pot full of oil, in hand without letting a drop to fall." [7] During the pregnancy, the woman was highly revered. It was considered vital to keep the woman in a positive environment so that her entire system may become a warm and healthy nest for the growing fetus. "The woman is the chief cause for progeny. If she is protected, the progeny is protected. Among all the stages of life, that of the householder is the most important and sacred." [8] In Ayurveda, the "doshas": vata, pitta and kapha are a representation of the elements within us. Our "constitution" is considered to be the various levels or percentages of these doshas in each individual. The science of Ayurveda does not see human beings as separate from nature, but as part of nature. As such, vata is of the air and ether elements. Pitta is of the fire and water elements and kapha is of the earth and water elements. When we are seeking balance in our lives, we attempt to bring awareness to the foods we eat, herbs and lifestyle practices. Through this awareness, we begin to notice that like increases like and the opposite brings balance. For example, to someone who's constitution may already have a large amount of air, it will be beneficial to add more qualities of earth for grounding. In this way, a harmonious balance is found between the three doshas. This leads to a long, healthy life. In preparation for pregnancy, it is key to look at all aspects of the individual's lifestyle so that the best support can be administered. In the Caraka Samhita, women are instructed "for three days, right from the day of onset of menstruation, the woman should observe celibacy, sleep on the ground, take food from an unbroken vessel kept in her hands and should never clean her body." [9] In attempts to get pregnant, a couple "should be treated with oleation and sudation therapies and thereafter dosas from their body should be eliminated by the administration of vamana (emesis) and virecana (purgation) therapies." [10] "The process of pancha karma is ideal for this … Preparation begins with both partners undergoing purification … This is followed by rejuvenation." [11] "In today's modern Western world, it may not be desirable not to bathe during menses or to sleep on the ground. However, both partners can undergo panchakarma and follow a rejuvenation plan that emphasizes the reproductive system." [12] Above all, balancing the doshas is ideal before attempting pregnancy. INFERTILITY
The Sushruta Samhita states "the sperm led into a healthy and well-developed uterus through the agency of the Vayu … meets the maternal element (ovum) in that viscus. Then the impregnated matter undergoes a process of fission, and takes shape after the pattern of its father's species … the lymph cycle is metamorphosed into sperm in men, or into ovum in women, in the course of a month … the most favourable time for fecundation is between the fourth and twelfth day after the appearance of the flow" [13] From what we now know about the menstrual cycle, "on day 12 estrogen, LH and FSH are all peaking together to assure that ovulation takes place … The LH surge along with the spike in FSH helps prepare the egg for release on day 14." [14] Ovulation is when the egg drops in the uterus, and it is within this 24 hour window that fertilization is most likely. While trying to become pregnant, for "an increasing number of modern-day couples the problem is infertility, and the cause is not always known." [15] It can become very frustrating for a woman when she wants to but is unable to conceive. This is often the reason many couples turn to adoption after years of trying to conceive without any success. However, for a woman going through infertility herself, the option of adoption is not usually primary in her mind when she is trying to become pregnant. "Even in a fertile woman, there is delay in conception because of the defects in the uterus, mental afflictions, defects in sperm, ovum, diet and regimens, union in inappropriate time and want of strength." [16] "Stress and tension are often the root of infertility … It is not aging that exhausts us of our fertile potency, but unhealthy aging." [17] It is important to remind this woman that there are many options for her, but the best one will be for her to be patient and to reduce any judgments or stress surrounding her process. It is easy to slip into blame or insecurity surrounding this difficulty, but there are large amounts of research that provide information for building up her reproductive system as well as her husband's. As mentioned above, a healthy uterus is priority. Thus, uterine tonifying herbs are "extremely potent in vitamins and minerals. They feed and nourish the reproductive organs, are used for restoring vitality and balance, and give general tone to the system … Some examples of uterine tonics are: black cohash root, comfrey root and leaf, dong quai root, ginger root, licorice root, motherwort leaf, nettle leaf, squaw vine, strawberry leaf, and vitex (chaste berry)." [18] A study from BMC Pregnancy and Childbirth in 2006 states that, "Given the high prevalence of the use of complementary therapies and medicines in our community, and the relative lack of evidence of either efficacy or harm, it is important that health care providers do ask about the use of alternative medicines and therapies as a routine. Reasons for not telling may be that patients felt that doctors (or other care providers) may reject the idea of the alternative therapies, or that women may assume that if a supplement is 'natural' it is therefore safe." [19] Even with the best intentions, there are sometimes complications in the process of using herbs, especially unsupervised. Though herbal formulas are considerably more natural than most western drugs, our bodies are still very sensitive and no single natural drug is going work in exactly the same way for everyone. "Women most commonly reported that they had chosen to take the supplements based on their own knowledge, or advice from friends, with naturopaths being the next most common source of advice. Pregnancy care providers such as midwives, general practitioners and obstetricians were rarely reported to have advised herbal supplement use." [20] In the case of using herbs to ensure a positive pregnancy, "hospitals should encourage traditional practitioners to work together with modern practitioners, and safety and effectiveness of herbal medicines used during pregnancy should be approved and announced to the community." [21] Women who are pregnant should be especially discerning with what they take internally. Since their bodies are going through such a drastic change and they are currently responsible for two, it is best to exercise caution and consult an authority on the subject before making any decisions. The necessity of proper research behind herbal practice is even emphasized in pro-holistic books: "In Ayurveda and yoga, it is important to follow your doctor's or midwife's dietary recommendations, such as guidance about which nutrients to emphasize and how many calories to consume." [22] That being said, Gladstar offers a fertility formula that is "applicable to the man in the family, also." [23] Before introducing her formula, she mentions that "it is hard to say how much the herbs I've suggested have helped. There are so many factors involved" but maintains that these herbs do "help heal the reproductive organs and balance hormonal levels … aid in restoring overall vitality and health … All these factors are important when one is considering pregnancy or lack of it." [24] Female Fertility Tea 3 parts wild yam root a pinch of stevia 2 parts licorice root 1 part ginger root 4 parts sassafras bark or root 1 part cinnamon bark 1 part vitex (chaste berry) ½ part false unicorn root ½ part dong quai root ½ part orange peel (for men, substitute ginseng) Use four to six tablespoons of the herb mixture per quart of water. Add the herbs to cold water and bring to a slow simmer over low heat. Keep pot tightly covered. Simmer gently for twenty minutes. Remove from heat and allow to infuse for another twenty minutes. Strain. Drink three to four cups daily. [25] Dr. Frawley offers additional methods of promoting fertility with various administrations. His Sexual Vitality Formula, Musli Pak herbal jelly and Phala Ghrita medicated ghee are included below. Sexual Vitality Formula
Gokshura, Asteracantha longifolia, kapikacchu, ashwagandha, shatavari; all equal parts Tonic, stimulant, aphrodisiac, rejuvenative Decreases Vata and increases Kapha, does not overly increase Pitta Sexual debility, impotence, swollen prostate, low vitality, poor immune function, lower back pain 1-3 grams morning and evening. Warm milk (and ghee) – these are also considered aphrodisiacs Do not take where there is poor digestion or congestion. COMBINATIONS For Kapha take with Digestive Stimulant. Take with rich diet of milk nuts, oils and tonifying, nurturing food Musli Pak
White musali, ghee, sugar, Trikatu, cinnamon, cardamom, chitrak, ashwagandha, cloves, nutmeg and special minerals Nutritive tonic, aphrodisiac Sexual debility, infertility, emaciation, lack of strength 1-2 tsps., 2-3 times a day Phala Ghrita
Triphala, saussurea, katuka, calamus, sariva, galangal, bamboo manna, ghee Tonic, endocrine stimulant Sexual debility and infertility in women 1-2 tsps. twice a day Dr. Frawley expands upon infertility, stating that it is "usually associated with poor nutrition or lack of proper development of the reproductive organs. Accumulation of fluids or stagnation of blood can also cause it." [29] He continues, saying that treatment requires "nourishing and strengthening foods … mainly the tonic herbs for strengthening the female reproductive system." [30] Dr. Frawley even adds that "Reproductive system disorders are given less emphasis in men but should not be overlooked … tonification therapy is generally required, with anti-Vata diet and foods to increase the semen." [31] The herb Ashwaghanda is a popular reproductive tonic. A study found on concerning puberty, pregnancy, and post-natal care from the perspective of Ayurveda states that "Ashvagandha and ghritha (ghee) both are immuno modulators and improve the immunity both in the mother and the foetus. Ashvagandha is vata hara (pacifies vayu) and since vata is the most important principle that governs the whole event of pregnancy and child birth, can be maintained in its normal balanced status." [32] In the same study, it is mentioned that "food preparation by name Antina unde is given to the girls after menarche, during pregnancy, and after delivery. Dates form the main ingredients in this preparation. Dates act as haemostatic thus prevent excess bleeding either during menstruation, pregnancy or after labour. Dates are also known to increase weight, enhance energy and improve the immunity." [33] After cross referencing this with another study discussing Ayurvedic food in pregnancy, it was found that "Banana with dates, figs and ghee every day in pregnancy is one of the best natural tonic foods. It also improves and increases the blood during pregnancy and hence prevents pregnancy anemia to a great extent." [34] Pregnancy anemia refers to the lack of healthy red blood cells that carry oxygen to the tissues of the mother and child and is most commonly caused from an iron deficiency. Ayurvedic Cooking For Westerners states that "Children, babies, and pregnant mothers should not fast, except under rare circumstances. These are times to emphasize physiological building, not cleansing." [35] Thus, the foods eaten by the mother during pregnancy should be tonifying and fortifying, so that the uterus can support fetal growth. Gladstar presents that "Endometriosis is considered to be a leading cause of infertility. These problems can be detected by modern medical tests and are often, though not always, correctable." [36] Dr. Frawley states, "Endometriosis is more Kapha in nature with the excess growth of the uterine membrane … An anti-kapha, anti-tumor and general detoxifying and reducing approach is useful with typical herbs like guggul, myrrh, turmeric and dandelion. Black pepper and katuka or goldenseal can be taken with honey." [37] In this case, a person would need to take more purifying and reducing herbs before attempting pregnancy. HYPERTENSION / PREECLAMSPIA
In Yoga Mama, Yoga Baby, Bachman promotes the combination of Ayurveda and yoga during pregnancy, saying that combined they can "help you give your little one as much positivity as possible when she's in the womb … both Ayurveda and yoga can help you honor pregnancy and birth as important rites of passage—and honor yourself as you move through them." [38] The benefits of yoga are vast, but there are many postures that specifically promote a healthy and easeful pregnancy. Mula bandhas, which are energetic locks at the pelvic floor, (also known as kegels), in utkata konasana or malasana will strengthen the pelvic floor muscles and decrease urinary and fecal incontinence during pregnancy. Restorative yoga calms the body and mind by triggering the parasympathetic nervous system. In doing so, our bodies release the relaxation response and this reduces stress. Poses such as supta baddha konasana or ananda balasana will open the hip flexors and this can make for an easier transition when labor comes. "Prenatal yoga helps a woman to prepare for a peaceful and natural birth, to develop self-confidence and trust, and to feel comfortable with a changing body, wavering emotions, and other common challenges." [39] An online article from 2015 records pre-natal yoga benefits, and concludes that, "Prenatal yoga provides the expectant mother with the opportunity to develop mental health and well-being and build a connection with her unborn baby during pregnancy." [40] However, "As a tree standing in the current of a river gets afflicted by the forceful downward movement of wood, stone pieces and water during the rainy season, so the foetus in the uterus of the mother gets afflicted with the vitiated dosas." [41] When the doshas become imbalanced during pregnancy, complications can arise. "Intrauterine growth restriction (IUGR), gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), and preeclampsia (PE) are some of the more common disorders. These disorders affect over 15% of pregnancies in developing countries, resulting in negative maternal and perinatal outcomes." [42] In the same study, results showed that "Yoga has been found to get the lower weight gain, promote good psychological health by improving sleep, and decreasing stress, anxiety, and depression, relieve chronic pain syndromes such as arthritis, chronic low back pain, and migraine headaches, and improve chronic conditions such as hypertension and diabetes in adults." [43] Bachman confirms this, "doing yoga postures increases circulation, flexibility, stamina, and balance; strengthens back muscles; increases mental alertness and concentration; improves digestion, uplifts energy, and reduces fatigue and stress. … Research suggests that prenatal yoga can also improve sleep; relieve lower back pain; reduce nausea, headaches, and shortness of breath; and lower the risk of preterm labor and pregnancy-induced hypertension." [44] "Preeclampsia is the onset of hypertension and protienuria or edema during pregnancy … Preeclampsia presents with … a rise in blood pressure greater than 30/15 from the pre-pregnancy state." [45] Unfortunately, "There are no references in the classical texts for the treatment of this condition." [46] In treatment of hypertension, it is noted that "As the life of the mother and child may be at risk, a medical evaluation is required" adding that, "traditional treatment can be supported by ayurvedic treatment … hypertension is a key component of the condition and should be managed accordingly." [47] Dr. Frawley's approach to hypertension explains that hypertension "is most commonly a Pitta condition, reflecting the driven nature of fiery types. But it can occur in the other doshas as well." [48] "Most of its indications and treatment are similar to that of heart diseases, with the addition of specifically nervine herbs such as gotu kola, calamus, valerian, skullcap, and jatamamsi." [49] "Strong diuretics should be avoided as they may cause more problems by causing electrolyte disturbances." [50] Dr. Frawley's Heart Tonic offers a formula that "can be combined with the Brain Tonic (no. 6) or the latter taken alone with honey or ghee as per the dosha." [51] Heart Tonic / Arjuna Plus
Arjuna 4, ashwagandha 2, guggul 2, sandalwood 1, cardamom 1 Cardiac, tonic, alterative, hemostatic Heart weakness, palpitations, arteriosclerosis, hypertension, coronary heart diseases, angina, after heart attacks, post surgery, cardiac edema: Can be used wherever arjuna is indicated, balanced for all three doshas. 1-3 three times a day. Water generally. For Kapha with honey, for Pitta with cool water or ghee, for Vata with warm water or ghee. With milk for tonic action. As per constitution. Brain Tonic / Gotu Kola Plus
Gotu kola 4, ashwagandha 2, calamus 1, haritaki 1, sandalwood 1, licorice 1 For Kapha with honey, for Vata with warm water and for Pitta with cool water. Vata and Pitta can also take with milk and ghee. Nervine, antispasmodic, diuretic Insomnia, headaches, nervousness, irritability, anxiety, mental weakness, poor memory, poor concentration, hypertension, drug detoxification, to counter addictions. Can be used whenever Gotu Kola is indicated. Balanced for al three doshas and a good tonic for the mind. 1-3 grams three times a day after meals. With cool water to cool the mind, with ghee (clarified butter) or warm milk as a tonic. No special dietary recommendations, except to avoid overly tasty, spicy or heavy, processed or junk food which interferes with the proper functioning of the brain. Coffee and other stimulant beverages should also be avoided. MISCARRIAGE
A miscarriage, in sanskrit known as garbhapata, is also known as a habitual abortion and can be caused for several reasons. More specifically, a miscarriage is defined as "a spontaneous abortion before the 20th week of gestation." [54] It is commonly "a Pitta condition of excessive movement of the downward moving air (apana) … the general treatment for miscarriage involves an anti-Pitta diet, with avoidance of spicy and oily foods." [55] The tragic occurrence of a miscarriage initially presents a woman with a sudden and very significant vata imbalance. To a woman, the death of her baby comes with a tremendous feeling of loss or empty space that may also manifest into guilt or self-blame. Grief is natural after this event, but eventually she should allow herself to heal and let her despair go. Dr. Frawley advises that "After a miscarriage, care must be taken first to move out all stagnant blood and heal the uterus with emmenagogue herbs such as aloe gel, myrrh, turmeric and manjistha. After a week or two follow this therapy with tonification therapy." [56] During tonification therapy, "Rest and rejuvenation are indicated … oil therapies and a vata-pacifying diet will help … such as pizzichilli, anuvasana basti and svadishtana chakra basti." [57] These oil therapies are best administered by a trained Ayurvedic practitioner. Proper supervision will ensure the most beneficial experience. In Sanskrit, puttraghni yoni vyapaad refers to the condition of which the vagina is in after a miscarriage. Translated, it means the 'destroyer of little son'. As seen above, Dr. Frawley recommends manjistha as an herb for excess bleeding. In The Yoga of Herbs, it is stated that "Manjistha is probably the best alterative or blood-purifying herb in Ayurvedic medicine . Good for all inflammatory conditions of the blood (or the female reproductive system) … It increases blood flow and promotes healing of tissue damaged by injury or infection." [58] Angelica is also a emmenagogue herb. It is "one of the best tonics for women, nurturing the uterine organs and promoting their regular function … As a tonic it works best with shatavari." [59] Aloe gel is a rejuvenative tonic that is tridoshic, which means it is balancing to all three doshas. It has a special action on the female reproductive system when taken internally. "As a nutritive tonic, aloe can be combined with shatavari … and as an alterative and emmenagogue with manjistha." [60] Ayurveda is a medicine that works under the emphasis of prevention. In order to avoid illness and suffering, Ayurveda encourages wholesome practices that incorporate food choices, proper lifestyle management, and herbalism. Instead of trying to come up with a treatment for an illness, Ayurveda looks to find a cure. Thus, the disease is severed at its root cause and future manifestation of other symptoms is prevented. In the case of miscarriage, "Prevention begins with proper preparation of the couple prior to procreation. A healthy couple will have a lower likelihood of miscarriage." [61] During pregnancy, it is best to tonify with herbs "for building the reproductive tissue like shatavari, ashwagandha, bala". [62] In the Dravyaguna Vijnana, shatavari is a sattvic, or harmonious, herb that "is indicated for promoting fertility." [63] "It is a renowned rejuvenative and is most specific for the female reproductive system … best known for its actions as a reproductive tonic" that "increases sexual capacity, improves breast milk supply, and diminishes risk of miscarriage." [64] Bala is tonifying for all vata disorders. It works as a rejuvenative heart tonic that also has a special action on the reproductive system. Red raspberry also has a hemostatic quality. However, it should be used with extreme discretion because while "American red raspberry has a good reputation for reducing miscarriage", its precautions state that "other varieties are known to promote abortion; high Vata; chronic constipation". [65] STILL BIRTH / CAESARIAN
The difference between a miscarriage and a still birth is that a miscarriage manifests in bleeding. The Caraka Samhita states that "The foetus gets destroyed in the pelvis (of the mother) or there is delay in delivery if factors contrary to the ones described for its growth are present." [66] The factors that the Caraka Samhita is referring to are ones that "help in the growth of the foetus in the pelvis of the mother: 1. excellence of the factors responsible for the production of the foetus, viz. Mother (ovum), father (sperm), satmya (wholesomeness), rasa (digestive product of the mother's food) and sattva (mind); 2. adoption of proper regimen by the mother during pregnancy; 3. availability of nourishment and heath through upasneha (transudation) and upasveda (conduction) respectively; 4. proper time; and 5. instinctive or natural tendencies." [67] "Sushruta, who advocates Caesarean section in hopeless cases of obstruction, lays down that the instrument should be employed only in those cases where the proportion between the child and the maternal passage is so defective that medicated plasters, fumigations, etc., are not sufficient to effect a natural delivery." [68] Ayurveda was pro-surgery if necessary, as we have learned that "Sushruta, himself a practical surgeon, was the first to advocate dissection of dead bodies as indispensable for a successful student of surgery." [69] During the times of the Sushruta Samhita, this was a dangerous procedure and the life of the mother and child were both at risk. This operation is common today due to many reasons, intended or not. As is the case in any surgery, proper tonification therapies and rasayana herbs (rasayana referring to the "path of essence", meaning herbs with highly rejuvenative powers meant to prolong life) are required afterwards. A still birth, like a miscarriage, highly vitiates vata, and steps need to be taken to ensure the pacification of this dosha. POST-PARTUM DEPRESSION
Post-partum depression is an increase of vata dosha, which is caused by a rise in the element of ether or space in the pelvis. This can manifest in great overwhelm or depression. "Depressed mothers may become apathetic, emotionally withdrawn, and unresponsive to their offspring, while the first months of the newborn's life are the ‘sensitive period' for the mother-child bonding. Maternal postpartum depression is harmful to the development of the newborn, whose early socialization, cognitive development, and speech acquisition are largely in mother's hands." [70] The first several years of a child's life are critical for learning and bonding. When a mother becomes depressed due to the sudden absence of kapha dosha in her pelvis, she must take steps to build that up again so she can be there for her child. This requires "samsarjana krama", which are tonification therapies and rasayanas, the types of herbs that improve rasa (the fluids of the body like lymph and plasma) and slowly build up healthy digestion. Samsarjana krama typically follows after purification therapies like pancha karma. It includes lifestyle decisions such as rest and sexual restraint, oil therapies, and a light diet of kitcheree that slowly strengthens the digestion. Kitcheree is a very balancing, tridoshic meal that is traditional of India. It is composed of rice, mung bean, and optional vegetables. Abhyanga, shirodhara and svedana are examples of traditional oil therapies that build vitality and strength throughout the whole system. Further research is encouraged on these specific practices, as they often are alluded to be the key to the ancient sages' health. It was said that these rejuvenative therapies were to the sages as ambrosia was to the gods. By taking these therapies and drugs the ancient sages were protected from illness, weakness, disease, old age and even death. CONCLUSION
While herbs can certainly be helpful in supporting health, Ayurveda emphasizes curing the disease at its root cause mainly through lifestyle decisions and food intake. This includes the quality of the food, whether it is dosha-appropriate, when it is eaten, how slowly it is chewed, and how peaceful the environment is in which it is eaten. Lifestyle decisions such as avoidance of stress, daily abhyanga, neti pot, tongue scraping, pranayama and meditation are the basic foundation of a strong Ayurvedic practice. While in the process of trying to become pregnant, there are certain herbs that can act as a support in addition to these daily practices. A study of the herbal usage by pregnant women in Western Ethiopia states that, "Among herbal supplements, raspberry leaf (14%), ginger (12%) and chamomile (11%) were the most widely used; while the most commonly used herbs in our study area were garlic, tenaadam, and ginger … herbs used in our study were studied to be safe in most cases. Studies suggest ginger effectiveness against nausea and inflammation. there is insufficient studies regarding adverse effects of traditional plants during pregnancy." [71] Some of these herbs have consistent reasons for use across the board, "for example, raspberry leaf tea used as a uterine tonic, ginger used for relief of nausea and vomiting." [72] It is obvious that when dealing with complications in pregnancy there are several options of herbal medicine to choose from. However, as "herbal medicine is not currently subject to the same regulations as conventional drugs" [73] it is recommended to take proper precaution and preform adequate research. An article quote from the Ancient Science of Life puts it perfectly: "Ayurveda is more practical and experience based medical science Swasthasya Swasthya Rakshnam" is its primary goal. Even today notion "Prevention is better than cure" is given. Keeping this view in mind special food and few herbs, is prescribed to an expectant mother. It was the opinion of Acharyas that is a pregnant woman follows the regimen prescribed; she will seldom need any medication." [74] This is goal of Ayurveda: preventative medicine that strengthens the person from the inside out, helping them become a healthier version of themselves in harmony with nature. When we focus more on a cure than a treatment, we support balance in our system and further protect ourselves from disease. Once we are whole and fully healed ourselves, we can more successfully offer healing to another, such as a mother to her baby. REFERENCES
[1] Jiang, Q. et al.,Thieme Medical Publishers, American Journal of Perinatology, 2015, "Effects of Yoga Intervention During Pregnancy: a Review for Current Status". [2] Ibid. 1. [3] Bachman, Margo, Yoga Mama, Yoga Baby: Ayurveda and Yoga for a Healthy Pregnancy and Birth (Sounds True, Inc. 1st edition, 2013), p. 5. [4] Sharma, R. K. and Dash, Bhagwan translation, Caraka Samhita Vol 2 (Chowkhamba Sanskrit Series Office, Varanasi, India, 2013), Chapter VIII, v. [5-8], p. 465. [5] Ibid. 4, Chapter VIII, v. [10-14], p. 470. [6] Dr. Halpern, Marc, Textbook of Clinical Ayurvedic Medicine, (Sixth Edition), Vol II (Grass Valley: California College of Ayurveda, 2008), Page 5-38 [7] Ibid. 4, Chapter VIII, v. [22], p. 478. [8] Prof. K. R. Srikanta Murthy, Ashtanga Samgraha, (Chowkumbha Orientalia, Varanasi, India), Vol II, Chapter II, v. 40. [9] Ibid. 4, Chapter VIII, v. [5-8], p. 465. [10] Ibid. 4, Chapter VIII, v. [4], p. 464. [11] Ibid. 6, p. 5-21. [12] Ibid. 6, p. 5-22. [13] Susruta, S. and Bhishagratna, Kunja: Translator, Sushruta Samhita, (Chaukhamba Orientalia, Varanasi, India, 1991), Introduction, p. XXX. [14] Ibid. 6, p. 5-5. [15] Gladstar, Rosemary, Herbal Healing for Women, (Touchstone, 1st edition, 1993), p. 165. [16] Ibid. 4. Chapter II, v. [6-10], p. 353. [17] Ibid. 15, p. 165. [18] Ibid. 15, p. 110. [19] Forster, D. et al., BMC Pregnancy and Childbirth, 2006, "Herbal Medicine Use During Pregnancy in a Group of Australian Women".
[20] Ibid. 19. [21] Ibid. 19. [22] Ibid. 5, p. 42. [23] Ibid. 15, p. 167. [24] Ibid. 15, p. 166. [25] Ibid. 15, p. 167-168. [26] Dr. Frawley, David, Ayurvedic Healing, (Lotus Press, Twin Lakes, Wisconsin, 2001), p. 392. [27] Ibid. 26, p. 375. [28] Ibid. 26, p. 379. [29] Ibid. 26, p. 258. [30] Ibid. 26, p. 258 [31] Ibid. 26, p. 259-260 [32] Jayashree, K. S., Ancient Science of Life, 2008, "Maternal Care Through Mainstreaming Ayurvedic Approach". [33] Ibid. 32. [34] Nanal, Vaidya R. M., Ancient Science of Life, 2008, "Food In Pregnancy: An Ayurvedic Overview". [35] Morningstar, Amadea, Ayurvedic Cooking for Westerners, (Lotus Press, Twin Lakes, Wisconsin, [36] Ibid. 15, p. 165. [37] Ibid. 26, p. 256. [38] Ibid. 3, p. 6. [39] Ibid. 3, p. 31. [40] Ibid. 1. [41] Ibid. 4, Chapter II, v. [29-30], p. 359. [42] Ibid. 1. [43] Ibid. 1. [44] Ibid. 3, p. 31. [45] Ibid. 6, p. 5-45. [46] Ibid. 6, p. 5-45. [47] Ibid. 6, p. 5-45, 5-46. [48] Ibid. 26, p. 216. [49] Ibid. 26, p. 216. [50] Ibid. 6, p. 5-46. [51] Ibid. 26, p. 216. [52] Ibid. 26, p. 389. [53] Ibid. 26, p. 386. [54] Ibid. 6, p. 5-39. [55] Ibid. 26, p. 257. [56] Ibid. 26, p. 258. [57] Ibid. 6, p. 5-41. [58] Dr. Frawley, David and Dr. Lad, Vasant, The Yoga Of Herbs, (Lotus Press, Twin Lakes, Wisconsin, second revised and enlarged edition, 2001), p. 178. [59] Ibid. 58, p. 159. [60] Ibid. 58, p. 100. [61] Ibid. 6, p. 5-40. [62] Ibid. 26, p. 256. [63] Nishteswar, K. and Hemadri, K., Dravyaguna Vijnana, (Chaukhamba Sanskrit Pratishthan, Jawahar Nagar, 2013), p. 178. [64] Dr. Halpern, Marc, Principles of Ayurvedic Medicine, (California College of Ayurveda, 2014), p. 98 [65] Ibid. 58, p. 139. [66] Ibid. 4, Chapter IV, v. [29], p. 402. [67] Ibid. 4, Chapter IV, v. [27], p. 401. [68] Ibid. 13, p. XIX – XX. [69] Ibid. 13, p. XX. [70] Truijens, S., et al., BMC Pregnancy Childbirth, 2014, "The HAPPY study (Holistic Approach to Pregnancy and the first Postpartum Year): design of a large prospective cohort study". [71] Bayisa, B., et al., Jundishapur Journal of Natural Pharmaceutical Products, 2014, "Use of Herbal Medicine Among Pregnant Women on Antenatal Care at Nekemte Hospital, Western Ethiopia". [72] Ibid. 19. [73] Ibid. 73. [74] Dwivedi, M., Ancient Science of Life, 1995, "Ayurvedic concept of food in pregnancy".



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Dr christine klipping

Publications dr Christine Klipping _ Articles Oral follicle-stimulating hormone agonist tested in healthy young women of reproductive age failed to demonstrate effect on follicular development but affected thyroid function. Fertil Steril. 2016 Jan 6 [Epub ahead of print]. K Waellnitz, I Duijkers, C Klipping, T Rautenberg, B Rohde, C Zurth. A two-centre, open-label, randomised study of ovulation inhibition with three transdermal contraceptive patches, each containing different amounts of ethinyl oestradiol and gestodene in healthy, young women. J Obstet Gynaecol, Early Online 1-8, 19 Oct 2015. V Brache, L Cochon, IJM Duijkers, DP Levy, N Kapp, C Monteil, JL Abitbol, C Klipping. A prospective, randomized, pharmacodynamic study of quick-starting a desogestrel progestin-only pill following ulipristal acetate for emergency contraception. Hum Reprod Advance Access September 23, 2015. I.J.M. Duijkers, C. Klipping, Y. Zimmerman, N. Appels, M. Jost, C. Maillard, M. Mawet, J-M. Foidart, H.J.T. Coelingh Bennink. Inhibition of ovulation by administration of estetrol in combination with Drospirenone or levonorgestrel: Results of a phase II dose-finding pilot study. Eur J Contr Reprod Health Care 2015; 20; 476-489. M Mawet, C Maillard, C Klipping, Y Zimmerman, J-M Foidart, HJT Coelingh Bennink. Unique effects on hepatic function, lipid metabolism, bone and growth endocrine parameters of estetrol in combined oral contraceptives. Eur J Contrac Reprod Health Care, 2015; online: 1–13. ST Cameron, C Berger, L Michie, C Klipping, K Gemzell-Danielsson. The effects on ovarian activity of ulipristal acetate when ‘quickstarting' a combined oral contraceptive pill: a prospective, randomized, double-blind parallel-arm, placebo-controlled study. Hum Reprod 2015;30:1566-72.