Prof. Dr. Sujata Kadam (IND)

Preconceptional care is a set of prevention and management interventions that aim to identify and modify biomedical, behavioural and social risk to women health or pregnancy outcome. Ayurveda has emphasized the concept of planned pregnancy through Garbhadhan sansakar to beget a supraja i.e healthy progeny by choice not by chance. Preventive care and prospective planning prior and after conception are the pillar of preconceptional care. Preconceptional counselling is also considered as preventive obstetrics, that helps to minimize complication of pregnancy by changing the physical and mental status of couple willing for pregnancy. Aim of the pre-conceptional care in Ayurveda is to have a planned conception, to achieve healthy progeny with longevity, physical, psychological and spiritual health.

Pre-conceptional care mainly includes procedures like:
I. Detoxification procedures (Shodhan)
II. Rasayan and Vajikaran therapy
III. Life style modification
IV. Yoga, Pranayama and meditation

Pre-conceptional care (Garbhadhan Vidhi)
Planned detoxification (Shodhan) procedures, life style and diet before pregnancy provides optimum status of Dhatu, improves the quality of all the factors essential for conceptions. Detox process (Shodhan) is the best procedure to balance the Doshas in the body. If the person undergoes this process then the vitiation of doshas can be well controlled, it also maintains a balance among all dhatus and enhances fertility. Before planning for conception, after thorough examination of couple, type of suitable panchakarma procedure may be planned, couple is advised to undergo this selected process as per indications. Panchakarma procedure will be followed by health promoting drugs and the drug, diet which are beneficial to improve the quality of sperm and ovum.

During this whole course couple is advised to follow the healthy lifestyle which is helpful in keeping tridosh in balanced state and helpful in mind stability. Yoga has been shown to greatly health promoting helpful general relaxation, reduce anxiety, stress and depression, so specific yoga regimen is also advised to a couple.

Prenatal care (Garbhini Paricharya)
Ayurveda has described a systematic and planned programme for Garbhini (Pregnant lady) which is called Garbhini Paricharya (Antenatal care). Garbhini Paricharya emphasize on Ahara, Vihara and Vichara as these have a direct effect on the health of mother and child. The literal meaning of Garbhini Paricharya is an all-round care of pregnant woman. In other words, we can say that, a planned programme of observation, education, and medical management of pregnant lady which is directed towards making pregnancy and delivery a safe and satisfying experience.

In Garbhini Paricharya general as well as specific diet and drug schedule is prescribed for pregnant women. The concept of monthly regimen (Masanumasik garbhini paricharya) is very explicitly described in Ayurveda which can fulfil the aim of having healthy progeny and Sukhprasav (easy parturition).

The primary objectives of dietary regimen are to provide optimum protection to foetus and mother, to achieve complete somatic and neural development of the fetus. The diet is planned considering the monthly requirement of fetus for its proper development. The diet of pregnant woman after proper digestion, eventually leads to nourishment of women’s body, formation of breast milk, nutrition to the foetus. The diet should be madhur, hridya, sheeta, drava pradhan, pleasant to heart and mind, in appropriate time and quantity based on her agni bala, desha, kala and satmya. Unctuous food elements like milk, ghee, butter etc. should be medicated with appetizer in order to prevent agni mandya.

Garbhini Paricharya is a unique concept with elaborate descriptions on quality and quantity of maternal nutrition, lifestyle, psychological status which if followed can bestow a quality child. Diet and medications prescribed here having the Rasayana properties not only replenishes the deficiencies instead by having the capacity to reach up to the cellular level which can bring about positive changes in primitive cells of the embryo and fetus thereby preventing the possibilities of future diseases.

Complete somatic and neural development of the fetus prevents or & treat complications if any and achieve normal delivery at term drugs beneficial for maintenance of pregnancy and for foetal growth should be taken with proper consultation. Though common food and medications have been recommended here depending on Desh, Kala, Ritu and availability alternates can be suggested/prescribed. Maintenance of mental health along with beneficial diet and mode of living is necessary during pregnancy. Mental health not only provides good physique but also good Sanskara on foetus.

As per liking of the pregnant woman prayers, reading holy books, mind pleasing literature. Positive thinking. Listening / playing / reciting of soft music enjoyment in nature, wearing of ornaments and flowers if interested, use of soft perfumes such deeds are useful to keep oneself happy and in a pleasant state of mind which is very much essential for fetal growth.

Prenatal Yoga can be very helpful in maintaining normal healthy pregnancy and preparing for labour as it teaches the mother to take cues from her body and maximize its natural potential. There are many different kinds of Yoga, but most of the poses can be altered to fit the abilities and need of any individual pregnant woman. Some documented benefits of prenatal yoga are reduction of maternal stress and anxiety, reduction of pregnancy related pain, improves quality of sleep during pregnancy and improves overall birth outcomes. Yoga, Pranayam and meditation helps in mind stability, alleviation of mental strain and anxiety, increases working capacity of heart and lungs, improves blood circulation, beneficial for fetal growth, improves bearing down capacity during labour and facilitates the easy parturition.

The approach of Indian systems of medicine relating to the care of the mother and child namely conception, fetal growth, prenatal, intra natal and post-natal care are holistic in nature, safe, effective and in turns may reduce maternal and neonatal morbidity and mortality.

In the Caraka Samhita, it is written that no gift surpasses the gift of life. Conception is seen as a divine act of creation, but also as an expression of health. In Ayurveda, preparation for pregnancy begins long before conception. Both partners prepare together so that ovum and sperm are of optimal quality and the environment in the woman's body is such that the pregnancy can be carried to term successfully, and a healthy child is born.

In the panel we will discuss with experienced international Ayurveda experts about the concrete practice of an Ayurvedic fertility and preconception consultation: What holistic support can we offer in Ayurveda and what are the concrete measures? What can women and men themselves do to improve their fertility and can Ayurvedic measures and modern reproductive techniques be integrated? And we address the question of what Ayurvedic counseling looks like when, despite all the measures, pregnancy does not occur and the desire to have a child is not fulfilled.