Module on ‘Sutika Charya and Jatakarma: The Regimen for Parturient Lady and Neonate in Ayurveda’ by -Dr. Mangalagowri V Rao

SUTIKA CHARYA AND JATAKARMA: THE REGIMEN FOR PARTURIENT LADY AND NEONATE IN AYURVEDA

 

 

Special regimen is advocated for parturient lady in Ayurveda known as Sutika Paricharya, to facilitate the physiological process to normalcy. The regimen known as Jatakarma is advocated in Ayurveda for the care of the neonate immediately after delivery. This process helps in acclimatization of baby to external environment.

Postnatal period

1 ½ month to 6 months or till the menstruation starts is considered as postnatal period in Ayurveda.

• अथजातस्योल्बं मुखं च सैन्धवसर्पिषा विशोध्य – Immediately after birth the ulba or lunago and mouth should be cleaned by gently rubbing with salt and ghee
• घृताक्तंमूर्ध्नि पिचुं दद्यात् – The cotton soaked in ghee should be kept over the fontenelle over the head
• ततोनाभिनाडीमष्टाङ्गुलमायम्य सूत्रेण बद्ध्वा छेदयेत् – The umbilical cord should be tied by thread at 8 angula distance and cut
• तत्सूत्रैकदेशंच कुमारस्य ग्रीवायां सम्यग् बध्नीयात्- The other end of thread should be tied to the neck of the neonate
• (II Su. Sha.10/12 II)
• अथकुमारं शीताभिरद्भिराश्वास्य जातकर्मणि कृते – Resuscitating the baby by sprinkling cold water

Process of Lehana after Jatakarma

• मधुसर्पिरनन्तचूर्णमङ्गुल्याऽनामिकयालेहयेत् – The powder of Ananta (Hemidesmus indicus) with honey and ghee should be given to baby by smearing to ring finger

Massage

• ततोबलातैलेनाभ्यज्य- Massaged with Bala taila

Bath

• क्षीरवृक्षकषायेण – Decoction of Kshirivriksha (Vata, Plaksha, Parisha, Ashvattha, Udumbara)
• सर्वगन्धोदकेन– Water flavoured with agents like Tvak, Ela, Patra, Nagakeshara, Karpura, Lavanga etc.
• वारूप्यहेमप्रतप्तेन वा वारिणा- water quenched with hot silver or gold ball
• कपित्थपत्रकषायेणवा – decoction of Kapittha leaves
• कोष्णेन– Luke warm water
• यथाकालंयथादोcषं यथाविभवं च – According to season, dosha or condition
• स्नापयेदेनं– neonate should be given bath
• (II Su. Sha. 10/13 II)
• अथसूतिकां बलातैलाभ्यक्तां वातहरौषधनिष्क्वाथेनोपचरेत् |- The parturient lady should be massaged with Bala taila, and given bath with Kashaya of Vatahara drugs.
• सशेषदोषांतु तदहः पिप्पलीपिप्पलीमूलहस्तिपिप्पलीचित्रकशृङ्गवेरचूर्णं गुडोदकेनोष्णेन पाययेत् – To pacify remaining Doshas powder of Powder of Pippali (Long pepper), Pippalimula (Piper Chaba), Chavya, Chitraka (Plumbago zeylanica), Nagara (Ginger) commonly known as Panchakola churna should be administered with hot jaggery water. It facilitates expulsion of lochia rubra.
• एवंद्विरात्रं त्रिरात्रं वा कुर्यादादुष्टशोणितात् |- This should be followed for 2-3 nights till the expulsion of vitiated of blood.
• विशुद्धेततो विदारिगन्धादिसिद्धां स्नेहयवागूं क्षीरयवागूं वा पाययेत्त्रिरात्रम् | – After such purification rice gruel prepared from Vidari gandha or milk should be administered for 3 days.
• ततोयवकोलकुलत्थसिद्धेन जाङ्गलरसेन शाल्योदनं भोजयेद्बलमग्निबलं चावेक्ष्य |- The meat soup cooked with Yava (Barley), Kola (Zizipus Jujuba or jujube fruits) and Kulattha (Horse gram) should be administered with rice as per Agni and Bala..
• अनेनविधिनाऽध्यर्धमासमुपसंस्कृता विमुक्ताहाराचारा विगतसूतिकाभिधाना स्यात्, पुनरार्तवदर्शनादित्येके ||१६||- In this way abstaining from normal diet and lifestyle for a period of 1 ½ month is known as Vigata Sutika or completing postnatal period. Others consider 6 months as Sutika kala.
• सूतिकांतु खलु बुभुक्षितां विदित्वा स्नेहं पाययेत परमया शक्त्या सर्पिस्तैलं वसां मज्जानं वा- Intake of ghee, oil, fat and bone marrow as per hunger
• सात्म्यीभावमभिसमीक्ष्यपिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरचूर्णसहितम्|- Panchakola
• स्नेहंपीतवत्याश्च -Despite of intake of large amounts of fats and oils
• सर्पिस्तैलाभ्यामभ्यज्य– Massages with ghee and oil
• वेष्टयेदुदरंमहताऽच्छेन वाससा;- Followed by binding abdomen with cloth.
• तथातस्या न वायुरुदरे विकृतिमुत्पादयत्यनवकाशत्वात्| – No bandaging leads to vitiation of Vata due to available space
• जीर्णेतु स्नेहे पिप्पल्यादिभिरेव सिद्धां यवागूं सुस्निग्धां द्रवां मात्रशः पाययेत्|- After the digestion of Sneha gruel prepared with seasoning of Pippali etc. drugs with ghee/oil is administered.
• उभयतःकालंचोष्णोदकेन च परिषेचयेत् प्राक् स्नेहयवागूपानाभ्याम्|- Hot water bath in morning and evening before Sneha Yavagu pana
• एवंपञ्चरात्रं सप्तरात्रं वाऽनुपाल्य क्रमेणाप्याययेत्| स्वस्थवृत्तमेतावत् सूतिकायाः – This has to be followed for 5-7 days to maintain the health of lady after delivery. (Cha.Sha.8/48)
• Should avoid anger, exercise and coitus
• The medicated milk advocated is based on commonly available ingredients of the Balajeerakashaya that is strength promoting and Vatahara.
• Lepidium sativum / Garden cress seed is highly nourishing & rich source of iron. As per Ayurveda it is Vatahara so if administered in the form of payasa it nourishes all & also helps in reducing the backache which is quite common.

Method of preparation of Chandrashura Payasa (Garden cress kheer)

• The seeds are roasted and made into coarse powder.
• Then cooked in milk for 10minutes and jaggery is added after cooking and cooked for sometime with constant stirring.
• The flavouring agents a like pepper, cardamom is added and served hot with little ghee

Other measures to be followed during postnatal period

• Jivaniya, Brimhaniya, Madhura Vatahara dravya Kashaya/oil for massage, bathing and irrigation and diet.
• Fumigation with Kushtha, guggulu and Agaru mixed with ghee.
• Powdered Pippali and Nagara given with rice gruel and ghee.
• Rice gruel mixed with meat soup, Kulattha Yusha,.
• Decoction of Lodhra, Arjuna, Kadamba, Devadaru, Bijaka and Karkandhu given for purification of blood and vagina.
• After one day fasting, Nagara and Haritaki should be given with jaggery, followed by Kulattha Yusha in the afternoon.
• Adequate sleep: Stress and improper sleep is the major cause for many disorders. Hence one should not supress it. Intake of milk at night, Foot massage, body massage, Yogic practices facilitate sleep.

Yogic practices advocated during postnatal period

Principles

• During postnatal period Yogic practices help to strengthen and tighten the pelvic floor muscles and prevent prolapse of uterus.
• They relieve upper back tension and breast discomfort.
• The practices also help to reduce the excess weight gain during pregnancy and to bring back the tone of abdominal muscles.
• They also help to establish a mental balance. The practice of Yoga can be started 6 weeks after delivery.
• Ashvini Mudra: It can be practiced in any posture and the practice can started as early as 7 days after delivery. In this practice, the Anus and perineal muscles should be contracted and relaxed repeatedly. This has to be practiced 20-30 times twice daily. It strengthens perineal muscles and helps to prevent uterine prolapsed.

Yoga Schedule

• Asanas
• Standing Position: Padahastasana, Ardhachakrasana, Tadasana, Ardhakatichakrasana, Trikonasana, Surya Namaskara
• Sitting Position: Padmasana, Vajrasana, Mandukasana, Paschimottanasana, Gomukhasana
• Prone Position: Bhujangasana, Shalabhasana, Dhanurasana, Makarasana
• Supine Position: Pavanamuktasana, Padotthanasana, Setubandhasana, Viparitakarani, Naukasana, Shavasana
• Pranayama: Nadishodhana (Anuloma Viloma) Pranayama, Bhramari
• Shatkarma: Kapalabhati
• Dhyana

Multiple Choice Questions

1. According to Ayurveda, following statement is true regarding postnatal period/ Sutika kala
2. Sutika Kala is up to the six months after the delivery
3. Vata Dosha is aggravated during Sutika Kala
4. Both a and b
5. Sheeta chikitsa is done during Sutika Kala
6. Which one is a suitable advice for postnatal period
7. Massage with bala taila
8. Medicated rice gruels
9. Sudation
10. All
11. Which of the following drug is helpful to facilitate expulsion of lochia rubra
12. Panchkola Churna with jaggery water
13. Yashtimadhu Churna with honey
14. Bhallataka with ghee
15. Sitopaladi Churna with Luke warm water
16. Which one is used as fumigation/ dhoopan dravya
17. Ashwagandha (Withania Somnifera)
18. Guggulu (comiphora mukul)
19. Mulethi (Glyceriza glebara)
20. Arjuna (Terminalia Arjuna)
21. The practice of Asanas can be started…
22. after the 6 weeks of delivery
23. after the 1 week of delivery
24. after the 2 week of delivery
25. after 3 week of delivery
26. During postnatal period Yogic practices helps to-
27. strengthen the pelvic floor muscle
28. prevent prolapsed of uterus
29. strengthen the back muscles
30. all
31. Following Yogic practices are indicated during postnatal period
32. Kapalabhati
33. Surya bhedana
34. Both can be done
35. None
36. ……………. Mudra helps to strengthen perineal muscles, hence advocated during postnatal period
37. Jnana mudra
38. Ashvini mudra
39. Akasha mudra
40. None of the above
41. Following asana can be done during the postnatal period
42. Padahastasana
43. Surya namskara
44. Trikonasana
45. All the above
46. Chandrashura Payasa is advocated during pregnancy has following property
47. Vatahara
48. Balapushti vardhaka
49. Pittahara
50. Both a and b

Answer Keys

1. C
2. D
3. A
4. B
5. A
6. D
7. C
8. B
9. D
10. D

 

 

Links for further reading

 

1. https://www.researchgate.net/publication/318262077_A_COMPREHENSIVE_REVIEW_ON_IMPLICATION_OF_PATHYA_KALPANA_AND_PATHY-APATHYA_DO%27S_AND_DON%27TS_IN_STREE_ROGAS_GYNECOLOGICAL_DISORDERS
2. https://www.ayurlog.com/index.php/ayurlog/article/view/275 (Sutika Paricharya And Its Importance)
3. http://www.iamj.in/current_issue/images/upload/233_236.pdf (A review on sutika paricharya)
4. https://ayurlog.com/index.php/ayurlog/article/view/657 (Sutika Paricharya and its clinical importance according to various Samhitas.)
5. https://www.hilarispublisher.com/proceedings/an-observational-survey-of-the-traditional-medicinal-practices-with-regard-to-sutika-paricharya-postnatalcare-in-india-23843.html (An observational survey of the traditional medicinal practices with regard to sutika paricharya (post-natal-care) in India)
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5158159/ A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding
7. https://www.ncbi.nlm.nih.gov/books/NBK553649/ (Postnatal care up to 8 weeks after birth, NICE Clinical Guidelines)
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3336337/ (Maternal care through mainstreaming Ayurvedic approach)
9. https://pubmed.ncbi.nlm.nih.gov/22754076/ (An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda)
10. Premvati Tiwari, Ayurvediya Prasuti-tantra evam striroga (Part I), Choukhambha Orientalia, Varanasi