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Introduction

Garbhavastha (pregnancy) is a physiological situation in which the embryo is conceived and grows in the womb in order to maintain the species. It is a moment of metamorphosis, when incredible transformations occur. The lady would be prone to Vikrutis due to the Prachalita dhatus and Doshas, according to Charak. As a result, the pregnant lady must be handled with extra care. Everything which affects the mother has impact up on the fetus. Everything that happens to the mother has an effect on the foetus. According to Maharshi Charaka, if all six factors, Shukra (sperm), Artava (ovum), Atma, Ashaya (uterus), Kala (time), and the pregnant woman's diet and way of life are normal, she remains healthy and gives birth to a child with good health, energy or strength, voice, compactness, and superiority over other family members. The foetus gets its nutrition from rasa, which the mother provides through the Upasnehan (moisture-attracting) and Upasweda processes (osmosis).[1]

According to Maharishi Kashyapa the Rasa formed from mother’s diet performs three functions such as nourishment of woman’s body, formation of milk and nourishment to the fetus. Improper diet or mode of life can lead to anomalies of fetus.[2] Thus, to reduce the complications like damage to foetus, risk of miscarriage, anemia and other unforeseen complications related to pregnancy, Garbhiniparicharya (antenatal care) should be followed by the pregnant woman, which is described in our classics. Garbhaja vyadhis are produced as a result of Maatrujaapacharas, according to Acharya Charaka. Vagbhata emphasises the need of sensitive care from those who join her. They need to comfort her and make her feel at ease and stress-free.[3]

Due to reasons such as haemorrhage, difficult abortions, infection, obstructed labour, hypertension, and others, maternal mortality is more common in developing countries than in developed countries. Foetal mortality happens in the antepartum period owing to a variety of factors including chronic foetal, maternal, and foetal congenital malformations. Antenatal care is critical in overcoming these challenges. [4,5,6]

Clinical Importance of Garbhini Paricharya [11]

First Trimester - Because embryogenesis occurs throughout the first trimester, a greater amount of energy is necessary at this time. Kshira, Ghirta, Krusara, Payasa, and Kshira treated with Madhur ausadhi will offer all of this energy. Most women experience nausea and vomiting throughout the first trimester of pregnancy, preventing them from eating a balanced diet, resulting in dehydration and nutritional loss. Dehydration may be avoided by eating a cold and sweet liquid diet, as well as drinking milk. The anabolic properties of Madhura group drugs will aid in the proper health of the mother and foetus. Drugs should not be provided during the embryonic phase because they can disrupt organogenesis and induce teratogenicity. Only folic acid supplementation is required since it is required for the formation of methionine (which is required for the DNA methylation reaction). The foetus would not be stable until 4 months, according to Acharya Kashyapa, hence no medication should be given. Milk is a natural supply of folic acid, as well as a healthy source of carbohydrate, fat, proteins, as well as all vitamins, minerals, and enzymes required for foetal and maternal nutrition. Milk is an external supply of progesterone hormone, which is required for pregnancy to continue. Upasneha and Upasweda provide nourishment for the foetus until Vyaktagarbha, for which milk is beneficial; breast milk is theUupadhatu of Rasa dhatu. ?

Second Trimester - Foetal growth in 2nd trimester occurs by cellular hyperplasia and cellular hypertrophy. From the fourth month onwards, the foetus' muscle tissue increases significantly, necessitating additional protein, which is obtained from animal sources such as meat, milk, cheese, butter, and so on. The foetus gets nutrients and stability from milk. Cooked sasti rice, which is recommended in Garbhini paricharya, is high in carbohydrate and gives the body energy. Meat provides nutrition to the foetus and aids in the development of the foetus' muscles. During last month of second trimester pedal edema is observed, so Ghrita medicated with Gokshura (Tribulus terrestris) is used. Ayurveda described qualities of Gokshura as Mutravirechaka (diuretic), Shothahara (anti-inflammatory) and Krimighna (anti-bacterial), so it helps to reduce oedema and other complication of water accumulation by gravid uterus in the later months of pregnancy.

Third Trimester - Ghrita administered with the Prithakparnayadi group of medicines is diuretic, anabolic, relieves emaciation, and suppresses Pitta and Kapha doshas. Their consistent usage during the seventh month may aid in the health of both the mother and the foetus. Yavagu, which is Balya and Brimhana, is consumed by the mother and foetus throughout the eighth month. In late pregnancy, most women have constipation; Asthapana Basti, which is beneficial for Vata anulomana, is taken during the eighth month and cures constipation. Apart from that, it may have an effect on the autonomous neurological system that governs the myometrium and aids in the regulation of their activity during labour. Tampons of oil in the vaginal canal lubricate the cervix, vaginal canal, and perineum, facilitating proper labour. This may kill vaginal harmful microorganisms and prevent puerperal sepsis. Tampon usage on a regular basis may have an effect on the autonomic fibres that govern myometrium and regulate its functioning. Madhura group milk and medications are recommended throughout the entire pregnant time.

Garbhopaghatkar Bhavas (Factors likely to harm the foetus)

• According to Acharya Charaka- use of excessive heavy, hot and pungent substances, harsh and violent activity.[12]

• According to Acharya Sushruta -Vyavaya, Vyayama, Atitarpan, Atikarsan, Divaswapna Ratrijagaran, Shoka, Yanaavarohana, Bhaya, Utkatasana, Sonitamoksan, Vegadharan, Snehan etc.

• According to Acharya Vagbhata- Tiksna Ausadh, Vyavaya, Vyayama.

• According to Acharya Kashyap- Should not look at declining moon, setting sun and both the rahus, she should not remain for long in acutely erect or flexed posture and carry heavy weight for long, avoid tremering, excessive laughing and trauma, use of cold water and garlic.

Garbhasthapak Drugs (Substances beneficial for maintenance of pregnancy)

Acharya Charaka and Kashyap prescribed certain drugs during pregnancy. Vagbhata has indicated use of Prajasthapana drugs described in Sutrasthana after Pumsawana karma. Some of the drugs mentioned by Acharyas are Aindri (Centella asiatica), Brahmi (Bacopa monieri), Amogha (Stereospermum suaveolens), Avyatha (Tinospora cordifolia), Shiva (Terminalia chebula), Satavirya (Asparagus recemosus), Vatyapuspi (Sida cordifolia), etc.Effect of use of contraindicated things by pregnant woman [11]

Discussion

Pregnancy and childbirth are nature’s gift to the women. Pregnant women's care is identical to that of the foetus. As a result, pregnant women should be treated with care and provided with pleasant and appropriate items, while also being protected from any elements that may cause defects in the foetus. Antenatal period is very crucial in women life as there is a continuous growth of the embryo or foetus, there is also variation in its requirements of food and nutrition. Kashyapa stated that the lady's meal should be considered in relation to Desha, Kala, Matra, Agni, etc. The requirements of the developing embryo are different in different months so acharya mentions Paricharya according to the need of embryo or foetus.

Conclusion

Garbhini paricharya refer to antenatal care which recommends Ahar (specific dietary regimen) Vihar (normal daily activity) and Vichara (psychological and emotional activities). It is the comprehensive coordinated approach to medical care and psychological support that begins before conception and extend throughout antenatal period. After following the dietetic regimen from 1 to 9 month, the woman remains healthy and delivers the child possessing good health, energy or strength, voice, compactness, much superior to other progeny.