According to World Health Organisation, Preconception care is the provision of biomedical, behavioural and social health interventions to women and couples before conception. It aims at improving their health status and reducing behaviours and individual environmental factors that contribute to poor maternal and child health outcomes.
Ayurveda, the science of life explained every aspect of life from daily regimen, seasonal, regimen, menstrual regimen, do’s and don’ts in different diseases, prevention, causative factors and treatment of diseases. Along with these, Ayurveda also throw light on pre- conception care at different contexts.
In present era, the incidence of congenital anomalies is increasing day by day. The first cohort study in India revealed that the congenital anomaly rates were high, affecting 1 in 44 births in the cohort. This highlights their public health importance. By following the Ayurvedic regimens before conception, will surely help to prevent such problems to a great extent by improving the parental health there by improving the quality of sperm and ovum and formation of a health embryo. Ayurveda explains pre- conception care starting from the age preferable for pregnancy, factors responsible for pregnancy, how to perform the act of coitus to get sreshta praja etc.
Rajaswalacharya( Mode of living during menstruation)
During the first 3 days of periods, women should remain isolated. She should avoid sleeping during day time, application of kajal, crying, bathing, oil anointing, massaging, cutting of nails, fast racing, laughing, talking too much, listening to too many topics, combing, fast wind as well as excessive exercises.
She should sleep on bed of darbha (A type of scared grass ) spread over the ground, eat havisya (meal made of ghee, shali rice and milk) or yavaka (meal made of barley and milk).
By following these women can adopt the physiological changes during menstruation and prevent menstrual abnormalities.
Age and Criteria for Marriage
According to Acharya Susruta, the age prescribed for marriage is 25 for male and 16 for female.
Acharya Vagbhata said it as 21 yrs and 12 yrs respectively and added some special characteristics for that girl. That she should belong to the same gotra of the man, nor in blood relation, not having contagious diseases, who is beautiful, modest, possess good qualities and who are free from sins, praise worthy and the marriage should be performed with auspicious method. The age said by Acharya Vagbhata is the age of marriage and not of conception. In India, during the time of Vagbhata there was prevalence of child marriage, but the couple were allowed to live together some years. The qualities for selection of bride can be taken for both partners. Recent studies also proved that consanguineous marriage (marriage in b/w blood relation) carry recessive traits.
Appropriate age for conception
Acharya Susrutha said that the males get sexual maturity only by age of 25 and female by age of 16. Acharya Charka says that male can get sexual maturity at the age of 16. So that is the appropriate time of conception when both partners are of full vigour and valor at this age and the born child also posses these qualities
Factors responsible for conception
The factors responsible for conception according to modern gynaecological texts includes:
- Healthy spermatozoa
- Capacitation and awesome reaction and acquire motility.
- Motile spermatozoa
- Ovulation
- Patency of fallopian tube and oozyte should be picked up by fimbriae
- Fertilisation of oozyte by spermatozoa at ampulla of tube
- Embryo should reach the uterine cavity after 3-4 days of fertilization
- Endometrium should be receptive and corpus luteum should function adequately
Ayurveda explains these all factors in four major terms
- Ritu ( Time of ovulation )
- Kshetra ( The Uterus or the reproductive tract )
- Ambu ( Nourishment including hormones )
- Beeja ( Healthy sperm and ovum )
Ritu – means kala or time, it explains the importance of ovulation such as when the conception chances are high and also ritu describes about the seasons Aadana Kala and Visarga Kala. Among these visarga kala (winter period), gives strength to the human body. So conception during this period gives a healthy progeny compared to that during adana kala.
Kshetra – It devotes a healthy uterus. Uterus is having different parts, i.e. cervix, fundus and body. It is attached with fallopian tube and the tube has fimbriated end which opens to the peritoneal cavity and also after ovulation the ovum is collected and transported to the sperm in the isthmus of tube. The cervix and its secretions are responsible for the capacitation and acrosmal reactions of the sperm that enter the cervix during the act of coitus. This help in the transportation of sperm to the isthmus of tube. The inner lining of uterus is called as endometrium. After the union of sperm and ovum in the fallopian tube the embryo should travel to the uterus within 3 – 4 days and should be implanted in the endometrium. For that the endometrium should be receptive. Ayurvedic Acharyas are explaining this whole science in a word Kshetra which is very relevant.
Ambu – Ambu means water. Water is the nourishing factors for plants. In this context Acharya says about all the nourishing factors should be normal. There can be the hormones and the nutrition to the fetus from the mothers. According to Acharya susruta, the fetal nourishment before vyaktibhava is by upasnehana and upasvedana nyaya( i.e. from the nearby tissue of uterus ). After the formation of umblilical cord (i.e. Nabhinadi ) through the nabhinadi which is directly connected to the hridaynadi of mother.
Beeja
Beeja refers to healthy spermatozoa and ovum. When the beeja is deposited in the vagina it is travelling high to the fallopian tube for this, the beeja should posses all required qualities like spatikapham (clear) , dravam (liquid – gives idea about viscosity) snigdham (unctuous), madhuram ( sweet due to its fructose content) and madhugandhi (smell of honey).
Ovum is produced only in ritukala. So for ovulation there should be normal menstruation and for getting a healthy ovum rajaswala charya has been explained.
Ayurvedic Panchkarma and preconceptional care
Panchkarma is a versatile and effective therapy in all types of problems. It includes 5 types of therapies namely vaman (Emesis), virechana (Purgation), Vasti (Enema), nasya (nasal administration of medicine) and raktamokshan (bloodletting). In preconception care, after marriage it will be beneficial for the couple to take a panchakarma therapy to get blessed with a healthy baby.
Ayurvedic preconception care, starts from the menopause, by the regimens followed by the girl during menstrual period including diet and other. For getting a proper child, “Soumanasya”(Happiness) is considered to be as the best therapy. Mentally prepared mind and body favours the development of child. Along with that, they can start to have an Ayurvedic regimen with medicines and diet for one or two months as a part of preconceptional care and after that can try for a baby with happy mind and without any stress. After all, Life will be given from the hands of God. As per Ayurveda, sukra can mix up with ovum but atma (life) will be generated from God only. So, mind filled with prayers and a well nourished body can only reproduces a healthy child.