In the ayurvedic concept, the Postpartum period is called suitika kala and the care during this period is called sutika Paricharya. Sutika Kala is explained as one and a half month after childbirth (that is 6 weeks in modern science) or up to the next mensuration.
Postpartum period is also known as the Puerperium. This period begins immediately after childbirth up to 6 weeks and is a period in which the mother’s anatomical and physiological changes during pregnancy return to a non-pregnant state. This period is a critical phase in the lives of a mother and newborn baby. Most maternal and Infant deaths occur during this time. Yet, these are the most neglected periods for the provision of quality care. In the immediate week following delivery woman needs extra care including partner and family as it is a physically and mentally demanding situation.
In the ayurvedic concept, the Postpartum period is called suitika kala and the care during this period is called sutika Paricharya. Sutika Kala is explained as one and a half month after childbirth (that is 6 weeks in modern science) or up to the next mensuration. But according to Acharya Kashyap, who gives more importance to children and babies, the sutika Kala is up to six months after childbirth and expulsion of the placenta Sutika avastha is said to be an immune-suppressed state due to garbhavriddhi, where there is Shitilata in sarva shareera dhatus, different types of pains and bleeding which leads to kshaya in dhatu, agni (digestive fire) and bala (strength or immunity) and there is an alteration in physiological and psychological state. Up to the next menstruation, the lady is called sutika because mensuration is seen only after dhathu Paripurnata (replenishment of dhatusdhatus), healthy state of body and accumulation of blood in the Yoni Pradesh. Replenishment of dhatus is affected when there is excessive blood loss and anaemia or due to certain other causes. Only after physical and psychological health is retained then the women restart her menstruation. If the endometrium is diseased (due to acute Postpartum infection) the blood will not get accumulated, and mensuration will not restart.
In every classic we get descriptions about Sutikagara (accouchement ward), probably these were constructed for every parturient woman and dismantled afterwards. It should be constructed before the ninth month of pregnancy in a land which is free from stones, gravel, pieces of earthen pots and has an excellent appearance. The house should be facing either east or north and constructed with wood of any tree out of bilva, bhallataka, varuna Khadira etc or any wood advised by Brahmanas or people having knowledge in Atharva Veda.
The house should be well smeared with cow dung or lime covered/roofed (with wooden frame) curtained or have well-fitted doors. With the advice of the architect specific places to keep fire, water, motor with Pestle along with separate bathroom latrine and kitchen should be constructed in such a way that the place becomes comfortable in all seasons. The articles to be stored in Sutikagara is also explained. This includes ghee, oil, honey, different types of salt, medicinal drugs such as kushta, vidanga, Nagara,pipali, langali, lashuna, hingu etc. Maireya, Sura, asavas etc. beverages, two pieces of stones, two pestles two Mortars, a donkey, a bull, two needles made of gold and silver, sharp instruments with iron( to be used in labour ), two beds made of same wood for Sutigakara. Woods of tinduka and ingudi should be stored for lighting fire in labour ward. Multiparous women who are good-hearted, continuously busy in services, possessing strong character, experience in conducting labour which basically affectionate in nature, free from grief, having good endurance and capable of making a pregnant women happy should be present in the Sutikagara. Along with them, Brahmanas possessing knowledge in Atharva Veda should be present there. Apart from these all, necessary arrangements told by Brahmanas, and old aged lady should also be stored there.
After the beginning of the 9th month on some auspicious day when Chandra and grahas are in a beneficial position, then during maitra period pacifying oblations should be offered. At first, cows, then brahmins along with the fire and water should be made to enter the ward, the pregnant women should offer grass, water, honey and parched paddy to the cows, and should wash the hand and feet of brahmins and offer them washed rice, flowers and nandimuka fruit and reverential salutations. Then she should sip the water and take blessings for welfare. Now the pregnant women should enter the labour ward by keeping the right foot first and during that time Brahmins should recite holy words. She should stay there and wait for the onset of labour.
The description of Sutikagara gives us the idea of importance given for pregnancy childbirth and Postpartum care in ancient times through Ayurveda. It throws light on hygiene, preoperative measures etc.
Objectives of sutika paricharya are pathya Aahara vihara for sutika, stanya poshan and shishupalana. The principles of sutika paricharya are Agni deepana, Aama pachana, dhaatu poshana and dathu vardhana.
In general, all classes have advised massage, oral administration of fats with medicinal drugs which are improving digestion and decoction for 3 to 7 days after delivery.
From the 7th or 12th day medicated meat soup is advised. After ingesting this, her abdomen should be massaged and wrapped properly with a big clean cloth. Wrapping produces compression of the abdomen and thus prevent hollow space, so the vayu does not get vitiated. After digestion of ghee, liquid gruel made with rice and medicated with pipali etc. drugs mixed with ghee should be given. A hot water bath is advised during the morning and evening.
Suthika Paricharya in Practice
- After delivery gudodaka and pipali choorna can be given. Gudodaka is vatanulomana (normalized vata) and shulaprashamana. (Pain reliving)
- After that yusha(mudga yusha) added with 1teaspoon of panchakola choorna is given.
- When patient feels hunger, satmya food can be taken.
- Non vegetarian food or soup can be given after 7 to 10 days.
- Yavagu can also be given, panchakola siddha yavagu(improves digestion), Vidarigandhadi yavagu (nourishes) etc can be given. Shatavari ksheerapaka yavagu (regulates the synthesis and secretion of breast milk).
- Mamsarasa or meat soup helps in the regeneration of the endometrium which starts on the seventh day.
- Kadali rasayanam, godhuma halwa, Kheer (Payasa) with dry fruits, kushmanda avaleha with milk, pumpkins etc. are very good for sutika.
- Ashwagandha, amlaki, shatavari, guduchi, shatapushpa, rasona, mudga, masha, chanaka etc are good when dhatukshaya is more.
Bahyaprayoga in Sutika
- Sarvanga abhyanga with Bala thailam. It helps in the involution of uterus, cervix, vagina, pelvic floor and pelvic fascia and is a relief for pains. Immediately after delivery abhyanga is done to yoni, lower abdomen and back and after that tight bandaging is done.
- Parisheka with dashmool kwath or ushnodaka pariksheka is done after bala thaila abhyanga.
- Swedana (foementation) is contraindicated in sutika.
- Dhupana with atasi, sarshapa, lashuna, bhurja patra etc can be used.
- Vatahara basti can also be given.
Episiotomy Wound Care
- Wash with Sukhoshana (Lukewarm) panchavalkala kwatha
- Lepana with haridra and Kumari (aloevera).
- Pichu with any ropana ghritha(ghee prepared with drugs of healing property).
Sutika rogas are also described in Ayurveda samhitas, so if sutika is having those rogas its treatment is also added with general sutika paricharya.
Apart from that managing postpartum depression was also found to be very relevant nowadays. In earlier times, new mother and baby were protected and cared for by all which made the mother to feel good and wholesome. Living in a separate room surrounding with mantras, and religious rituals make the baby have healthy growth and prevents from infection. Post-partum is an entirely new stage of a mother’s life. So, we together can make her life ease without any miseries.