Promoting the Health of Mother and Baby During Pregnancy Using Ayurveda by Christine Visco

Introduction

Pregnancy is a happy andjoyous time of life for many women. It can also be a challenging time of life as tbe mother's body goes through numerous changes in order to create and support the development of a new life. Ayurveda is an excellent addition to the care provided by medical doctors and midwives. Ayurveda creates support for the physical, mental/emotional and spiritual bodies of the mother and her baby.
 
This paper is written for Ayurvedic practitioners, alternative care practitioners, mothers and fathers-to-be, and other people who already have some basic knowledge of Ayurveda and who want to apply and broaden that knowledge to include care during pregnancy.  Topics covered within the paper include modern references and classical texts.
Several of the books referenced include much more information on this topic than is covered in this paper and readers are encouraged to seek out those sources.
 
Promoting the Health of Mother and Baby During Pregnancy Using Ayurveda begins with a month by month description of developments during pregnancy. Itthen covers the topics of apana vata, nutrition, tbe daily routine, yoga asana, meditation, happiness, challenges, herbs as well as herb examples and herb research, treatments, classical month by month regimens, Indian herbal gbees, Sanskrit terms for pregnancy, and preparing for the baby.

Month by Month Description of Pregnancy using Classical Texts and Modem Research

Month 1: The embryo takes the form of ajelly. 1 A gelatinous substance is formed.2 The zygote begins to divide immediately after conception. Itthen travels down the fallopian tube and embeds in tbe thick lining of the womb where it links up with the mother's blood vessels.' Fertilization and implantation into the uterine wall occur. The baby's brain, heart and spinal cord begin to form. Baby is 1/25th of an inch long.4
 
Month 2: The embryo takes the form of a knot (a male), an elongated muscle (a female), or a tumour (a eunuch).' The molecules of air, fire, earth, water and ether are acted upon by pitta, vata, and kapha - an elongated shape indicates a female, a lump-like appearance indicates a male and a tumour-like shape indicates an absence of sex.6 The embryo floats in a fluid-filled sac; it has a simple brain, spine and central nervous system. The digestive and respiratory systems are beginning to develop.7  The baby's heart begins to beat, the neural tube along the baby's back closes, the umbilical cord appears, and the fmgers and toes form. Baby is Y.inch long.8
 
Month 3: All senses and limbs as well as their organs appear.9 Lumps appear that will form the hands, legs and head.10  The fetus has all the sense organs as well as completely formed limbs including fingers and toes. The heart starts beating and circulates blood. 11 Movement begins, neurons multiply, sex may be apparent, and fingernails and toenails appear. Baby is 3 inches long and weighs 4/5 of an ounce.12
 
Month 4: The mother feels excess heaviness in her body due to the stabilization of the fetus.13 All limbs and organs become more distinct; viscus of the heart allows consciousness to form. Desires of the heart are thus made manifest to the mother and must be followed so that the baby is not born deformed.14  The fetus has a neck as well as joints in the arms and legs. The hard bones begin to develop.15  The baby flexes and kicks, hormone effects are apparent, skin begins to form and facial expressions are possible.  Baby is 4 to 5 inches long and weighs just less than 3 ounces. 16
 
Month 5: There is an increase in flesh and blood of the fetus; the mother may get thinner. 17  The fetus gains the mind (manah) and wakes up from its sleep of sub-conscious existence.18  The fetus is quite active, kicking and turning.  The sex organs are visible and there is a fine, hairy covering called a lanugo that has developed. 19 Fat stores begin to develop, the baby begins to hear, movement begins to happen, urine is produced and eyebrows appear. Baby is 6 inches long and weighs about 9 ounces.20
 
Month 6: There is an increase in strength and complexion of the fetus; the mother may lose her strength and complexion.21 Cognition (buddhz) enters the fetus. The fetus straightens out and becomes erect.22  A grayish-white, cheesy coating called vernix covers the skin. Sweat glands form.23  Bone marrow begins producing blood cells, taste buds develop, practice breathing occurs as amniotic fluid moves into and out of the lungs, a regular sleeping and waking cycle appears, and foo1prints and fingerprints form. Baby weighs 1 Y.to 2 pounds.24
 
Month 7: There is an all around development in the fetus; the mother may become deficient in all aspects of her health.25 All limbs and members of the body are developed.26 Fat starts to accumulate under the skin and the brain develops dramatically. The baby can suck its thumb and respond with facial features to different tastes.27 Eyes can open and close, it's movements are forceful, and hiccups can be experienced.  Baby weighs 3 to 4 pounds.28
 
Month 8: Ojas moves back and forth between mother and baby. The mother may experience a wavering feeling of sorrow and joy due to this movement. The unsteadiness of the ojas makes delivery during this month dangerous.29 Ojas does not remain stable and birth at this time isn't safe.30  The baby's head is now proportionate to the rest of the
body.31  There should be at least 10 movements every 2 hours but they will be less forceful. Pupils can constrict, dilate, and detect light. Baby is 16 to 19 inches long and weighs 6 to 6 Y,pounds.32
 
Month 9: Normal delivery takes place between the beginning of the 8"' month and before the end of the 10"' month (counting lunar months of 4 weeks).33  Most of the lanugo hair and vernix have been lost  The skin will be flesh­ colored and plump.  The baby shifts to a head down position.34  Fat continues to accumulate, organ function improves, and the placenta provides antibodies.  Baby is 19 to 21 inches and weighs 7 to 8 pounds.35
 

Apana Vata

Apana  Vata must be kept in balance during pregnancy.   Itis the downward moving flow of energy in the body and must not be too strong or too weak.   Most ayurvedic recommendations will be to balance apana vata.  An emotional disturbance that can be caused by excess vata is anxiety.  Foods, rest, and oil massage will be prescribed in order to restore balance.36   ''The apana vata is key to maintaining the pregnancy as well as birthing the baby at the time of
labor.'.37
 

Nutrition

Food needs to be fresh and wholesome. Fresh vegetables and fruits, whole grains, and dairy products are the mainstay of the diet. Eat organic; avoid packaged foods, irradiated foods or genetically engineered foods. Food should be delicious and usually cooked because it is easier to digest.38 Vegetable intake is extremely important. Dark, leafy greens like collards, kale, broccoli and green lettuces as well as squashes, sweet potatoes, and carrots should be eaten at least daily. A broad range of vitamins and nutrients will be provided by these vegetables.39 "The mother should be given whatever she wants during this period except perhaps those that are harmful for the foetus.',40 Denial of desires can lead to aggravation of vata. Even things which are harmful can be used ifthey are processed or combined with things that are wholesome.41  Gratifying her desires will result in a strong, long-lived, virtuous son. "A non-gratification of any sensual enjoyment by its mother during gestation tends to painfully affect the particular sense-organ of the child.42
 
Eat all 6 tastes (sweet, sour, salty, pungent, bitter, and astringent), but emphasize sweet, sour, and salty. Examples include dairy (whole milk, butter and yogurt), sweeteners (honey and natural sugar), oils (olive oil and ghee), fruits,
vegetables, beans (mung beans or split mung dahl), spices (fennel, cumin and ginger), and nuts (blanched almonds).43
 
How food is eaten is just as in3portant as what food is eaten. The mother should feel light, happy and satisfied after her meal. She should not feel unconliortable, have gas or pain, or feel dull.44  Rec=endations include eating the main meal at noon, waiting at least 3 hours between meals, and sitting down while eating. Also, she should taste the food, not have distractions, and avoid overeating.45
 
Sattvic foods will build ojas.  These include many of the ones previously listed but most in3portantly include milk and ghee (clarified butter).   Milk should be taken warmed wiili cardamom or turmeric added for better digestion.   It is recommended to take it as a snack and not wiili a meal.  Ghee is a nourishing, unctuous food.  It promotes digestion and is digested quickly.46   Sattvic food is especially good for building ojas during ilie gth monili.  Ghee,
milk, dates, apricots, and sesame seeds are all recommended. 47  Tamasic foods often produce ama instead of ojas.
 
These are hard to digest foods like meat, eggs, alcohol, aged cheese, leftovers, fermented foods, mushrooms, onions, gar1i.c, and peanuts.48
 
It is important to keep the fetus nourished throughout pregnancy. Dr. David Bruker presented research ilia!shows low birth weight may be linked to disease later in life. The theory is that ifnutrients are insufficient then they will be diverted from organ development to more important areas like brain development During the time an organ is developing it needs to receive ilie correct nutrition or it may never develop properly.49
 
Weight gain is extremely individualized '"The most important factor seems to be a steady weight increase on healthy foods." Ifthe diet is high-quality then there shouldn't be any worries about whether the weight gain is too high or too low. It is important to pay attention to the body's messages. Eating when hungry, even if in the middle of the night is important.50
 
The greatest care is required during the first trimester and last trimester. During the first trimester, emphasis should be placed on nurturing the uterine bed by consuming foods that help the rasa and rakta: juicy fruits, coconut water, and milk. During the last trimester, there should be less fat, less salt and less water in the diet.51
 
"Excellent nutrition includes pure water, controlled breath, abundant light, loving and respectful relationships, beauty and harmony in daily life, positive, joyous thoughts, and vital foodstuffs."52
 
Ayurveda practitioners have a wide range of beliefs about what foods should be consumed for optimum health. Practitioners range from raw food vegetarians, vegetarians, vegans and meat eaters.
 
"If you do include meat, fish, poultry and eggs in your diet now, DO NOT attempt to drastically change your diet during pregnancy. This could trigger a release of toxins to your child, plus the body will need to use different enzymes and digestive juices to build and assimilate vegetable protein rather than animal protein." It is important for everyone but especially those who choose to eat meat to ensure that the elimination system is functioning properly.53
 
The Cleveland Clinic says that vegetarians can have a healthy pregnancy and remain on their diet. Important facts to remember are that 200 to 300 more calories each day are needed, a variety offoods should be consumed and enough protein should be eaten. Three servings each day are recommended of protein. Nutrients to focus on include calcium, iron, vitamin C, folic acid, vitamin A and vitamin Bl2.54 The body needs 15% more energy, Khalsa recommends 300-500 more calories each day.55 If there is any doubt about adequate nutrition, supplements should be taken.56 She also recommends extra calcium during the 2••half of pregnancy to ensure adequate jaw growth.57
 
The work of Dr. Weston A. Price studied isolated non-industrialized  peoples and the relationship of diet to human health.   "Dr. Price's research demonstrated that humans achieve perfect physical form and perfect health generation after generation only when they consume nutrient-dense whole foods and the vital fat-soluble activators found exclusively in animal fats.'"'8 The Foundation recommends pregnant women consume cod liver oil, raw milk, butter, eggs, fresh liver, seafood, beef and lamb, coconut oil, bone broths, soaked whole grains and fresh fruits and vegetables.59 The Foundation also provides resources for obtaining healthy foods and food preparation techniques that could be beneficial to anyone.60

Daily Routine

Two of the main components of a daily routine are going to bed early and getting up early. It's important to go to bed during the kapha time of day (6pm to 1Opm).  It is easier to fall asleep and sleep will be more restful.  It is important to wake up before the kapha time of day (6am to 1Oam). Energy, vitality and alertness are greater if waking before 6am.61 Naps should be avoided except during the hot summer months.62  Rest though should be frequent and before feeling tired  Rest is especially needed in the first two months of pregnancy as well as the last two months.63
 
Abhyanga, a full-body self-massage, is important to perform each day. Stress and fatigue that may push vata dosha out of balance are relieved through abhyanga. Warm sesame oil by placing a container in warm water. Apply oil with an open palm using long strokes on the long bones and circular strokes on the joints.  Massage all parts of the body and very gently apply oilto the abdomen. A warm bath or shower after the abhyanga helps open the channels of circulation.64 Massage of the nipples is recommended after the 4"' month.65
 
Foot massage can also be used to help balance vata. Energy will be kept flowing throughout the body and all systems will be stimulated. This would be an excellent activity for the partner to perform.  Use sesame or almond oil. Warm baths are also an option that can relax the muscles allowing better circulation and preventing stagnation of toxins. 66
 
A sitz-bath is recommended a few times each week or every night for the last 6 weeks prior to birth.  A handful of linden flowers steeped in one liter of water and added to the bath will aid in softening the perineum. 67
 
For those mothers new to Ayurveda, the book Aveda Rituals by Horst Rechelbacher offers a very easy introduction to Ayurveda as well as the parts of the daily routine.68  For further guidance on the daily routine, see "The Daily Routine" under "Ayurveda" on the website http://www.dragonflyhealing.net 69
 
Yoga As11na
Walking, swimming and yoga asanas are the best exercises.70  All normal asanas can be practiced during the first trimester.  During the 2nd and 3rd trimesters, do not put pressure on the abdomen; examples would be cobra (bhujangasana) and bow poses (dhanurasana). Inverted postures should not be practiced during the 3rd trimester. The best asanas encourage pelvic and hip-opening; these can be done sitting or standing. Examples would include bound angle sitting pose (baddha konasana) and open legs forward bend (upavista konasana). Postures that promote flexibility and strength of the spine are also good.71  Khalsa's book The Gift of Giving Life includes a 20 page chapter on breathing, yoga and relaxation.  She discusses several yoga positions that can be practiced daily; both why and how are covered.72
 
Some yoga studios offer special classes for pregnant mothers.  One example is Down Doggie Yoga Studio in Grass Valley, CA which offers a special program called Bodhi Baby Yoga.73  The owner of the studio Deborah Jordan says, "Yoga not only helps a pregnant women exercise but teaches her how to relax into discomfort. Yoga is nurturing and teaches us to relate to our bodies and ourselves with compassion and respect. Prenatal yoga empowers a woman as she prepares for childbirth and parenthood by turning her attention inward strengthening her confidence, her ability to trust her intuition, to speak her truth for the health and well-being of herself, her baby, and her family."74
 
The Gunasheela Surgical and Maternity Hospital in Bangalore, India conducted a study of 335 women. Approximately half practiced one hour of yoga each day including postures, breathing and meditation. The other half walked 30 minutes twice a day. They began the study with women between 18 and 20 weeks of pregnancy. The conclusion of the study determined that yoga is safe. Italso improves birth weight and decreases preterm labor. "Complications such as isolated intrauterine growth retardation (IUGR) (p < 0.003) and pregnancy-induced hypertension (PIH) with associated illGR (p < 0.025) were also significantly lower in the yoga group."75

Meditation

During pregnancy, entrainment occurs. "Entrainment is the tendency of natural cycles to come into coordination  with each other." Bonding between mother and baby occurs as the two entrain; their biological rhythms matching eacb other. A research project that studied the effects of mothers who practiced Transcendental Meditation and their babies quiet alertness showed that those who practiced this technique had double the quiet alertness of those who did not meditate. 76
 
The mind must be trained in order to experience relaxation of the body.  "We have found that easy, fast birthing is highly dependent on the ability to relax and surreoder to the process of birthiog." The mind can be calmed by concentratiog on the breath. Allow breath to move in and out of the body as waves move in and out from the shore. "When we relax the body and bring the breath into a relaxed rhythm, we can then begin to hear the message of the internal voice and can even heal our aches and pains.'m
 
''The aura of a pregnant woman is one of the easiest to see, for it is particularly luminous and full of gold.''  ''The gold colour in the aura indicates that the pregnant woman is intensely connected to high spiritual beings who support and foster the embryo. Pregnancy is therefore a privileged time for spiritual growth. Itis a time to do a lot of meditation and enlightening reading, and to work at developing intuition and perception. "78

Happiness

Maternal attitude is the most important factor in determining the child's physical and emotional well-being. Growing up in India, Dr. Reddy observed the family and friends of the pregnant mother; they provided her with much emotional support. The family often cooked special treats and friends would bring gifts and sweets. The culture believes that for the baby to be happy, the mother must be happy.  The mother would take more rest and the father and in-laws would help out with household chores.79
 
Music can play a role in happiness.  Several studies have shown that uplifting, soothing music helps increase the baby's intelligence.80 "The sound of the veena (Indian string instrument which is held by the Goddess Saraswati), flute and Samaveda mantras gives health to the pregnant woman and the child within." An example of a CD is "Garbh Sanskar : Blessings For The New Arrival".81  A search conducted on Amazon.com of the word "Garbh" showed 4 CDs available.
 
Baby showers over 5 separate months are traditional in India.  Starting in month 3, the family and friends hold a shower to celebrate the five senses, one each month. Usually they are in this order: sight, taste, hearing, smell, and touch. Each shower celebrates a sense by giving gifts that stimulate that sense organ.82
 
Babies are able to remember things from their neonatal experience as well as learn while in the womb. Children have memories of incidents, they remember music that was played and they've shown knowledge of academic subjects that were taught. Babies also remember painful memories.  Those born to parents who had fights were more likely to have health issues. Those exposed to hard rock would move violently in the womb.83
 
During the 4"' month, it is important for the mother to have happy relationships especially with the father. This is due to the heart developing as the seat of consciousness.  Ifthere are disturbances during this time the baby's heart could develop defects. Before this time the baby is connected by astral projection only but after this time the mental body of the baby is connected to the physical body.84
 
About the 5"' month, the mother's navel begins to protrude out. The navel point is where 72,000 nerve endings unite just under the navel. These nerve endings become more exposed to outer vibrations. The mother's ability to feel her environment and those around her increases dramatically. This sensitivity needs to be honored and used as a method of protection for both mother and baby.85
 
During the 8"' month, the ojas moves between mother and baby. It is important to rest during this time and eat ojas building foods. The mother shouldn't waste energy and should let the energy go inward  She should spend time in nature as well as chant and meditate. Things to avoid include overwork, worry, anger, hunger, excessive sex, sorrow and devitalized food 86
 
"Ayurvedic teachings promote a proper attitude of worship towards all pregnant women's.7  The mother needs a "clear joyful spirit" in a clean body.  She should wear clean and white garments.  She should avoid dreadful sights, painful or agitating sounds. Agitating emotions of the mind are dangerous (anger, fright, etc). She should not carry a heavy load or talk in a loud voice. The food she eats should be "...sweet, palatable, well-<:ooked, prepared with appetizing drugs and abounding in fluid substances."88 "The child in the womb feels pain in the same part of its body as the one in which its mother feels any; whether this (pain) may be from an injury or through the effect of any deranged rnorbific principle  (dosa) of her organism."89

Challenges

Many of the health challenges of pregnancy can be prevented by paying attention to nutrition. Low blood sugar contributes to mood swings and morning sickness. Insufficient calcium contributes to hypertension, backaches and severe labor pains. Lack of nutrients also contribute to varicose veins, constipation, anemia, hemorrhoids, and skin discoloration. Pre-eclampsia can be linked to acute malnutrition. 90
 
The best method of taking care of challenges is to resolve imbalanced conditions before pregnancy.   Pregnancy increases all three doshas: vata with change and expansion, pitta with metabolism and heat increased, and kapha with increased bulk of body.   These changes effect the woman's constitution as well as interacting with the baby's constitution and environmental  influences.  Therapies and herbs which distwb apana vata must not be used. Prevention is the easiest approach to health.91
 
Challenges can still occur despite the best efforts. These can include backache, high or low blood pressure, painful breasts, constipation, heartburn, hemorrhoids, indigestion, kidney problems, leaking urine, nausea and vomiting, nerves, insomnia, swelling of hands and feet, tingling and numbness of limbs, varicose veins, and other complications.92  Susun Weed's book The Wise Woman Herbal for the Childbearing Year covers many recommended foods and herbs that can be used during pregnancy to maintain and improve health. 93  Also, Khalsa's book The Gift of Giying Life, covers many herbal and non-herbal solutions to challenges that develop during pregnancy.94
 
The classical texts describe 9 diseases peculiar to pregnancy: anorexia, nausea, dryness of mouth, vomiting, edema, fever, anemia, retention of urine and diarrhoea.95

Herbs

"Don't take herbs during your pregnancy unless you are absolutely certain they are safe. Herbs are powerful and can have harmful effects on you and your baby ifthey are not safe for pregnancy.' 86  ''The FDA urges pregnant women not to take any herbal products without talking to their midwifes or doctors first  Women are also urged to consult a trained and experienced herlialist (or other professional who is trained to work with hems) if they want to take herbs during their pregnancies."  Some hems cause uterine contractions, miscarriage, premature birth and birth defects. Herbs should be used with caution.97  Greater caution with herb use is advised during the first trimester as well as with signs of a fragile pregnancy; that is why herb lists will differ.98
 
Herbs should be taken more for their nutritive value. Emmenagogues, purgatives and toxic herlis should generally be avoided  Very hot or very cold herbs as well as spicy hems and bitter hems should be used carefully.  Hems for
rebuilding the reproductive tissue are helpful: ashwagandha, bala, shatavari, white musali, and kapikacchu.  Chyavan Prash is recommended. Pitta women do well on shatavari and kapha women do well on cardamom, fennel and
basil. 99
 
The Natural Medicines Database rates hems based on safety. Red raspberry leaf, peppermint leaf, ginger root, slippery elm bark, oak straw, blond and black psyllium, garlic and capsicum have all been rated Likely Safe or Possibly Safe.100   This means there have been scientific evaluation, clinical and human studies that showed no adverse affects.101 Dandelion, German chamomile, and nettles have all been rated Insufficient Reliable Information Available. 102  This rating means there has been insufficient scientific evidence supporting their use.103 Nettles have also been rated Likely Unsafe. The reason for this rating may be concern about what part of the plant is used and how much. Saw palmetto, goldenseal, dong quai, ephedra, pay d'arco, passionflower, black and blue cohosh, roman chamomile, and pennyroyal are rated Likely Unsafe or Unsafe. 104
 
The proper time to use a specific hem needs to be researched in depth. An example is blue cohosh. Itshould not be used during pregnancy due to its effect of uterine stimulation. "It may be used in the 9th month of pregnancy, under the guidance of a trained health care professional. "105 Its typical use at that time is in a "Mother's Cordial", a formula that is used during "...the last 3 weeks of pregnancy as a partus preparator." This formula has been used for over a I 00 years. Ittones those muscles that are weak and relaxes those muscles that are spastic.106
 
Herbal infusions can supplement the need for increased nutrition. Infusions of red raspberry leaves or nettles are recommended for those with pitta or kapha dosha and infusion of oatstraw is recommended for vata dosha.101
 
Aroma therapy is another method of using herbs. Some essential oils that are considered safe to use during pregnancy include mandarin, tangerine, grapefruit, roman cahmomile, geranium, rose maroc, rose bulgar, ylang­ ylang, lavendar and jasmine. 108 Mitti Attar (baked earth) is a vata pacifying oil that is rubbed on the belly of a pregnant woman when the baby is too active.109 Some oils which are not safe to use during pregnancy include basil, cinnamon, clove, peppermint, and thyme. Research is necessary before use as with any herb.110

Examples of common herbs used during pregnancy

Nettle Leaves (Urtica dioica) - PK-V+111 - It has the most chlorophyll of any herb. It includes almost all known vitamins and minerals necessary for human health and growth. The taste is deep and rich and the infusion is a dark green color approaching black Nettle will aid the kidneys, nourish the mother and fetus, ease leg cramps and muscle spasms, reduce hemorrhoids, decrease pain during and after birth, prevent hemorrhage after birth, and increase richness and amount of breast milk.112 It also prevents kidney and bladder infections, prevents anemia, and glucosuria. 113 Nettles is high in vitamins A, C, K, calcium, potassium, and iron. Despite the Natural Medicines
Database giving nettles a rating of Unsafe, it is highly recommended by midwives and herbalists. 114
 
Red Raspberry Leaves (Rubus) - PK-V+ (in excess)115 - "It contains fragrine, an alkaloid which gives tone to the muscles of the pelvic region, including the uterus itself." It prevents miscarriage and hemorrhage, eases morning sickness, reduces pain during labor and after birth, and assists in the production of plentiful breast milk. It contains vitamins C, E, A and B as well as calcium and iron.116 "Some studies have even reported that using red raspberry leaf during pregnancy can reduce complications  and the use of interventions during birth." There is some controversy about which trimesters it can be used safely; many only use it during the 2ru1 and 3"' trimesters. 117
 
Dandelion Leaves (Taraxacum officinale) - PK-V+118 - Itis rich in calcium and  folic acid.119  It promotes general well-being, improves appetite, and reduces skin complaints. 120 It is best for treating pre-eclampsia.  Three ounces of fresh or cooked greens are recommended daily. Dandelion heals the liver, helps kidney function and provides a source of calcium and potassium.  It can also be taken as an infusion. 121  It can relieve mild edema and nurish the liver.122
 
Oatstraw (Avena Saliva) - VP-K+ 123 - It is rich in calcium and magnesium.  It helps relieve irritated skin, restlessness, and anxiety.124  Both oats and oatstraw can be taken with similar effects. It promotes a strong nervous system and endocrine system and also can ease spasms and inflan Jmation. 125 Oatstraw is an excellent rejuvenative for women weakened and tired by childbearing or who have had repeated pregnancies. 126
 
Ashwagandha (Withania sornnifera) - VK-P+ and Arna + (in excess) - "...is a good food for weak pregnant women; it helps to stabilize the fetus." 127
 
Shatavari (Asparagus racernosus) - PV-K+ or Arna + - "...its quality is sattvic and aids in love and devotion." It is a general, reproductive, and nervine tonic as well as a nutritive, rejuvenative, and denrulcent. 128
 
Oatstraw, Ashwagandha, and Shatavari are all rejuvenative tonics (rasayana karma) that "...rebuild the body-mind, prevent decay, and postpone aging." They increase the quality of the body and build ojas.129
 
Vidari, shatavari, yasthimadhu, and hrahrni are all considered life-building herbs that can be taken in milk and are rec=ended during the 2•• and 3"' months.  Brahmi can be taken after the 3"' month to help calm the nerves and is also considered a sustainer of pregnancy. From the 4"' to the 7"' month, hems like ashwagandha, kraunch beej, and guduchi are advised to strengthen the uterine muscles and provide nourishment to the embryo. They also help prevent intrauterine growth retardation. After the 7"' month, hems which are mild diuretics and urinary antiseptics are recommended such as gokshuru and sariva. Basil, which is anti-spasmodic is advised in small quantities. 130

Study of safety and efficacy of herbs during pregnancy

The Graduate Department of Pharmaceutical Studies at the University of Toronto, Canada has produced a series of articles reviewing the safety and efficacy of selected hems doring pregnancy and lactation. These articles appeared in The Canadian Joornal of Clinical Pharmacology issues for Fall 2006 and Winter 2008. The researchers searched 7 electronic databases and compiled data. Summaries of the research follow:
 
"...Panax ginseng was not associated with adverse effects when used during pregnancy."131  "There is no direct evidence of safety or harm to the mother or fetus as a result of consuming cranberry during pregnancy." 132  "In pregnancy, there is poor evidence based on theoretical and expert opinion and in vitro studies that chastetree may have estrogenic and progesteronic activity, uterine stimulant activity, emmenagogue activity and prevent miscarriages. "133  "Based on the available scientific information, blue cohosh should; 1) be used with extreme caution during pregnancy ..."134
 
"Ginkgo should be used with caution during pregnancy, particularly around labour where its anti-platelet properties could prolong bleeding time." 135  "Caution is warranted with the use of St. John's wort doring pregnancy until further high quality human research is conducted to determine its safety."136  "Echinacea is non-teratogenic when used during pregnancy." 137  "Black cohosh should be used with caution during pregnancy, particularly during the first trimester where its purported labour-inducing effects could be of concern,..."138

Research Study in Norway

Between February and June 2001, 4-00 women were interviewed within 3 days of giving birth concerning their use of herbs during pregnancy at Ullevltl University Hospital in Oslo, Norway.  36% used one or more herbs during their pregnancy and frequency of use increased by trimester.  The first trimester being the least and third being the most. "The most commonly used herbs were echinacea, iron-rich herbs, ginger, chamomile and cranberry." 39"/o of the women had used herbs that are considered harmful or lacking adequate data for safe use.139  ''Women between 26 and 35 years with a prior history of herbal drug use and highknowledge about herbs, are more prone to using herbal drugs in pregnancy." 140

Treatments

"A pregnant woman is to be treated very cautiously as ifone is walking with a pot full of oil, in hand without letting a drop to fall." Drugs, diet and other therapies should be soft, sweet, cold, pleasant and tender. "She should not be administered emesis; purgation, sirovirecana (therapy for the elimination of dosas from the head) and raktamoksana
(blood-letting)."141
 
"During the seventh month, the abdominal skin gets stretched giving rise to itching and striations, which are, called kikkis.  This should be treated by taking sips of the infusion of berries or butter medicated with Manjistha, the application of the pulp of sandalwood and lotus or of a paste made of neem, basil and manjistha, or oil medicated With Karveer 1eaves or J.asmm. e.,,142
 
In the 8"' month, it is recommended to start doing perinea! massage 4 or 5 times each week.  Itcan be done by the woman or her partner.  "Directions: Wash hands, then use licorice ghee as a lubricant and insert one or two fingers along the bottom of the vagina. After a couple of inches there is a "drop-off ' where the inner edge of the muscles lie. Massage the whole bottom half of this vaginal sling gently yet firmly enough to create a defmite stretching, burning sensation." Continue this stretching until birth. 143
 
During the last month, the woman should be given a small, gentle therapeutic oil enema to ensure apana vata is balanced. After this enenia, she needs to eat a vata reducing diet, adjusted to the season and her constitution.  Itis important to not aggravate apana vata during this time and the woman should avoid getting jarred, holding back gas or urine or bowel movements and she should not get chilled.144 Another version says to give a simple enema and then follow it with a retention enema of oil boiled with some hems and this may be repeated.  Tampons soaked in this same oil are kept in the vagina.145
 
Spotting of blood during any month should be considered serious. Treatment for this can be found in the Masanurnasik Chikitsa. 146

Month by Month Regimens from the Classical Texts

  • Month 1:Take wholesome food morning and evening. Drink milk regularly; it may be taken cold.147
  • Month 2: Take boiled milk with herbs having a sweet taste.148
  • Month 3: Take milk mixed with honey and ghee.149 Take sastika rice with milk.150
  • Month 4: Take milk along with 12g of butter.151 Take sastika rice with curd Also, take milk and butter and soup
  • made with wild animal meat 152
  • Month 5: Take ghee.153 Take sastika rice with milk. Also, take food with milk and clarified butter. 154
  • Month 6: Take ghee boiled with sweet herbs.155 Take sastika rice with ghee. Also, take gruel with clarified butter.156
  • Month 7: Follow the directions for month 6. Ifitching develops in the chest due to pressure of the foetus, use kneading and friction massage on the area. Food should be sweet in taste and alleviate vata. Eat small amounts and
  • don't add extra fat or salt. Water can be taken in small amounts after eating.157
  • Month 8: Take milk and gruel added with ghee.158 An enema should be given for restoring the nervous system and cleansing the bowels - that should be followed by an enema made of oil prepared with milk and herbs.159
  • Month 9: Receive an enema of oil boiled with sweet herbs. Cotton swabs soaked in this oil should be kept in the vagina for oleating the uterus and genital tract. Itwill support softening of the placenta, pelvis, waist, sides of the chest and back; downward movement of vata; normaliz.ation of urine and stool; softening of skin and nails; promotion of strength and complexion; and delivery with ease.160
  •  

Herbal Ghee taken In India

In southern India it is connnon to prescribe the woman to take one tablespoon  of herbal ghee daily during the 2 and 3"' trimesters. During the 4"' and 5th months, Kalyanakam  Ghrut is taken to develop the mental faculties and bodily systems.  Itprevents anemia and also congenital abnormalities.  During the last months, Thanka Sree Ghrut is taken to ensure complete development, a full term normal delivery and good fortune for the child.161

Sanskrit Terms for Pregnancy

There are a number of Sanskrit terms which may be useful to know if looking over the classical texts or researching Indian web sites. The term for embryo is garbha. The general management of pregnancy falls under Garbhini Vyakaran. The development of the fetus in the uterus is described under Garhavakranti. Special regimens for each month are prescribed under Garbhini Paricharya.  The delivery area is the Sootikagar. Diseases particular to pregnancy are called garbhopadravas.  Other terms to know includejeevaneeya which means life-building, garbhasthapak which means it helps the blastocyst implant into the endometrium of the uterus, and prajasthapan which means sustainer of pregnancy. 162

Preparing for the Baby

Pre-conception and pregnancy are the times to make all the plans for the delivery and postpartum recovery. Guidance may be needed concerning whether to use a doctor or a midwife, where the delivery is planned to take place, and who the mother wants present during the delivery. Consideration should be given to whether a birth attendant or doula is desired  Decisions should also be made for how the mother and baby will be cared for in the 40 days after birth.
 
Big changes are not recommended during this time. Many families choose to move house during pregnancy; one study showed 79% of expectant mothers were planning a move. The increased vata during "...a move can actually delay a mother's bonding with her baby after birth, or contribute to postpartum depression. "163
 
Books based on Ayurveda that can provide guidance for delivery and after birth include Tarn Taran Kaur Khalsa's The Gift of Giving Life Volumes 1 and 2164  Dr. Kumuda Reddy's For a Blissful Baby16 and Abhimanyu Kumar's Child Health Care in Ayurveda. 166  Two books expected to be published in 2008 by Ysha Oakes and Apama Khona1kar are Fortv Two Days for Fortv Two Years and Ayurvedic Cooking After Childbirth. Oakes provides training that she calls Postpartum AyurDoula Care through the Rocky Mountain Institute for Yoga and Ayurveda in Denver, CO. 167
 
Getting to know the local resources is important.  Examples inNevada County, CA include Birth and Early Parenting Educators, http://www.be,pe.info/ 168 and Down Doggie Yoga Studio, http://www.downdoggieyogastudio.com Down Doggie lists local resources for prenatal and postnatal care resources under links on their website.169

Conclusion

Ayurveda provides significant assistance to women during pregnancy and it is a complementary addition to the care provided by medical doctors and midwives. Mothers-to-be undergo many changes to their physical and emotional being during their 9 months of pregnancy as they create and support a new life. Ayurveda provides nutritional advice as well as practices such as meditation, the daily routine, yoga asanas, and considerations for happiness. Herbs can be used to assist the pregnant mother to feel her optimum as well as overcome challenges. Extreme care must be exercised though when choosing to take herbs and several resources should be referenced before considering an herb safe to use.  The trimester it is allowed, quantity and part of plant all need to be researched. Mothers who already practice Ayurveda will simply expand their knowledge and application while those new to Ayurveda will find it to be of assistance during their life changes.

Endnotes

1 Caraka Samhita. Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 391.
 
2 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 159.
 
3 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 67.
 
4 Mayo Clinic staff.  "Fetal Development, What Happens During the First Trimester?" Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
5 Caraka Samhita. Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 391.
 
6 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 159.
 
7 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 67.
 
8 Mayo Clinic staff.  "Fetal Development, What Happens During the First Trimester?" Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
9 Caraka Samhita. Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 391.
 
10 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 159.
 
11 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 68-69.
 
12 Mayo Clinic staff.   ''Fetal Development, What Happens During the First Trimester?" Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
13 Caraka Samhita. Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 398.
 
14 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 160.
 
15 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 69.
 
16 Mayo Clinic staff.   ''Fetal Development, What Happens During the First Trimester?" Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
17 Caraka Samhita. Vol II,editors R.K.. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 398.
 
18 Susruta Samhita. Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 162.
 
19 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 70.
 
20 Mayo Clinic staff.   ''Fetal Development, What Happens During the Second Trimester?" Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
21 Caraka Samhita. Vol II,editors R.K.. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 299.
 
22 Susruta Samhita. Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 162.
 
23 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 70-71.
 
24 Mayo Clinic staff.   ''Fetal Development, What Happens During the Second Trimester?" Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
25 Caraka Samhita. Vol II,editors R.K.. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 399.
 
26 Susruta Samhita. Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 162.
 
27 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 71.
 
28 Mayo Clinic staff.   ''Fetal Development, What Happens During the Third Trimester?"  Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
29 Caraka Samhita. Vol II,editors R.K.. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 399.
 
30 Susruta Samhita. Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 162.
 
31 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 72.
 
32 Mayo Clinic staff.   ''Fetal Development, What Happens During the Third Trimester?"  Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
33 Caraka Samhita. Vol II,editors R.K.. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 400-401.
 
34 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 73.
 
35 Mayo Clinic staff.  ''Fetal Development, What Happens During the Third Trimester?" Mayo Foundation for Medical Education and Research, Jul 25, 2007.
 
36 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 50.
 
37 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayuryedicforchildbearingyears.htm
 
38 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 76.
 
39 Romm, Aviva Jill. Natural Healing for Babies & Children.  Sri Satguru Publications, Delhi, India, 1996, p. 57.
 
40 Caraka Samhita, Vol II,editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 397.
 
41 Caraka Samhita. Vol II,editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 298.
 
42 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 160.
 
43 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 79.
 
44 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 80.
 
45 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 82-83.
 
46 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 86.
 
47 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayuryedicforchildbearingyears. htm
 
48 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 87.
 
49 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 89.
 
50 Romm, Aviva Jill. Natural Healing for Babies & Chil<lren. Sri Satguru Publications, Delhi, India, 1996, p. 57-58.
 
51 Nagral, Kumud: "Concept of Safe Motherhood in Ayurved". The Journal of Family Welfare. June 1997. 43
(2). P. 53-57. Location :SNDT Churchgate. From Ayurveda for You,
http://ayurveda-fozyou.com/women/motherhood.html  Note:  Dr. Nagral  is the author of Ayuryed  for Modem Medical Practitioners. Chaukhamba  Sanskrit Pratishthan DeJhi, 2008.
 
52 Weed, Susun S. Wise Woman Herbal for the Childbearing Year. Ash Tree Publishing, Woodstock, New York, 1986, p. 17.
 
53 Khalsa, Tam Taran Kaur.  The Gift of Giving Life.  Vol.  1: A Woman's Guide to Self-Discovery and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 97.
 
54 ''Nutrition During Pregnancy for Vegetarians".  Cleveland Clinic Center for Consumer Health Information.     http://www.clevelandclinic.org/healtb/health-info/docs/1 600/1674.asp?index.=4724
 
55 Khalsa, Tam Taran Kaur.  The Gift of Giying Life.  Vol. 1:A Woman's Guide to Self-Discovery and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 100.
 
56 Khalsa, Tam Taran Kaur. The Gift of Giving Life. Vol. 1 : A Woman' s Guide to Self-Discovery and  Natural Childbirth. Ancient Healing Ways, Espanola, NM, 1983. Note: Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 95.
 
57 Khalsa, Tarn Taran Kaur.  The Gift of Giving Life.  Vol. 1:A Woman's Guide to Self-Discovery and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 104.
 
58 "About the Foundation".   The Weston A. Price Foundation for Wise Traditions in Food, Fanning, and the Healing Arts. http://www.westonamice.org/splash2.htm
 
59 "Diet for Pregnant and Nursing Mothers". The Weston A. Price Foundation for Wise Traditions in Food, Fanning, and the Healing Arts. http://www.westonaprice.org/children/dietfonnothers.html
 
60 "About the Foundation".   The Weston A. Price Foundation for Wise Traditions in Food, Fanning, and the Healing Arts. http://www.westonaprice.org/splash2.htm
 
61 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 95-97.
 
62 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 98.
 
63 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 91.
 
64 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p.  101-102.
 
65 Khalsa, Tam Taran Kaur.  The Gift of Giving Life. Vol. 1:A Woman's Guide to Self-Discovezy and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 80.
 
66 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayuryedicforchildbearingyears.htm
 
67 Khalsa, Tam Taran Kaur.  The Gift of Giving Life. Vol. 1:A Woman's Guide to Self-Discovery and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 117.
 
68 Rechelbacher, Horst  Aveda Rituals.  Henry Holt and Company, LLC, New York, 1999.
 
69 Visco, Christine.  "The Daily Routine." http://www.dragonflyhealing.net/dailyroutine.htm
 
70 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York, 1999,p.  103-104.
 
71 Frawley, David and Kozak, Sandra Summerfield. Yoga for your Type. Lotus Press, Twin Lakes, WI, 2001, p.  197.
 
72 Khalsa, Tam Taran Kaur.  The Gift of Giving Life. Vol. 1:A Woman's Guide to Self-Discovery and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ Chapter 5, p. 54.
 
73 Down Doggie Yoga Studio, http://www.downdoggieyogastudio.com
 
74 Jordan, Deborah.  "Yoga, Conscious Birth and Conscious Parenting." Bodhi Baby Yoga, Down Doggie Yoga Studio, http://www.downdoggieyogastudio.com/article conscbirth.html
 
75 Narendran S, Nagarathna R, Narendran V, Gunasheela S, Nagendra HR "Efficacy of yoga on pregnancy outcome". Journal of Alternative and Complementary Medicine, 2005 Apr;l1(2):237-44.
 
76 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p. 36-37.
 
77 Khalsa, Tam Taran Kaur.  The Gift of Giving Life.  Vol.  1: A Woman's Guide to Self-Discovery and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 65-66.
 
78 Sagan, Samuel. Awakening the Third Eye, 3rd edition.  Clairvision School, 2007. http://clairvisionorg/
 
79 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York, 1999,p.  107-108.
 
80 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p.  110-111.
 
81 Patwardhan, Sushama.  "Gatbha Sanskar (prenatal education)". Ayurveda For You. http://ayurveda-forvou.com/women/garbhasanskar.html
 
82 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p.  110-111.
 
83 Romm, Aviva Jill. Natural Healing for Babies & Children.  Sri Satguru Publications, Delhi, India, 1996, p. 58.
 
84 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayuryedicforchildbearingyears.htm
 
85 Khalsa, Tam Taran Kaur.  The Gift of Giving Life. Vol. 1:A Woman's Guide to Self-Discovery and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1 and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 38.
 
86 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayurvedicforchildbearingyears.htm
 
87 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayurvedicforchildbearingyears.htm
 
88 Susruta Samhita. Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 253.
 
89 Susruta Samhita. Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 159.
 
90 Weed, Susun S. Wise Woman Herbal for the Childbearing Year. Ash Tree Publishing, Woodstock, New York, 1986, p. 17.
 
91 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayuryedicforchildbearingyears.htm
 
92 Khalsa, Tam Taran Kaur.  The Gift of Giying Life. Vol. 1: A Woman's Guide to Self-Discoverv and Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1 and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 86-93.
 
93 Weed, Susun S. Wise Woman Herbal for the Childbearing Year. Ash Tree Publishing, Woodstock, New York, 1986, p. 17.
 
94 Khalsa, Tarn Taran Kaur.  The Gift of Giving Life. Vol. 1:A Woman's Guide to Self-Discovery and  Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1 and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/ p. 84.
 
95 Nagral, Kumud: ''Concept of Safe Motherhood inAyurved". The Journal ofFamily Welfare. June 1997. 43 (2). P. 53-57. Location :SNDT Churchgate. From Ayurveda for You,
http://ayuryeda-forvou.com/women/motherhood.html Note: Dr. Nagral is the author of Ayurved for Modem Medical Practitioners, Chaukhamba Sanskrit Pratishthan Delhi, 2008.
 
96 Romm, Aviva Jill. Natural Healing for Babies & Children.  Sri Satguru Publications, Delhi, India, 1996, p. 60.
 
97 ''Natural Herbs and Vitamins During Pregnancy". American Pregnancy Association. http://www.americanpregnancy.org/pregnancyhealth/naturalherbsvitamins.html
 
98 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/fhayuryedicforchildbearingyears.htm
 
99 Frawley, David  Ayurvedic Healing. A Commehensive Guide, 2nd edition.  Lotus Press, Twin Lakes, WI, 2000, p. 256-257.
 
100 ''Natural Herbs and Vitamins During Pregnancy". American Pregnancy Association.
 
101 "Safety Ratings - Natural Medicines Database". American Pregnancy Association. http://www.americanpregnancy.org/pregnancyhealtb/naturalsafetyrate.html
 
102 ''Natural Herbs and Vitamins During Pregnancy". American Pregnancy Association. http://www.americanpregnancy.org/pregnancvhealtb/naturalherbsvitamins.html
 
103 "Safety Ratings - Natural Medicines Database". American Pregnancy Association. http://www.americanpregnancy.org/pregnancyhealtb/naturalsafetyrate.html
 
104 ''Natural Herbs and Vitamins During Pregnancy".  American  Pregnancy Association. http://www.americanpregnancy.org{pregnancyhealtb/naturalhei:bsvitamins.html
 
105 Tilgner, Sharai. Hei:bal Medicine From the Heart of the Earth. Wise Acres Press, Creswell, Oregon, 1999, p. 41. http://www.herbaltransitions.com/
 
106 Tilgner, Sharai. Hei:bal Medicine From the Heart of the Earth. Wise Acres Press, Creswell, Oregon, 1999, p. 236-237. http://www.herbaltransitions.com/
 
107 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators,  Sept 2001. http://www.wisewomanhood.com/tbayurvedicforchildbearingyears.htm
 
108 Rafael, Terry. "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators,  Sept 2001. http://www.wisewomanhood.com/tbayurvedicforchildbearingyears.htm
 
109 Crow, David.  Inthe Garden of the Medicine Buddha Weekend Workshop.  F1oracopeia, Apr 12-13, 2008. http://www.floracopeia.com
 
110 Klein, Vanessa Nixon.  "Aromatherapy for Pregnancy." Natural Bloom, Adventures in Holistic Health. July 7, 2005. http://www.naturalbloom.com/articles/aromatheraov-47I
 
111 Frawley, David and Lad, Vasant  The Yoga of Herbs.An Ayurvedic Guide to Herbal Medicine, 2nd edition.  Lotus Press, Twin Lakes, WI, 2001, p. 208.
 
112 Weed, Susun S. Wise Woman Herbal for the Childbearing Year.  Ash Tree Publishing, Woodstock, New Yoik, 1986, p. 20-21.
 
113 Romm, Aviva Jill. Natural Healing for Babies & Children. Sri Satguru Publications, Delhi, India, 1996, p. 60.
 
114 ''Natural Herbs and Vitamins During Pregnancy".  American  Pregnancy Association. http://www.americanpregnancy.org/pregnancyhealtb/naturalhei:bsvitamins.html
 
115 Frawley, David and Lad, Vasant  The Yoga of Herbs.An Ayurvedic Guide to Herbal Medicine, 2nd edition.  Lotus Press, Twin Lakes, WI, 2001, p. 138.
 
116 Weed, Susun S. Wise Woman Herbal for the Childbearing Year.  Ash Tree Publishing, Woodstock, New Yoik, 1986, p. 18-19.
 
117 ''Natural Herbs and Vitamins During Pregnancy". American Pregnancy Association. http://www.americanpregnancy.org/pregnancyhealtb/naturalherbsvitamins.html
 
118 Frawley, David and Lad, Vasant  The Yoga of Herbs.An Ayurvedic Guide to Herbal Medicine, 2nd edition.  Lotus Press, Twin Lakes, WI, 2001, p. 114.
 
119 Weed, Susun S. Wise Woman Herbal for the Childbearing Year. Ash Tree Publishing, Woodstock, New York, 1986, p. 22 & 35.
 
120 Romm, Aviva Jill. Natural Healing for Babies & Children.  Sri Satguru Publications, Delhi, India, 1996, p. 60.
 
121 Weed, Susun S. Wise Woman Herbal for the Childbearing Year. Ash Tree Publishing, Woodstock, New York, 1986, p. 51.
 
122 ''Natural Herbs and Vitamins During Pregnancy". American Pregnancy Association. http://www.americanpremancy.org/megnancyhealth/naturalhei:bsvitamins.html
 
123 Frawley, David and Lad, Vasant  The Yoga of Herbs.An Ayurvedic Guide to Herbal Medicine, 2nd edition.  Lotus Press, Twin Lakes, WI, 2001, p. 208.
 
124 ''Natural Herbs and Vitamins During Pregnancy".  American  Pregnancy Association. http://www.americanpregnancy.org/pregnancyhealth/naturalhei:bsvitamins.html
 
125 Weed, Susun S. Wise Woman Hei:bal Healing Wise. Ash Tree Publishing, Woodstock, New York, 1989, p. 200.
 
126 Weed, Susun S. Wise Woman Hei:bal Healing Wise. Ash Tree Publishing, Woodstock, New York, 1989, p. 204.
 
127 Frawley, David and Lad, Vasant  The Yoga of Herbs.An Ayurvedic Guide to Herbal Medicine, 2nd edition.  Lotus Press, Twin Lakes, WI, 2001, p. 160-161.
 
128 Frawley, David and Lad, Vasant  The Yoga of Herbs.An Ayurvedic Guide to Herbal Medicine, 2nd edition.  Lotus Press, Twin Lakes, WI,2001, p. 183-184.
 
129 Frawley, David and Lad, Vasant  The Yoga of Herbs.An Ayurvedic Guide to Herbal Medicine, 2nd
edition. Lotus Press, Twin Lakes, WI, 2001, p. 72-73.
 
130 Nagral, Kumud: "Concept of Safe Motheihood in Ayurved". The Journal of Family Welfare. June 1997. 43 (2). P. 53-57. Location :SNDT Churchgate. From Ayurveda for You,
http://ayurveda-fozyou.com/women/motherhood.html Note:  Dr. Nagral  is the author of Ayurved  for Modem Medical Practitioners,  Chaukhamba  Sanskrit Pratishthan Delhi, 2008.
 
131 Seely, Dugald; Dugoua, Jean-Jacques; Perri, Daniel; Mills, Edward; Koren, Gideon; "Safety and efficacy of panax ginseng during pregnancy and lactation", The Canadian Journal of Clinical Phannacology Vol 15 (1) Winter 2008:e87-e94; January 18, 2008, http://www.cjcp.ca/hm/
 
132 Dugoua, Jean-Jacques; Seely, Dugald; Perri, Daniel; Mills, Edward; Koren, Gideon; "Safety and efficacy of cranberry (vaccinium macrocarpon) during pregnancy and lactation", The Canadian Journal of Clinical Pharmacology Vol 15 (1) Winter 2008:e80-e86; January 18, 2008, http://www.cicp.ca/hm/
 
133 Dugoua, Jean-Jacques; Seely, Dugald; Perri, Daniel; Koren, Gideon; Mills, Edward; "Safety and efficacy of chastetree (vitex agnus-castus) during pregnancy and lactation", The Canadian Journal of Clinical Pharmacology Vol 15 (1) Winter 2008:e74-e79; January 18, 2008, http://www.cjcp.ca/hm/
 
134 Dugoua, Jean-Jacques; Perri, Daniel;  Seely, Dugald; Mills, Edward; Koren, Gideon; "Safety and efficacy of blue cohosh (caulophyllum thalictroides) during pregnancy and lactation", The Canadian Journal of Clinical Phannacology Vol 15 (1) Winter 2008:e66-e73; January 18, 2008, http://www.cicp.ca/hm/
 
135 Dugoua, Jean-Jacques; Mills, Edward; Perri, Daniel; Koren, Gideon; "Safety and efficacy of ginkgo (ginkgo biloba) during pregnancy and lactation", The Canadian Journal of Clinical Pharmacology Vol 13(3) Fall 2006:e277-e284; November 3, 2006, http://www.cjcp.ca/hm/
 
136 Dugoua, Jean-Jacques; Mills, Edward; Perri, Daniel; Koren, Gideon; "Safey and efficacy of St. John's wort (hypericum) during pregnancy and lactation", The Canadian Journal of Clinical Phannacology Vol 13(3) Fall 2006:e268-e276; November 3, 2006, http://www.cjcp.ca/hm/
 
137 Perri, Daniel; Dugoua, Jean-Jacques; Mills, Edward; Koren, Gideon; "Safety and efficacy of echinacea (echinacea angustifolia, e. purpurea and e. pallida) during pregnancy and lactation", The Canadian Journal of Clinical Pharmacology Vol 13(3) Fall 2006:e262-e267; November 3, 2006, http://www.cjcp.ca/hm/
 
138 Dugoua, Jean-Jacques; Seely, Dugald; Perri, Daniel; Koren, Gideon;  Mills, Edward; "Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation", The Canadian Journal of Clinical Pharmacology Vol 13(3) Fall 2006: e257-e261; November 3, 2006. http://www.cjcp.ca/hm/
 
139 Nordeng H, Havnen GC. "Use of herbal drugs inpregnancy: a survey among 400 Norwegian women.." Pharmacoepidemiology and Drug Safety. 2004 Jun;13(6):371-80.
 
140 Nordeng H, Havnen GC. "Impact of socio-demographic factors, knowledge and attitude on the use of herbal drugs inpregnancy." Acta obstetricia et gynecologica Scandinavica. 2005 Jan;84(1):26-33.
 
141 Caraka Samhita, Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 478.
 
142 Nagral, Kumud: "Concept of Safe Motherliood inAyurved". The Journal of Family Welfare. June 1997. 43 (2). P. 53-57. Location :SNDT Churchgate. From Ayurveda for You,
http://ayurveda-forvou.com/women/motherhood.html Note: Dr. Nagral is the author of Ayuryed for Modern Medical Practitioners, Chaukhamba Sanskrit Pratishthan Delhi, 2008.
 
143 Rafael, Terry.  "A Primer on Ayurveda for the Childbearing Years.  Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/tbayurvedicforchildbearingyears.htm
 
144 Rafael, Terry.  "A Primer on Ayurveda for the Childbearing Years. Part 3: Ayurveda for Pregnancy and Childbirth." Special Delivery, Vol 24, Issue 3, Page 2, Association of Labor Assistants and Childbirth Educators, Sept 2001. http://www.wisewomanhood.com/tbayurvedicforchildbearingyears.htm
 
145 Nagral, Kumud: "Concept of Safe Motherhood inAyurved". The Journal of Family Welfare. June 1997. 43 (2). P. 53-57. Location :SNDT Churchgate. From Ayurveda for You,
http://ayurveda-forv ou.com/women/motherhood.html Note: Dr. Nagral is the author of Ayuryed for Modern
Medical Practitioners, Chaukhamba Sanskrit Pratishthan Delhi, 2008.
 
146 Nagral, Kumud: "Concept of Safe Motherliood inAyurved". The Journal of Family Welfare. June 1997. 43 (2). P. 53-57. Location :SNDT Churchgate. From Ayurveda for You,
http://ayurveda-forvou.com/women/motherhood.html Note: Dr. Nagral is the author of Ayuryed for Modern Medical Practitioners, Chaukhamba Sanskrit Pratishthan Delhi, 2008.
 
147 Caraka Samhita. Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 486.
 
148 Caraka Samhita. Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 486.
 
149 Caraka Samhita. Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 486.
 
150 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 253.
 
151 Caraka Samhita Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 486.
 
152 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 253-254.
 
153 Caraka Samhita, Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 487.
 
154 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 253-254.
 
155 Caraka Samhita Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 487.
 
156 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 253-254.
 
157 Caraka Samhita Vol II, editors R.K. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 487.
 
158 Caraka Samhita, Vol II, editors R.K.. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 488.
 
159 Susruta Samhita, Vol 2. Kaviraj Kunjalal Bhishagratna  Chowkhamba Sanskrit Series Office, Varanasi, India, 2nd edition, 2002, p. 254.
 
160 Caraka Samhita. Vol II, editors R.K.. Sharma and Bhagwan Dash, Chowkhamba Sanskrit Series Office, Golghar, India, 2003 reprint, p. 488-489.
 
161 Patwardhan, Sushama.  "Garbha Sanskar (prenatal education)". Ayurveda For You. http://ayurveda-fozyou.com/women/garbhasanskar.html
 
162 Nagral, Kumud: "Concept of Safe Motherhood in Ayurved". The Journal of Family Welfare. June 1997. 43 (2). P. 53-57. Location :SNDT Churchgate. From Ayurveda for You,
http://ayurveda-forv ou.com/women/motherhood.html Note: Dr. Nagral is the author of Ayuryed for Modern
Medical Practitioners. Chaukhamba Sanskrit Pratishthan Delhi, 2008.
 
163 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret. For a Blissful Baby. Samhita Productions, New York,  1999,p.  107.
 
164 Khalsa, Tam Taran Kaur.  The Gift of Giying Life. Vol. 1:A Woman's Guide to Self-Discovery and  Natural Childbirth.  Ancient Healing Ways, Espanola, NM, 1983. Note:  Volumes 1and 2 can be purchased at Ancient Healing Ways, http://www.a-healing.com/
 
165 Reddy, Kumuda; Egenes, Linda; and Mullins, Margaret.  For a Blissful Baby.  Samhita Productions, New York,  1999.
 
166 Kumar, Abhimanyu.  Child Health Care in Ayurveda Daya Publishing House, New Delhi, India, 1999.
 
167 Oakes, Ysha and Khonalkar, Apama. Forty Two Davs for Forty Two Years and Ayurvedic Cooking After Childbirth. Not yet published. http://www.sacredwindow.com/Rocky Mountain Institute for Yoga and Ayurveda, http://www.rmiva.org
 
168 Birth and Early Parenting Educators, http://www.bene.info/
 
169 Down Doggie Yoga Studio, http://www.downdoggieyogastudio.com