Every thought, action, and decision a pregnant mother makes is directly correlated to the health, vitality, and essentially, the life potential of the child. She must be mindful that every element, food article, aroma, sight, and sound entering or surrounding her body impacts the fetus, directing the dependent soul to a greater state or to a more weakened state of health. Holistic care relating to pregnancy becomes essential as soon as the mother and father even decide to embark on the journey of parenthood—before conception even takes place. Ayurvedic practices and principles applied to the pregnant mother and her pending child provide a sincere potential for an enriched pregnancy and birthing experience, contributing to greater mental, emotional, spiritual, and physical health of the mother, child, and father. How can the modern, western-born mother implement the ancient teachings of Ayurveda as she embarks on the journey to bring a vital new life into this world? This review of literature will offer an array of insight shedding light on how the three pillars of life, herbal treatments, five sense therapies, and spiritual practices can be incorporated and utilized throughout the pregnancy experience.
THE THREE PILLARS OF LIFE
As much as her lifestyle allows, the pregnant mother would greatly profit adhering to the Ayurvedic principles encompassing the three pillars of life. Proper routines around food, sleep, and sexual practices will establish a foundation for an ameliorated and more harmonious pregnancy. Considering that all food ingested by the mother supplies the fetus with the building blocks of development, the highest quality and ideal quantities of foods should be consumed. The foundation of an expecting mother should emphasize a balanced kapha increasing food regimen, accentuating the sweet and salty tastes and limiting the bitter and pungent tastes.
Chopra, in his holistic pregnancy book, Magical Beginnings and Enchanted Lives, infuses Ayurvedic concepts when dealing with western pregnancies. He mentions that even though the mother will tend toward “sweet foods” (meat, dairy, grains, nuts, etc), all six tastes—sweet, salty, sour, pungent, butter, and astringent— play an essential role in optimizing the nutrition available to the mother and her baby. Sweet tastes impart nourishing and tonifying attributes that encourage healthy tissue formation. Sour foods, such as citrus fruits, berries, and fermented foods, aid in digestion and stimulate the appetite; sour fruits specifically provide adequate amounts of vitamin C and flavonoids—which contribute to healthy cell development and immune function. Salty tastes, when naturally integrated in foods, support water-absorption, enhance digestion, and can be sedating. These include seaweed, seafood, and the natural mineral salts found in fruits and vegetables. Pungent tastes, such as common culinary spices like garlic, chili peppers, onion, clove, cayenne, cinnamon, ginger, etc., help to stimulate and support digestion and metabolism, relieve nausea, and cleanse the sinuses and respiratory system. Bitter tastes are found in an array of green and yellow vegetables that contain important phytochemicals that support immune function, promote healthy growth, and often encourage cleansing and detoxification of the body. The last taste, astringent, initiates a drying response on the mucosa and creates a “puckering effect” throughout the body. Astringents include cranberries, pomegranates, asparagus, and many beans and legumes—which contribute complete and abundant sources of valuable proteins and complex carbohydrates1.
So what does a mother want to achieve during pregnancy in regards to her dhatus (tissues) and body? The mother wants to foster a nourishing home and foundation for the developing fetus; without getting too absorbed by calories, meal sizes, and “pregnancy diets”, the mother will achieve balanced nourishment by simply emphasizing sweet, salty, and sour tastes that primarily tonify and fashion healthy tissue formation. Albeit, elevated intake of pungent, astringent, and bitter tastes deplete, dry-out, and exasperate purification of the mother’s body. All six tastes are vital, yet concocting the ideal balance of all the tastes in each meal is the ultimate—and, yes, obtainable—goal of the mother.
The Sushruta supports that, “the food should by amply sweet, palatable (ojas producing food), well-cooked, prepared with appetizing drugs and abounding in fluid substances2;” overall, highlighting sweet, cool, and moist qualities. The Charaka Samhita and Sushruta Samhita describe similar “special pregnancy” dietary regimens: in the first month, according to the Charaka, the mother is to consume large quantities of cold, unprocessed milk; in the second month, “only milk prepared with sweet drugs;” milk with ghee (clarified butter) and honey added in the third month; ten grams daily of milk butter in the fourth month; in the fifth month, she is suggested to take ghee; ghee with sweet herbs should be taken in the sixth and seventh months; and, for the final months leading up to delivery, the mother should include milk gruel cooked with ghee into her diet3. This tonifying regimen is encouraged to be included in conjunction with a nutritious, balanced, and complete diet. The Sushruta recommends nearly identical additions of milk and/or ghee at the progressing stages of pregnancy, but also encourages the intake of shashtika rice with milk in the third month, with curd in the fourth, with milk in
the fifth, and with clarified butter in the sixth month of pregnancy. The addition of animal flesh soups to her diet along with including abundant emollient fatty substances is also noted as supportive to the mother especially in her later months of pregnancy4. The Sushruta is adamant that, “if treated on these lines, the enceinte [fetus] remains healthy and strong, and parturition becomes easy and unattended with evils5.”
Ramesh Nanal, a practicing Ayurvedic practitioner for over 35 years, incorporates useful pregnancy-related nutrition and specific food advice in his research; he succeeds in amplifying the clarity of the valuable information offered in the Caraka. He supports that stabilization of the fetus in the first trimester is essential—hence the importance of consuming sweet, cooling, and liquid food as suggested by the Sushruta. Garghasthapan foods (stabilizing to the fetus) help to anchor the placenta, and Nanal provides the example of supplementing with one tablespoon of Water Chestnut powder (Singhoda) decocted in a cup of warm milk with ghee, taking up to four cups a day. When the heart becomes active around the fourth month, “more pure kapha and rakta is essential for the fetus here6,” and thus, a higher quantity of milk curds with rice and ghee should be consumed during breakfast and lunch. In the fifth month, the mana (mind) of the fetus becomes active, and the buddhi (the intellect) enters the fetus at month sixth; Hyridra foods (ojas/immune building foods) become highly important, Nanal recommending an increased intake of milk (milk being described as “boon to the making of mind7”) along with ghee and rice. As the last trimester nears and the fetus’s organs and systems become more developed, Nanal merely states that the mother now “requires a specific prescription for each individual body constitution8” that also acknowledges her overall health and any lingering symptoms. Nanal goes on to introduce a few specific food-based supplements to deliver additional support and nourishment to the expecting mother:
- • Garden cress seeds roasted in ghee and mixed with milk and sugar taken in the last months help with tonification, general debility, and pregnancy anemia.
- • Crab, corn, and egg soup or soy milk with egg yolks consumed after the second trimester is noted to assist with strong bone formation in the fetus.
- • Spinach soup with onions and carrots also support bone health of both mother and child, along with helping with pregnancy anemia.
- • Apricots—naturally very high in vitamin A—with honey is depicted as a very effective nervine tonic, yet also assisting with constipation, preventing infections, increasing healthy blood formation, and reducing the chances of cellular degeneration.
- • Banana with dates, figs, and ghee taken every day in pregnancy is said to be a superior overall tonic that also improves and increases blood, preventing anemia to a great extent.
- • When soaked and ground in water, black currents can be helpful in all urine disorders while also helping to alkalize the body and tone the large intestine.
- • Dates soaked in milk overnight, ground in the morning, and mixed with cardamom and honey assists in healthy blood and bone formation in the fetus.
- • Mango juice with ghee and milk taken two times daily may prevent fetal abnormalities, increase fetus’s defense against infections, aid in proper development, ease delivery, and prevent post-partum complications.9
Supplementing an already nutritious, abundant, and whole diet with balanced, nutrient-dense foods compared to supplementing with bottled, store bought vitamins will do more to holistically support and nourish the mother and child. The Charaka notes that, “the entities derived from nutrition are these such as– formation of the body, growth, continuance of vital breath, contentment, corpulence and vigor,10” portraying the special importance of a proper and complete diet for a mother-to-be.
Ayurveda principles strongly support that the foods one consumes is only a component of achieving a healthy and complete diet; the proper routines and practices around eating contribute immeasurably to the inclusiveness of one’s diet. To benefit more fully from her meals, the mother should eat her meals in a peaceful and beautiful environment, eliminate alcohol, nicotine, and nonprescription drugs from her life, eliminate caffeine if possible, honor her appetite (eating only when she feels hungry and stopping when satisfied), refraining from overeating by paying attention to when her stomach is 2/3rds full, eat freshly prepared foods, reduce ice-cold foods and beverages, drink plenty of pure, room-temperature water every day, sit quietly for a few minutes following each meal, and honor any cravings that arise, yet indulging with awareness.11 In regards to cravings, both the Sushruta and Charaka agree that desires shouldn’t be ignored. The Sushruta averring: “A physician should cause the longings of a pregnant woman to be gratified inasmuch as such gratifications would alleviate the discomforts of gestation; her desires being full-filled ensure the birth of a strong, long-lived, and virtuous son. A non-fulfilment of her desires during pregnancy proves injurious both to her child and her ownself12,” and the Charaka agreeing that “whatever she wants should be provided to her except those which damage the fetus13.”
The other two pillars are considerably more direct. Regarding sleep, the mother should get a full night of sleep, avoid day sleep, avoid sleeping on her stomach and back (unless properly supported with an incline), and shouldn’t oversleep to prevent lethargy in herself and in birthing a lethargic and lazy child. The Sushruta supports that sexual intercourse should be avoided because of fear of harm to the child14 and the Caraka compromised with sexual activity being acceptable one time each month. However, with current research regarding sex and pregnancy, experts support that, “sex during pregnancy is extremely safe for most women with uncomplicated, low-risk pregnancies15.” Each pregnancy is unique and sexual desire can vary with each women, thus the mother should remain present with what feels appropriate and appealing to her, simply using her desires as her best guide. In general, however, it should be acknowledged that sexual intercourse in excess is depleting to both partners and that special care, more gentle practices, increased mindfulness, and emphasizing the sacredness around sexual union becomes valuable and supportive to the pregnant couple. Ayurveda is all about balance and catering to the uniqueness of all individuals, so regarding the pillars of life and all other practices falling under the Ayurvedic umbrella, always looking at what will best support the unique mother at the present is fundamental.
HERBS AND PREGNANCY
Herbs are quite a controversial topic when it comes to their consumption during pregnancy, especially when considering that medicinal quantities of any herb can have unpredictable consequences on individuals. However, herbal practices have boomed immensely in the west, steering more mothers toward herbal consumption during pregnancy. Inexorably, this has led to expanded knowledge of how herbs affect pregnant woman and their babies. In Aviva Romm’s research and time in practice as a midwife and herbalist, she summarizes herbs repeatedly observed to be safe and effective, those commonly used but may be harmful, and herbs to avoid all together during pregnancy. Romm acknowledges: “Overall, most herbs are safe, with little evidence of harm. Few reported adverse events have occurred, and those that have been reported typically involve the consumption of known toxic herbs, adulterants such as unsafe herbs or even pharmaceuticals additives, or inappropriate use or dosage of botanical therapies16.” Caution should always be taken, of course, and Romm and other sources state that, if anything, the majority of herbs should be avoided all together in the first trimester17.
Through scientific evaluation and clinical trials, Romm lists a handful of herbs seen repeatedly to be safe during pregnancy. Red raspberry leaf was found to be a mineral-rich, nutritive uterine tonic that, with long-term, low-dose (1.5-5 gm in tea/infusion) use leading up to parturition, can promote an expedient labor with minimal bleeding. To reduce the duration or occurrence of upper respiratory symptoms, intermittent use of Echinacea (as tincture) has been deemed safe. Chamomile tea in
moderate amounts can assist in relaxation, insomnia, and flatulence during pregnancy. In the case of a urinary tract infection, concentrated, pure cranberry juice (taking up to 32oz/day) is the ideal, non-anti-bacterial treatment that is safe and effective for pregnant women. Ginger, mentioned in many texts and research, is commonly recommended as a safe treatment for nausea, vomiting, and general morning sickness as long as the daily dose doesn’t exceed one gram of dried ginger powder18. Even the Natural Medicine Comprehensive Database, an extensive, online resource providing “Unbiased, Scientific clinical Information in Complementary, Alternative, and Integrative Therapies,” remarks ginger as one of the best known herbal treatments for morning sickness in pregnancy, stating: “Clinical research in pregnant woman suggests that ginger can be used safely for morning sickness without harm to the fetus19.” Other herbs, like Nettle to reverse iron-deficiency, cramp bark for irritable uterus relief, licorice (only for short-term use not exceeding a week) utilized for sore throat symptoms, motherwort for labor pain, black and blue cohosh and castor oil to simulate labor, and the external application of tea tree oil, garlic, and calendula oil for vaginal yeast infections are also notable treatments, yet less scientific research has been conducted to back up their safety—only traditional usage and empirical evidence is available20. So, what herbs should soon-to-be mothers avoid all together? The American Pregnancy Association lists saw palmetto, goldenseal, dong quai, ephedra, yohimbe, pau d’arco (in large doses), passion flower, black and blue cohosh (for women who are not at term), roman chamomile, and pennyroyal as herbs that are likely unsafe or unsafe for oral consumption during pregnancy. Possibly unsafe herbs may include aloe, ginseng, feverfew, kava kava, and senna, but like with most herbs, adequate research is limited21. Generally noted from the Caraka, “the diseases of the pregnant women should be managed with diet and drugs consisting mostly of soft, sweet, cold, pleasant and delicate things22.” While this is quite vague, the idea of judging herbal effects based on their gentler qualities could be of use for the pregnant mother trying to avoid harm.
Throughout the Vedas, while herbal recommendation (usually via external application) are noted for use in regards to serious pregnancy complaints and disorders, little is to be found mentioning common herbal use safety during pregnancy. The Sushruta, pertaining to the overall health benefits for mother and fetus, does however include that, “the growth, memory, strength and intellect of a child are improved by the use of four following medicinal compounds, used as linctus (pras’a): 1) well-powdered gold, kushtha, honey, clarified butter and vacha; 2) brahmi, shanka pushpi, powdered gold, clarified butter, and honey; 3) shanka pushpi, honey, clarified butter, powdered gold and vacha; and 4) powdered gold, maha nimba, white vacha, clarified butter and honey23.” As the mother progresses through her final term, bastis (enemas) are commonly employed to balance vata, particularly apana vayu—which is the vayu governing the decent of the child through the birth canal. A specific basti formulation the Sushruta suggests to help “restore vayu in her body (nervous system) to normal and to cleanse bowels, anuvasana basti(enema) with bala, atibala, shatapushpa, palala (flesh), milk, cream, oil, salt, madana fruit, honey and clarified butter.” It was then stated to follow with a basti made with milk and a decoction of Madhuradi-gana24. While the Charaka was vaguer, stating simply to “give unctuous enema with the oil cooked with sweet drugs25,” they can both be interpreted to support that tonifying, oil-based enemas with nourishing herbs, and maybe even nervines, would be beneficial to the mother during the eighth and ninth months of pregnancy. While ancient Ayurvedic remedies may be difficult to apply, utilizing Ayuverdic principles with the available herbs can benefit the western mother.
While taking caution and/or seeking herbal advice from an expert is never a bad idea in the case of including herbs during pregnancy, the moderate use of herbal nutritive teas and cooking spices are generally considered safe to be used freely. And, again referencing Romm, a final general list of safe herbs to use for mild pregnancy complaints—having only slight variation in the medical research she gathered—include: Echinacea, St. John’s wort, peppermint, spearmint, ginger root, fennel wild yam, meadowsweet, blue and black cohosh, red raspberry leaf, evening primrose, garlic, aloe, chamomile, pumpkin seeds, and ginseng26. Herbs, however, aren’t paramount to a healthful, joyous, and symptom-free pregnancy. Through diet, including proper daily routines and practices, and managing overall stress of the mind and body, an expecting woman may find she has no need to reach in the herbal cabinet for symptomatic relief.
DAILY ROUTINES AND PRACTICES
The ancient Vedic practioners are adamant about implementing more sattvic routines and rituals in daily life. The Sushruta claims: “Those women who are devout in their worship of the gods and the Brahmins and cherish a clean soul in a clean body during pregnancy are sure to be blest with good, virtuous and generous children; whereas a contrary conduct during the period is sure to be attended with contrary fruits2.” Today, we may not be as devout in our thinking, but promoting and conducting practices that support spiritual growth, keep the body clean and healthy, and keep the mind calm and joyous can support and enhance the experience leading up to and following parturition. Before uncovering the practices most beneficial to the mother-to-be, the Sushruta obstinately remarks on actions prohibited during pregnancy:
“A woman should avoid all kinds of physical labor, sexual intercourse, fasting, causes of emaciation of the body, day-sleep, keeping of ate hours, indulgence in grief, fright, journey by
carriage or in any kind of conveyance, sitting on her haunches, excessive application of Sneha (oil) karmas and venesection a the improper time (after the eight month of gestation), and voluntary retention of any natural urging of the body28.”
Even with these “don’ts” having been recorded in texts thousands of years ago, these simple examples still can provide a baseline of actions to avoid during pregnancy in the modern day. Implementing yoga (encompassing meditation and breathing), increased overall mindfulness, and five sense therapies as routine practices during pregnancy is supported by the ancient texts, and all can be safely and conveniently integrated into an expecting mother’s day.
While strenuous exercise is almost always prohibited during pregnancy, conducting some form of exercise can be beneficial in maintaining the strength of a pregnant woman’s body—especially as the fetus grows and her energy and physical demands increase. To maintain bone strength, muscle tone (of all organs), heart endurance, and to keep her mind at ease, mild to moderate (depending on previous fitness and exercise routine before pregnancy) exercise should be adhered to daily starting at around the second trimester—because of the instability of the fetus in the first trimester, much more caution should be taken during that time. Brisk walks in nature, swimming, tai chi, and yoga are just a few examples of exercise options that will holistically sustain the mother. Yoga, the sister science of Ayurveda, is not only ideal because of its physical benefits, but yoga helps to calm the mind, alleviate stresses, and as Chopra puts it, “yoga awakens mind/body harmony, making it easier for you to make choices that are good for you both physically and emotionally29.” Because prenatal depression has been noted to be a progressively prevalent factor, recorded to affect as many as 49% of pregnant women, and being observed to be “a risk factor for prematurity, for developmental delays, and for later behavior problems in childhood and adolescence30,” safe and non-invasive measures to mitigate depression in pregnant women should be encouraged. In Tiffany Field’s study utilizing yoga and tai chi as a complementary therapy for prenatal depression, anxiety, and sleep disturbances, she found that women who participated in tai chi/yoga sessions for 20 minutes daily for 12 weeks while in their second and third trimester (weeks 22 to 34 of pregnancy) depicted greater decreases in all three areas she observed. They utilized the Center for Epidemiological Studies-Depression Scale (CES-D), which is a self-report assessing the frequency of present depressive symptoms including: “depressed mood, feelings of guilt and worthlessness, feelings of helplessness and hopelessness, loss of energy, and disturbances of sleep and appetite31.” With only positive results recorded, this study supports that yoga and/or tai chi is a cost-effective, safe, and convenient way to successfully reduce depression and associated symptoms during pregnancy.
Yoga can be modified for all levels, and yoga encompasses not just asana (the physical practice) but also breathing techniques, mindfulness, and meditation, making it accessible to everyone in some form. In a comprehensive literature review conducted by Kathryn Curtis, Aliza Weinrib, and Joel Katz on implementing yoga and its subsequent effects on pregnancy and the labor/delivery experience, they concluded that yoga is indicated during pregnancy having supportive psychological, physiological, neuromuscular, and immunological impacts on the mother throughout term and through and following parturition32. One of the studies they examined was a monitored yoga program lasting 12-14 weeks which compared pregnancy-related discomfort in women who completed the program to those receiving standard hospital care. The findings support that a “prenatal yoga program is safe for pregnant women and can reduce the discomforts of pregnancy and increase maternal self-efficacy and self-confidence33.” A second note-worthy study mentioned in the review described a holistic 16 week long (week 20 to 36 of pregnancy) program including asana, breathing techniques, lectures, and deep relaxation techniques. Not only did the yoga group show significantly greater improvements in physical, psychological, environmental, and social domains tested, but the author pronounced yoga as “a noninvasive and cost-effective way of improving quality of life and interpersonal relationships during pregnancy34.” With this last study, the experience of the mother throughout and following labor was examined. After a 10 to 12 week yoga program (throughout week 26-28 to week 37-38) was followed, maternal comfort, objective and subjective pain, length, augmentation, and the use of medication all in relation to labor, along with the overall birth outcome, was recorded. For the mothers who followed the yoga regimen, the first stage and the total duration of labor was significantly shorter, self-reported and observed pain scores were drastically lower, and evidence supports that maternal comfort at four different assessment points during and following labor was seen to be significantly higher than the mothers not following the yoga program35. While caution and medical approval should always be considered with all actions during pregnancy, overall, yoga asana, breathing techniques, and meditation/mindfulness practices most likely will only provide relief and increased comfort during and following pregnancy.
Yoga encompasses such a broad spectrum of practices and asanas, so for a mother new to yoga, where is a good place to start? Chopra’s book includes many asana, breathing, and meditation practices suitable for pregnant women. Slowing down with yoga will encourage the mother to bring more awareness to her breath, while also helping with joint flexibility, balance, and muscle tone. Poses, and their potential benefits, that Chopra recommends include as follows:
- • Butterfly pose with spine extended straight and slowly lengthening forward. This pose slowly opens up the pelvic girdle, which by increasing flexibility in this region, the mother may experience more ease upon delivery as the baby passes through that region.
- • Cat and Cow pose working deeply and slowly with the breath as she moves from one position to the next. This benefits the mother by increasing spinal flexibility and hip mobility, also helping with low back pain that is often experienced with pregnancy.
- • Squatting pose with feet planted on the floor, hips reaching toward the floor, elbows pressing out on the inside of the knees, and breathing to extend the spine and squat lower in the pose. This works to widen the pelvis and has been observed to ease labor and reduce the chance of perineal tearing—this pose also commonly practiced around the world as a birthing position because of these noted benefits.
- • Pelvic Tilts/ Bridge pose with legs perpendicular to the floor and hips lifted off the floor extended towards to sky, while the shoulders ground into the floor. This assists with spinal flexibility, relieving lower back congestion and improving overall circulation in the pelvic region.
- • Half pigeon, with straight spine and slowly walking the hands forward, is another great pose to open up muscles and fascia in the hips and groin region.
- • Child’s pose with the belly resting between the knees spread wide on the floor and arms extended forward. The mother will find greater ease in her back muscles, hips, and pelvic region, while also allowing belly muscles to soften and relax.
- • Simple twists, whether sitting upwards or performed from laying on her back, are great for massaging internal abdomen organs and lengthening the spine36.
Chopra also mentions Kegel exercises, relating to mula bhanda in the yogic realm. Regularly practicing these can drastically improve pelvic muscle tone and the functions of the organs in that region. Strengthened pelvic muscles can aid in preventing urinary incontinence, improving circulation around the pelvis, and preventing hemorrhoids, while easing delivery because of more control contracting and relaxing those muscles37. These practices conclude some simple examples that even mothers who have never before taken a yoga class can perform and receive much benefit. Endless yoga asanas are recognized that support the mother, but trained guidance and the use of props may be necessary to ensure no harm is done. Maintaining mindfulness and awareness of breath not only as she stretches and opens her body through yoga asana, but as she endures all her activities and actions should be a primary goal of the mother as she carries her baby and prepares for birth.
More and more research and controlled trials are being conducted on mindfulness, pranayama, and mediation during pregnancy as an effectual and risk-free method of decreasing stress and anxiety. Especially considering the negative impacts of stress on the mother and infants, including reduced adaptive immunity, lower birth weights, increased chance of preterm births, and cognitive, emotional, and developmental deficiencies in infants—and considering the harmful nature of reducing stress symptoms with pharmaceuticals—simple, non-invasive approaches are becoming key to help with stress and depression in pregnant women. In Ka Po Chan’s study, he implemented an Eastern Based meditative intervention (including mindful eating, mindful walking, mindfulness prenatal and postnatal exercises, daily practice of ‘self help, helping others,’ crisis intervention: turn curse into blessing, daily practice of ‘bliss,’ three minutes-breathing practice, body scan, mindful breathing, etc.). He compared the birth weight, maturity, Apgar score (simple assessment of how the baby is doing at birth), and umbilical cord blood cortisol levels in babies whose mothers followed the integrative meditative approach to those who didn’t. His “evidence suggests that meditation as an intervention has a strong relationship to positive health outcomes, overall well-being and adjunctive treatment for diseases38.” The infants of the intervention group also portrayed a better response to stimulus along with having better overall temperament39. In another study that also focused on mindfulness, the author designed a randomized controlled study to evaluate the effects of an existing mindfulness meditation program in a sample of pregnant women experiencing elevated levels of stress. They described mindfulness to refer to “a process that cultivates a mental state of awareness and acceptance of present moment experiences, including one’s current sensations, thoughts, bodily states, and environment40.” With sharp contrast to the control group, the mindfulness intervention led to a decline in pregnancy-related anxiety and perceived stress, along with revealing an overall increase in mindfulness41. In a final related study involving the regular practice of Bhramari pranayama (bee breath) for two months by pregnant women as a potential measure to prevent the occurrence of pre-eclampsia, there was a “statistically significant reduction in basal BP, response to cold stress (body’s reaction to hand immersion in cold water) and basal pulse rate after two months of this yogic practice42. They supported that pranayama practiced overtime can restore the balance between the sympathetic and parasympathetic components of the autonomic nervous system, revealing how these practices not only help the body on the emotional level when dealing with stress and anxiety, but on a physical—even quantitative—level as well. While these studies disclose just a few examples of a small handful of complementary practices, all defend that implementing a regular mindfulness/meditation and breathing practice—all of which fall under the “Ayurvedic approach”— throughout pregnancy will only bring an increased sense of ease and well-being to the mother and her baby during and following pregnancy.
FIVE SENSE THERAPIES
Ayurveda strongly asserts the importance of balancing and supporting the five senses; five sense therapies and overall awareness of how the mother and fetus are effected by the external world through the five senses is an essential component to a balanced pregnancy. Not only will the mother feel more at ease and supported, but the fetus’s development prior to and following birth is significantly influenced by tastes, smells, touch, sounds, and sights the mother comes in contact with. Chopra elaborates on this concept, including ideas on how to encourage balance through the information perceived by the five senses of the mother and fetus:
The fetus is quite sensitive to outside sounds; studies support that by eighteen to twenty weeks, the fetus is hearing and responding to outside sounds. Experiments where small microphones were placed inside the womb of a pregnant women revealed that over half the words spoken by a man and over a third of the words spoken by a woman were understood. The mother’s voice is the most recognized and responded to, and if the father’s voice it frequently present, fetuses have been observed to respond to his voice soon after birth43; thus, the mother and father should be regularly talking, singing, telling stories, etc. to the unborn child throughout pregnancy. The mother, also being sensitive to sounds, will benefit by surrounding herself with calming and beautiful sounds. That could be in the form of music she enjoys and inspires her, positive and supportive conversations, or going out in nature and enveloping herself with the abundant, serene sounds of the natural world. Chopra notes that “pleasing sounds can lower blood pressure, enhance immunity, and reduce anxiety44.” Sounds and music can also be utilized to balance a dosha vitiation: with more anxiety and vata present, gentle and calming music will help to ground the mother; with heated emotions and heightened pitta, cooling and soothing sounds will suffice; and, with lethargy, melancholy, and more kapha present, uplifting and revitalizing music can support increased energy and motivation. While intently utilizing beautiful sounds will positively impact the mother and fetus, distressing, loud, obnoxious noises and stressful and odious conversations may have an antagonistic effect and, if possible, should be avoided.
The fetus is also directly affected by touch: “Pressure through external massage leads to changes in fetal activity and heart rate, and by six months in the womb the unborn baby is as responsive to touch as a one-year-old baby45.” As the mother changes her position, so does the fetus; studies reveal how rapid and abrupt movements of the mother trigger a motor response and alter heartrate in the
fetus. On the opposing end, fluid and rhythmic movements of the mother, such as dancing, tai chi, and yoga, can bring ease to both mother and child. Daily full-body self-oil massage (abhyanga) is a practice recommended as an essential component of balancing regular routines in the Ayurvedic realm, and the pregnant mother would greatly benefit from incorporating a daily 10 to 20 minute abhyanga into her morning. Not only is the oil nourishing and tonifying, the rhythmic movements and strokes of gentle massage assists with lymph flow, circulation, immune function, and delivers an overall improved sense of well-being. If stretch marks are a concern, applying body butters, coconut oils, or avocado oils with the addition of vitamin E and/or the essential oils of chamomile and helichrysum may bring relief to prone or affected regions. Different oils may also have distinctive influences on the mother: sesame, almond, and walnut oils are heavier, warmer oils that help to pacify vata; coconut, avocado, and olive are cooler oils that are thought to be more balancing to pitta; and, mustard seed, sunflower, and safflower oils, which are warmer and less dense, are valuable to kapha. Warming these oils, infusing them with doshic-appropriate essential oils, and/or following the massage with a warm bath will augment the benefits and increase the sensations of this soothing oil therapy.
Specific massage of the perineum (the area surrounding the birth canal) in the months leading up to birth will become an essential addition to the mother’s daily massage routine. Chopra mentions that this will not only aid in keeping the tissues nourished, but it will mildly stretch the tissues and better prepare them for a delivery, decreasing the chance of tearing or injury in that region46. Uttara bastis (an herbal oil enema of the vaginal canal where one to two ounces of warm, medicated oil is held in the vagina as the pelvis remains in an upward-tilted position) is an Ayurvedic practice used for the same tonifying purposes, but with an advantage of administering herbal oils for broader effects on the mother and womb. The Charaka mentions a slightly different approach, proclaiming that, “A swab soaked with [sweet herbal] oil should be placed inside the vagina to lubricate the seat of the fetus as well as the entire genital tract” with added benefits of softening “the entities which hold the fetus, womb, waist, sides and back of the woman at the time of delivery, wind gets in normal course, urine and feces in normal state get through the passage easily; skin and nails also become soft, strength and complexion are improved and she delivers the child as desired, excellent and healthy with ease and in time47.” Because of how essential is it to support and normalize apana vayu (the downward flow that will govern the safe and easy delivery of the fetus) in an expecting mother—especially in the last half of the third trimester—these practices will do more than nourish and strengthen the perineal tissues, but will also support the other physical and subtle actions that apana vayu governs. Comment [KS1]:
The womb is generally a dark place exposing the fetus to an insignificant amount of light (2 to 10% of visual outside light is thought to be perceived by the fetus), and the fetus has been observed to be only slightly responsive to changes in lighting and visuals of the outside world. However, the sights and visual exposures of the mother can impact the fetus because of how the mother responds on a more subtle level. Exposure to violence, gore, and distasteful images and scenery impairs the mother, even being noted to suppress the immune system49. In contrast, being encompassed by beauty and kind acts enhances immune function in the mother—and thus the child. Creating a home environment that is beautiful and begets delight (even including color therapy concepts to bring greater balance), getting out in nature every day, gazing into the starry sky each night before bed, and incorporating balancing color meditation (based on doshic vitiations) can all add to the well-being of the mother, and in essence, the fetus.
Tastes ingested by the mother slightly impact the fetus, studies suggesting that “an unborn baby will increase or decrease his swallowing based on the flavors present in the amniotic fluid50.” Sweet tastes are observed to be the most desirable to both the fetus and mother—as we have already explored—and bitter tastes are seen to be the least desirable, being depicted by babies swallowing less when bitter tastes are injected in the womb. Much has already been imparted on the matter of tastes and nutrition for the mother to be, so just a final reminder of the importance of including all six tastes on a daily basis and excluding all foods perceived as “distasteful’ and invoking a negative response in the mother, and by default, the fetus.
The final sense, smell, has a slight—yet notable—influence on the fetus. Evidence suggests that babies remember smells and tastes they are exposed to in the womb and are likely to express greater preference for foods whose fragrances they were exposed to during pregnancy. Because the child only knew the scent of his mother’s amniotic fluid for the first nine months of life, studies have depicted that “if a newborn baby is given the choice of suckling on her mother’s unwashed breast, which secretes a smell similar to the smell of amniotic fluid, or on a breast that has been washed, more than 75% of the time the newborn will choose the breast with the familiar amniotic smell51.” The tastes, and thus the smells, entering the mother’s body does subtly transfer to the fetus, but the scents and aromas in the mother’s environment will be more impactful on her well-being, moods, behaviors, and energy levels. Unpleasant odor can deplete and offset the mother, while pleasant and tasteful aromas can soothe and encourage an increased feeling of peace. Intentional aromatherapy—essential oils, fresh flowers, natural wax candles, etc being all great options—can be utilized to calm or uplift the mother, balancing vitiated doshic states experienced throughout and following pregnancy. A few examples of vata pacifying, calming aromas include lavender, geranium, chamomile, vanilla, juniper, and rose. To counter pitta and intense/heated feelings, scents like jasmine, rose, neroli, mandarin, sandalwood, and lavender are seen to cool and soothe. Invigorating and purifying scents that may assist in pacifying stagnation and kapha-related symptoms of the mind include cinnamon, juniper, ginger, bergamot, and citrus aromas. Diffusing, burning, incorporating these in massage oils and baths, or simply keeping a scented vile or spritzer bottle handy are all great methods of utilizing the profound effects of aromatherapy.
Considering how intake through the senses influences the mother and fetus, the mother should utilize this knowledge to create a more balanced pregnancy. The Sushruta was adamant that negative exposure of the five senses can be harmful to the mother and fetus, strongly asserting, “she should not touch nor come into contact with unclean, deformed or maimed persons, and should forego the use of fetid smelling things, avoid dreadful sites and painful and agitating sounds and the use of dry, stale, and dirty food as well as that prepared overnight52.” While we can’t expect a mother to constantly be in control of all the qualities she is taking in through her senses, she can, however, achieve more mindfulness of what she is exposed to in her environment and how to mitigate the aspects that aren’t supportive.
Pregnancy is a sacred time and should be treated as such. Commonly in the west we assist pregnant mothers with not much more than increased food intake, prenatal supplements, and regular doctor check-ups. While many successful births have occurred following the standard western lifestyle, Ayurveda looks deeper into optimizing health, ease, and vitality of the physical and subtle bodies of both the mother and fetus. Following a balanced, tonifying diet with the addition of food supplements for nutrient and rejuvenating support, including safe herbs only when necessary, incorporating an individualized exercise and yoga asana routine for the mother, implementing a meditation and pranayama practice, and utilizing therapies and simple lifestyle choices to bring balance in through the five senses are all effective regimens that play a preventative, stabilizing, and, overall, supportive role for the mother-to-be. To create a pregnancy experience that is void of stresses, frustrations, and unnecessary discomforts and abundant in love, contentment, ease, and joy is absolutely an achievable goal. Implementing Ayurvedic practices in a way that is compatible with the lifestyle of a western-born mother will assist in obtaining this goal, not only as she carries the child, but as she goes through labor, delivery, and caring for the child post-partum. Ayurveda isn’t a cure, but merely a balancing way-of-life that supports our body, and ultimately our soul, as we embark on the journey of life; and, if we are so destined, this journey may include the magical experience of pregnancy.