Ayurveda and Pregnancy
Updated: Jan 3, 2020
Earlier this year, our second child was born, and having gone through pregnancy again, I am going share a few tips from an Ayurvedic perspective while they are fresh in my mind.
Make Vaata your friend
Ayurveda's big offering in pregnancy is the understanding that this is a time when your Vaata dosha will naturally rise. Vaata dosha is composed of two of the pancha mahabhutas (five core elements: fire, earth, water, air, space) -- air and space. Vata dosha represents the force of movement. This dosha will rise steadily throughout pregnancy, coming to a climax for childbirth. This is nature's way of supporting the tremendous force necessary for childbirth.
Ayurvedic analysis rests on a foundational principle -- "like increases like." During pregnancy, the body is especially sensitive to Vata-aggravating foods and lifestyle as Vata is on the rise, and therefore, the Ayurvedic approach to supporting pregnancy involves being mindful of this sensitivity. Ayurveda does not remedy the excess Vata building up in your body as this Vata is necessary for childbirth. However, it does recommend avoiding excess Vata in your foods and lifestyle during pregnancy, as too much Vata can cause a miscarriage.
Post-partum, Ayurveda makes direct interventions to bring your Vata down and help you heal. We will talk about that a little later in this post.
All Trimester Food Advice
Pregnancy requires mindfulness of your Vata dosha. During this time, it is important to eat foods that are easily digestible. Raw foods (like salads and smoothies) are not easily digestible (unless you have a truly excellent digestion), and due to their cold nature, they aggravate Vata dosha very easily. An aggravated Vata dosha not only increases the risk of miscarriage, it also makes concentration on any work difficult as the mind gets jumpy. Ayurveda recommends warm cooked foods during your pregnancy. As an aside, we are now learning from evolutionary biology that it is the act of cooking that is most likely to have helped us evolve from primates into humans (see TED Talk by Prof. Suzanna Herculano-Houzel); and we likely need cooked foods to support the energy that sustains our neural connections.
The First Trimester: Go Easy
The first trimester is when most mothers tend to have symptoms of nausea and exhaustion. It is important to recognize that our body is changing and to go easy. If you were already used to a certain level of exercise, you may continue it after checking with your medical practitioner. However, Ayurvedically, this is not a good time to pick a new form of exercise. The exception is gentle prenatal Yoga -- that is because it is grounding and will not increase Vata further. As Vata is on the rise, mothers can find it beneficial to ground themselves in this way.
The first trimester is also considered the most risky time for foetal development. Ayurveda strongly recommends the avoidance of high travel during this trimester. It is important to understand that this advice has to be interpreted from a relative perspective. If your body was already used to traveling, then it won't be shocked by the same pace of travel continuing on. However, if you were not used to traveling a lot, it would be a bad idea to suddenly start traveling in your first trimester.
The Second Trimester: Enjoy yourself
Ayurveda considers this the stable period of the pregnancy. If you were wanting to go somewhere on a holiday, this is a good time to do it. This is also a great time to introduce a galactagogue (in plainspeak, a galactagogue is an herb that enhances milk production so that you will have plenty of milk by the time baby is born). In Ayurveda, Shatavari (asparagus racemosus) is known for being an effective galactagogue that reduces the chances of suppressed lactation, and also a protector against miscarriage. Shatavari rootlets are processed into a powder and available online.
When consuming Ayurvedic herbs, it is necessary to understand that these herbs also come with a recommendation for the Anupana, or the vehicle that is ideal for transporting the herb into the body. Shatavari's anupana is warm milk. If a mother has a weaker digestion and cannot handle milk, water is a secondary substitute (though, not ideal).
Shatavari is also available as granules mixed with sugar and cardamom, and sold as Shatavari Kalpa. These can be mixed into milk instead of sugar. They should be avoided by those who have diabetes (even gestational).
I took Shatavari Kalpa granules cooked in warm spiced milk during my first pregnancy. I had no lactation problems then. In my second pregnancy, my digestion was weaker, so I took Shatavari powder in room temperature water, and again had no lactation problems. I also went on a long road trip with my family during this trimester and those are beautiful memories.
It is in the second trimester that you will also start noticing cravings. This may not be applicable to every mother, but when it happens, Ayurveda strongly recommends that you honor it (barring alcohol cravings or smoking that is known to cause reproductive harm). These cravings come from the fetus' need for nourishment. For me, I didn't have any cravings for my first child. However, just when labor began, I had a huge baklava craving. My spouse took me to a nearby Whole Foods where I had a baklava in between contractions in the parking lot. Just so you know, my daughter has a huge sweet tooth, and thanks to her, I am into making all kinds of desserts. For our second, the second trimester was when I would feel the need to eat something cooling in the middle of the night. I would end up eating 1 or 2 raw carrots -- I wouldn't eat more as that would adversely affect my digestion. The Ayurvedic teachings tell us that sometimes, a vegetarian mother can have a strong craving for meat -- this is not to be ignored. The fetus is asking for more earth from the five elements perspective. To honor it, foods that are predominant in earth must be eaten.
The second trimester is also a good time to enroll into a childbirth education class. There tends to be a wide range of offerings, including at your neighborhood hospital. We had a strong preference for natural birth with a holistic approach rooted in a strong scientific grounding. Hence, we chose to take classes from Blossom Birth, a childbirth education non-profit that stood for those values. Another wonderful education resource is Birthing from Within which views childbirth as a rite of passage. My spouse also found Ina May Gaskin's book on childbirth to be very helpful. Reflecting on the number of years it takes us to develop professional competency in any area, it is humbling to realize that we do need to put in the time to educate ourselves on the numerous decisions coming our way in childbirth. These decisions require us to think about our values and who we want to be.
The Third Trimester: Slow down
This is a time of slowing down. It is a great time to introduce a meditative grounding practice if you haven't already started one in the first two trimesters. Ayurveda considers childbirth a multi-dimensional event of which the physical is just one. There are emotional and spiritual aspects to childbirth that also need their space. Giving the emotional and spiritual aspects their due space helps you honor childbirth in all its dimensions.
For the emotional aspect of childbirth, we found it truly helpful to hire a doula the first time around as we concluded that there was so much to learn and navigate in the medical system that we really needed guidance. It led to a great outcome -- we learned a ton about childbirth from someone who assists mothers all the time as her day job. In Ayurveda, much respect is accorded to the "midwife," who is the holder of ancient wisdom. Midwifery is an active profession in the United States and supports mothers who'd like to go with home birth. We decided to go with a hospital birth and took the services of a midwife as a doula. We were transparent about our decision process and communicated to my obstetrician that we would like to include our doula in the decision team. Doctors tend to be sensitive about how doulas communicate and they want doulas to speak openly and not behind the back of the doctor. Our doula, Treesa MacLean, was comfortable with that and so were we. The relationship with the doula is not just one of transacting information. Treesa felt like a second mother to me and I felt relieved to have her in the delivery room.
For our second delivery, my spouse and I felt well-prepared thanks to the education we had received from our doula the first time around. We had wanted to have a home birth the second time but could not do so as our insurance would not cover it and we were not able to financially afford it. However, our preparation helped us go through the hospital process much more smoothly than the first time, thanks largely to the time and attention my spouse put in. My spouse (who happens to be a professional Decision Analyst) has written a guide to managing labor from Decision Analysis perspective to help partners of mothers assist in the childbirth process the way he was able to do, thanks in large part to his professional training and aptitude for decision analysis. For first-time moms, this is a great time to enroll your spouse into attending childbirth classes and learning how to support you emotionally throughout the process.
Emotional support in childbirth also has a community aspect to it. This is a time when you lean into your vulnerability and allow others to support you. We have a special gratitude for those who helped us out during this time. Friends came together to offer us food support post-partum. It is important to let friends know about the kind of food you need post-partum (see the next section). Our friends also made the time for us during the third trimester. I remember fondly the outdoor picnics and the pampering that comes a mother's way during this trimester.
The spiritual aspect involves working on the deepest part of ourselves to be able to honor the special privilege that parenthood brings us. For our first child, I went for a 10-day Vipassana meditation sit. This was very special -- the volunteers helping out with the course accommodated my special needs and made me feel comfortable. I remember fondly that the first time I felt my daughter move was during the 10-day sit. Her kicks were prominent during the evening discourses from our teacher S. N. Goenka, reminding me that there were two people listening in the same body. I enjoyed the discourses that much more. For our second child, my spiritual nourishment came through my school's Ayurveda clinic practice, teaching Ayurveda and my teacher's discourses in the Vedic Spiritual Studies Program. No matter what your spiritual path is, this is a great time to view pregnancy from your spiritual perspective.
Childbirth and PostPartum: The 40 Day Rule
For both my children, thanks to the classes my spouse took, he was able to correctly identify that I was in labor, while I was in denial -- I had wanted our children to come a few days later! I cannot sufficiently emphasize how important it is to treat childbirth as nature's classroom and a great opportunity for education. My spouse will hopefully write a decision-making guide soon for this part. All I will say for now for mothers is that don't beat yourself up for anything that happens or does not happen during childbirth. I have known mothers who were crushed by the fact that they had a c-section baby after all the work they put in to be healthy. What is important is that your child is healthy and well, and that you are recovering well. Ayurveda takes a super-practical approach and meets you wherever you are.
Now, let's go on to post-partum healing. A little after your baby comes out, your contractions will continue in order to deliver the placenta. Right after that, it is very important that your nurse caregivers do an abdominal massage with warm compress to start the process of healing. These massages will need to continue once you come home, and I will say more about it a little later.
Right after childbirth, it is important to have light digestive meals that are healing. I had khichdi cooked liberally in ghee. Khichdi is an Ayurvedic superfood that balances all the three doshas: Vata, Pitta and Kapha. I avoided the hospital meal options (my spouse ate those).
Khichdi (serves 2)
Ingredients: rice, yellow mung lentils, ghee, cumin seeds, pink Himalayan salt
Wash 3/4 cup of rice and 3/4 cup of lentils. Add 1.5 cups of water, 1/2 tsp of pink Himalayan salt and pressure cook. If you are cooking on open stove, then cook until the water has almost disappeared. Then, prepare the tempering by heating 2 tbsp of ghee. When the ghee is hot, drop in 1/2 tsp of cumin seeds. If you hear them splutter, the temperature is just right. The tempering goes on top of the cooked khichdi. Make sure you heat it only for a few seconds in that spluttering mode. You may add seasonal vegetables before pressure cooking. Spinach and opo squash are great options.
This is the time to make major interventions to reduce your Vata and heal your uterus. As we have already mentioned, like increases like. Therefore, to reduce Vata, we must increase the opposite -- Kapha, or the force of stability. We bring the earth into our body in multiple ways. One of the most important ones for the rapid healing of the uterus is the consumption of wheat laddoos (balls) that are created using the following recipe:
Wheat Ladoos (about 15 pieces):*
1 cup whole wheat flour – dry roasted
½ cup nuts (mixture of nuts, I usually do slivered almonds, black raisins) – dry roasted (can also be roasted in a little ghee in the later stage)
1 tsp Gond (edible resin) – dry roasted. I grind the whole pack when I buy it and then roast in ghee when I am ready to make the laddoos.
½ cup sugar (can add more or less depending on taste preference) – fine grind or leave as it is (if you like a little crunch in your laddoos)
½ tsp cardamom - fine grind
½ tsp ginger powder (this is a must, it helps in digestion and lactation )
Ghee- enough to hold the laddoo together (use warm ghee). I usually heat ghee, add the ground edible gum, nuts, roasted wheat flour and all the remaining ingredients. Mix well and keep it on low, you want to roast it a little more in this stage.
Let roasted flour cool down. Now roll the laddoos and enjoy!! Cool them down before you transfer to an airtight container, store them at room temperature. They last for at least 6 months.
*: Hands should be dry at all times especially while rolling the laddoos.
1 or 2 of these balls should be consumed every day (depending on your digestive fire). It is important not to overdo it. Nursing mothers tend to crave more sweet-tasting things. This is not always the case, but when this craving arises, the wheat balls are a great option compared to other desserts. If you don't have the time to make these wheat balls yourself, consider requesting someone from your community to follow the recipe and make them for you. I had them from day one.
This is also a great time to introduce methi (fenugreek) in your diet. This is an herb that is somewhat bitter and a known post-partum galactagogue. In the United States, this can be found in Farmers Markets (the Chinese farmers tend to carry it). It can also be found in Indian grocery stores. In my first pregnancy, while I had no lack of milk supply, I did experience pain in my breasts (engorged breasts) due to channel blocking. Consuming methi helped alleviate that. I cooked every meal with methi in some form. If I was having chapatis or parathas, I would mix methi in the dough. If I was having lentil soup, I'd cook the lentils with methi. A favorite dish was aloo methi (potatoes sauteed with methi).
Post-partum warm oil massages are great for reducing your Vata and a strong recommendation from Ayurveda. These massages are very liberal with the quantity of oil to be used. I used Dhanwantaram oil. Sesame oil works best. Heavier oils (like Dhanwantaram also sesame based) are better than lighter ones as they have more earth. The stroke of the massage should always be clockwise on the belly to aid digestion. In Ayurveda, metabolism is not limited to what you eat. Even your skin digests. So the oil is rubbed into the skin with the intention of absorption by your body. I did the massage every day for an hour for the first forty days. For babies as well, oil massages are therapeutic because their Vata is also high, and also because an oil massage strengthens their bones. However, for babies, the oil massage should begin only after the umbilical cord falls off. My son continues to get a 15-20 minute massage every day. His massage is gentle (don't pull baby limbs) with extra care taken around the neck.
Finally, Ayurveda puts a strict recommendation on new mothers to stay at home for the first 40 days, as getting in contact with outdoors air is considered as a major Vata aggravation. Ayurveda cautions that not taking adequate rest in the first forty days will lead to major weakening of bones later in life. This may manifest as early onset arthritis or osteoporosis. For both our babies, I followed this dictum and rested for the first forty days. One exception was our doctor's checkup for our babies, where we kept our exposure to a minimum. During this 40-day period, it was greatly helpful to have the support of my spouse. He ensured that everyone knew we were going to nest during these 40 days, and therefore would not be in a position to welcome visitors. We only started meeting friends after the first 40 days. Our wonderful friends understood this and supported us in a big way during this time.
Here are some more resources:
Ayurvedic Parenting: A recording of my sharing at a Vedika Sangha on the preparation for childbirth.
Ayurveda on Pregnancy: Recording of talk by visiting Professor and Vaidya Dr. Mahesh Sabade. Prof. Sabade goes deep into month by month recommendations.
Self-paced Mother Baby Workshop: This recording is of a workshop conducted at Vedika by mothers (including myself) who have followed Ayurveda. The holistic approach spans a spectrum from preparation for conception to baby care.