A primer on Ayurveda for the childbearing years Part 1: basic Ayurvedic concepts. (Feature Article)(Cover Story).

What is Ayurveda and How Is It Useful?

Ayurveda is the 5,000-year-old system of healing from India that teaches "the way of life." This way does not dictate one path for all, but offers the information for understanding the basic energies of the universe, how they manifest in differing amounts, and how to maintain one's own personal balance of energies in a way that allows mind, body, and soul to express in the highest possible way. Ayurveda is being talked about more and more in alternative health magazines and yoga communities. It is a natural sister to yoga.

I became drawn to Ayurveda when I was a busy homebirth midwife, supporting women in pregnancy, birth, and postpartum with natural means. Why did some herbs and therapies work for one person with a condition, while another person with the same condition didn't respond favorably to that same help? I saw that a piecemeal approach to using natural remedies was based on symptomatic treatment--one of the problems with Western medicine. Just as one birth plan doesn't work for all laboring women, one treatment doesn't work for all women who are nauseated in pregnancy. A holistic approach deals with the person more than with the disease, encouraging and supporting the natural healing responses in that person.

Chinese medicine was becoming more popular at that time and I considered it. But when I read about it, the terms and philosophy just wouldn't fit into my head. Then I heard a tape by Deepak Chopra, someone influential in popularizing Ayurveda in the United States. Chopra's charismatic address drew me to look more into Ayurveda. As I read about Ayurveda it was like recognizing what I already knew. Many of the principles and applications fit my own intuition and experience in my body. So I began my studies in earnest.

That was seven years ago. After hours and hours of classes, reading, and practicing, I see that Ayurveda delivers all and more than what it promised me. It is both as simple and commonplace as the sun rising each day, and as complex as all of the forces that allow that to happen and us to view it. What I'll explain to you here is for simple and commonplace use. To delve into the more complex levels takes time and dedication. I encourage you to go for that level, if you, like me, feel that pull to integrate your knowledge with this rich system.

Ayurveda, like midwifery, finds intuition to be the highest authority. Sometimes people get bound up in the guidelines about how to achieve balance through diet, lifestyle, and therapies, making them into rules written in stone. Then they get discouraged when they can't follow them exactly, right from the start, so they quit. This perfectionistic view is a disease in itself. Just as written protocols might guide you as you begin working with women in childbirth or if your intuition isn't at the forefront, so, too, do the guidelines and principles of Ayurveda. They help you get to the point where you are clear enough and are experienced enough to go with the flow with confidence. Ayurveda even recommends methods to increase native intelligence, through increasing mental clarity.

The stages of disease process are important to understanding the holistic nature of Ayurveda. Health is not an all or nothing state, which we all know from our experience. Yet Western medicine can rarely deal with changes happening in our body (except as individual symptoms) unless they have progressed all the way to a specific disease.

Ayurveda begins noticing and addressing imbalances at a very subtle level, before it is really "a disease." The earlier in the disease process an imbalance is addressed, the easier it is to treat and recover from. Treating imbalances before they move out of their home place in the body is the easiest way. Even when treating imbalances that are already relocating, the body is not yet severely weakened, so although treatment may need to last longer, it is still not too difficult.

Ayurvedic Stages of Disease Process

Accumulation: the imbalance accumulates in its home location in the digestive tract.

Aggravation: imbalance continues increasing at home and by pressure, creates symptoms elsewhere.

Overflow: imbalance overfills its site and begins to go to other areas.

Relocation: imbalance moves through bloodstream into tissue levels.

Manifestation: specific symptoms of disease in those specific tissues; a disease can be diagnosed by Western medicine here. It's no longer just a matter of imbalances moving through the body.

Diversification: disease symptomology is more entrenched and can be

identified as being Vata, Pitta, or Kapha type of a disease.

The aspect of Ayurveda that is most commonly known is the doshas. These are basic energies that act within all living beings. Vata comes from ether and air elements. Pitta originates from tire and some water. And kapha comes from water and earth elements. The qualities of the three doshas are outlined in Table A. All of us have all three of the doshas operating within us. We all need all of the qualities working at doing different jobs in our bodies.

Each individual has a doshic proportion set at birth. The proportion of the doshas that is the healthy level for an individual is called the constitution. Our constitution is determined by the three main influences: the environment when we are conceived (climate, thoughts, condition, and constitutions of the parents); the diet, lifestyle, and emotions of the mother during pregnancy; and our spiritual destiny. We can determine what this constitution is for a person through investigating the long-term trends of the body and mind, and by pulse diagnosis. The constitution is the benchmark of health. It's usually expressed as x: Vx Px Kx, with x = differing numbers from 1 to 3, according to the proportions of the particular constitution. When our current levels of the doshas match our constitutional levels of doshas then our body and mind is balanced and expressing in the healthiest possible way.

Our current condition shows if we are getting too much of certain qualities and energies going into our bodies. The condition is a dynamic proportion of energies operating in our body. It is influenced by the changing conditions of what we eat, the weather, the emotions of people around us, our activities, our daily routine (or lack thereof), how we breathe, and our own thoughts and emotions. Maintaining a relatively stable condition requires changing our ways according to the seasons and what happens in our lives. The condition is also expressed as Vx Px Kx, as with the constitution. The condition is determined by noticing changes in our body/mind, and by pulse diagnosis. The advantage of pulse diagnosis is that subtle changes will show up in the pulse before showing up on the physical level and can be addressed more gently before they become physical.

Each of the doshas has five subdoshas that operate throughout the body more specifically. The one that is especially of note for childbearing is the Apana Vayu, which rules the movement of urine, feces, ejaculation, menses, and childbirth. A healthy Apana Vayu is key to healthy menses and childbirth. (This will be discussed more fully in future articles.) Subdoshas are examined through questioning and pulse diagnosis.

Another important concept is about the tissues. In Ayurveda seven tissue levels are recognized. Each tissue level feeds the next tissue level, going from the densest to the most subtle. We begin with the digested food, which feeds the plasma. The next level, blood, is fed by some of the plasma being digested into it. Then blood feeds muscle and so on. This means that, in general to nourish the reproductive level all of the other tissues must have been nourished and digested well so that the next level can receive nourishment. It takes about seven days for the nutrition to move from one level to the next--thus about 35 days to build the reproductive tissue. Tissue health can be ascertained by examination and questioning and by pulse diagnosis. In addition to foods, special herbs can be used to build tissues or increase digestion of that tissue level.

One more key concept in Ayurveda is the relationship between agni or digestive fire/ama or digestive toxins and health. When digestion is strong, the digestive toxins in the body are diminished. This is important because most diseases have ama as a component. It's also true that when there is a lot of ama, digestion is impeded. Thus a cycle can be set up: digestion being off leads to ama, which further reduces digestion and creates more ama. Maintaining

healthy digestion is primary. Ayurveda determines ama through questioning, tongue diagnosis, and pulse. Ama can be reduced and digestion increased by lifestyle and eating habit changes and by herbs. Especially effective is the cleansing and rejuvenation process of Pancha Karma. It brings ama out of the body, rekindles agni, and then feeds the body tissues with rejuvenative herbs.

Now you have a basic understanding of the main concepts of Ayurveda. In further articles I will cover specific applications to the childbearing year, including menstrual health as a basis for healthy childbearing, preconception preparation, pregnancy self care, and postpartum recovery, and rejuvenation, as well as simple Ayurvedic self-care for families.

Ayurveda Resources

Ayurveda in its most potent form is best practiced with the help of an Ayurvedic practitioner, although it is easily used on a simple level just from reading. There is no Ayurvedic licensing currently available in the United States; however, California has practitioners practicing legally and a bill is up in New Hampshire this year to license Ayurvedic practitioners.

A new organization has been formed, the National Ayurvedic Medicine Association, to create standards for education and practice. They have a website at http:// www.ayurveda-nama.org. Other websites are available by doing a search on the Web under "ayurveda." You can also read more about Ayurveda in the following books:

Ayurveda: The Science of Self-Healing, Dr. Vasant Lad, Lotus Press, 1984; concise book covers the basics of Ayurveda.

The Complete Book of Ayurvedic Home Remedies, Dr. Vasant Lad, Three Rivers Press, 1999; covers basic concepts and working with acute conditions.

Perfect Health: The Complete Mind/Body Program for Identifying and Soothing the Source of Your Body's Reaction, Deepak Chopra, Harmony Books, 1991; an easy to read introduction to Ayurveda.

TABLE A: THE DOSHAS IN THE BODY

Dosha               Vata                       Pitta

Elements            Ether and Air              Fire and Water

Main Qualities      Dry, Cold, Light,          Hot, Sharp, Oily,
                     Changeable, Mobile,        Spreading
                     Rough

Main Seat in the    Abdominal/Pelvic area      Solar plexus
 Body

Balanced            Flowing and Flexible,      Focus, Intelligence,
 Expression in       Enthusiastic, Creative     Good digestion and
 the Body/Mind                                   assimilation,
                                                 Leadership

Over Balanced       Constipation, Shakiness,   Heartburn, Skin
 Expression in       Gas, Cramps, Fatigue,      conditions, Diarrhea,
 the Body/Mind       Overwhelmed,               Inflammation, Anger,
                     Fearfulness,               Irritability,
                     Distracted                 Overly critical

Primary Bodily      Breathing, Nervous         Digestion, Red
 Tissue and          function, Bones,           blood cells,
 Functions           Elimination, Hearing       Vision, Skin,
                                                Muscles

Dosha                            Kapha

Elements                         Water and Earth

Main Qualities                   Moist, Cold, Heavy,
                                  Viscous, Inert, Dense

Main Seat in the Body            Chest

Balanced Expression in           Strength, Endurance,
 the Body/Mind                    Steadiness, Structure

Over Balanced                    Excess weight, Excess mucous,
 Expression in the                Congestion, Lethargy,
 Body/Mind                        Denial, Greed

Primary Bodily                   Fluid balance, Kidneys, Plasma,
Tissue and Functions              Fat tissue, Cerebrospinal
                                  fluid, Taste
TABLE B: SUBDOSHAS

Subdoshas                      Location                     Direction

Vayus (Vata)

Prana "inward"                 Senses, Brain,               Inward
                                Throat, Chest

Udana "outward"                Chest, Throat                Upward

Samana "the equalizer"         Small intestine              Balancing

Vyana "circulator"             From heart to whole body,    Outward
                                (especially extremities),
                                Joints

Apana "downward"               Pelvis                       Downward

Pittas

Sadhaka "determines what       Brain, Heart                 Inward
 is the truth"

Alochaka "governs vision"      Eyes                         Upward

Pachaka "digests things"       Stomach, Liver, Spleen       Equalizing

Bhrajaka "governs lustre"      Stomach                      Outward

Ranjaka "imparts color"        Liver                        Downward

Kaphas

Tarpaka "gives contentment"    Brain, Heart, Nerves         Inward

Bodhaka "gives perception"     Tongue, Sensory in head      Upward

Kledaka "that moistens"        Stomach-alkaline and         Balancing
                                mucous lining

Sleshaka "gives                Joints, Limbs, Skin          Outward
 lubrication"

Avalambaka "gives support"     Chest, Heart, Lungs          Downward

Subdoshas                                 Function

Vayus (Vata)

Prana "inward"                            Intake

Udana "outward"                           Output

Samana "the equalizer"                    Absorption

Vyana "circulator"                        Circulation

Apana "downward"                          Elimination of urine
                                           and feces, Menses or
                                           ejaculation, and
                                           Childbirth

Pittas

Sadhaka "determines what is the truth"    Inner combustion

Alochaka "governs vision"                 Receive light

Pachaka "digests things"                  Digestion,
                                           Discrimination

Bhrajaka "governs lustre"                 Digestion, Warmth,
                                           Sunlight

Ranjaka "imparts color"                   Warmth in blood

Kaphas

Tarpaka "gives contentment"               Calmness, Stability,
                                           Happiness

Bodhaka "gives perception"                Taste, Knowledge,
                                           Perception

Kledaka "that moistens"                   Liquifies food

Sleshaka "gives lubrication"              Holds together and
                                           ease of movement

Avalambaka "gives support"                Lubrication
TABLE C: TISSUES OF THE BODY

Dhatu or Tissue     Dosha and Elements    Subtissue

Rasa or plasma      Kapha--Water          Breastmilk or menstrual
                                           blood

Rakta or blood      Pitta--Fire and       Blood vessels and tendons
                     Water

Mamsa or muscle     Kapha--Earth/water    Ligaments and skin
                     and fire

Medha or fat        Kapha--Water          Omentum

Asthi or bone       Vata--Earth and air   Teeth

Majja or            Kapha--Water and      Sclerotic fluid of eye
 marrow/nerves       earth

Shukra/Artava or    Kapha--Water          Ojas
 male/female
 reproductive

Dhatu or Tissue                  Waste Products

Rasa or plasma                   Kapha dosha/phlegm

Rakta or blood                   Pitta dosha/bile

Mamsa or muscle                  Earwax, naval jelly, and toe jam

Medha or fat                     Sweat

Asthi or bone                    Nails and hair

Majja or marrow/nerves           Tears and eye secretions

Shukra/Artava or                 Smegma
male/female reproductive

--Terra Richardson practiced homebirth midwifery for thirteen years in Boulder, Colorado before retiring to focus on Wise Womanhood, offering midwifery training classes and holistic healing practice using Ayurveda, flower essences, and Reiki energy healing. She coauthored Pregnant Feelings with Rahima Baldwin Dancy and wrote the soon-to-be published Giving Birth to Ourselves--Contemplations for Midwives and Other Birth Companions. You can learn more about her classes and practice at http://wisewomanhood.bigstep.com or by calling 303-554-1800.

Editor's note: Look for more articles in this series in future isues of Special Delivery.