Efficacy of Garbhasanskara for Good Progeny in Present Scenario

During intrauterine life, the fetus is completely dependent on the mother. As a result, the health of the fetus directly depends on the health of the mother.Not only maternal nutrition, but maternal psychology, during pregnancy, has a significant effect on the health of the offspring and mother,too.Whatever emotional perceptions a woman has during her pregnancy are transmitted to the fetus. Ayurveda is an ancient science where all the measures are described under the title of Garbhasanskara to geta healthy and wellcultured child. The word Garbhasanskarais composed of two words ‘Garbha‘and Saskara’.Garbha means the fetus and Sanskara means Parivartana in Guna i.e., change in character. Thus, GarbhaSanskara is basically aimed at providing fundamental care for good physical as well as mental set up of a child. It includes three stages viz pre-conceptional care to get healthy Beeja i.e. sperm and ovum, care during pregnancy for development of the fetus and postnatal care i.e.Balasanskara. The present paper, expresses the concept of Garbhasanskara and its relevance in the present modern era. Review Article Shamkuwar et al.; JPRI, 33(37B): 242-250, 2021; Article no.JPRI.68848 243


INTRODUCTION
One of the most lovely aspects of being a woman is the ability to give birth to another life. A new life takes shape within her, is moulded, and is then born to be nurtured into a good human being.The famous Canadian scientist describes brain development and experience that "The experience in the womb shapes the brain and lays the groundwork for personality, emotional temperaments, and the power of higher thought from the moment of conception [1]. Ayurveda emphasized the importance of caring for the mother before, during, and after pregnancy, a long ago. Improper diet and lifestyle have a negative impact on fetal growth and can result in growth retardation and congenital anomalies. Prenatal maternal stress(PNMS)is a risk factor for autism and ADHD(attention deficit hyperactivity syndrome) [2].PNMS is associated with side effects such as preeclampsia, depression, increased nausea and vomiting during pregnancy, preterm labor, low birth weight, and low APGAR score.
[3] To avoid such dangers, Ayurveda prescribes appropriate diet, way of life, behavior, and clothing that are indigenous to a particular country and place, as well as using the same methods as they do. Proper care i. e.Paricharya before and during pregnancy, diet, behavior, and medications, ensures a normal pregnancy with a normal delivery of a healthy baby from a healthy mother. Garbhasanskara is best suited to caring for the unborn baby's physical, emotional, mental, and spiritual development, as well as the mother's health. [4] It seems, to be the scientific way leading to a good progeny, in the current scenario.

Aim
To establish the role and importance of Garbhasanskara

Objective
1. Conceptual study of Garbhasanskara. 2. To understand relevance of maintaining good physical and emotional status of mother and fetus in fetal outcome.

MATERIALS AND METHODS
Ayurvedic literature regarding Garbhadahansanskara, Garbhiniparicharya (antenatal care) and its importance before and after conception was searched thoroughly. Similarly, its effects on fetal well-being were also studied. Other research journals, papers, books related to conception, pregnancy, stress, music, yoga and its effect, etc. were also explored to collect the matter.

Garbhasanskara in Classics
Psychology and nutrition of the couple play an immense role in conception. MaharshiCharaka opines that for the achievement of conception, happy mood is essential. It means that the specific environment and psychology of a couple during coitus might influence the chances of conception [5] According, to Ayurveda, the tridosha Vata, Pitta , and Kapha are interconnected to mental characteristics Satva,Raja and Tamas.The tridoshas also affect the balance of these mental characteristics. Therefore the happy mood of couple during coitus is advised by Ayurveda to maintain the balance of doshas in their body. TheMana of fetus attains the characters of Satwa, Raja, andTama, etc.depending upon the psychological status of mother and father; the topics being listened by the pregnant woman, influence of deeds of the previous life, and specific practice of Mana [6]. He also describes that the effect of psychological state along with mode of life of mother produces abnormality of Beeja (ovum and sperm) resulting in congenital anomalies in fetus [7][8]. Maharshi Sushruta opines that whatever type of diet, behavior and conduct is followed by the couple at the time of coitus, born child possesses similar characters [13].
These references form the basis of Garbhasanskara and highlight the fact that Garbhasanskara influences development of the child.

Garbhadhana
Poorva Sanskara (Preconceptional Care) Three months before conception, preconception care begins with the preparation of the couple planning conception. It begins with the age of copulation, Rajaswalaparicharya (menstrual cycle mode of living), Pindashudhhi (body detoxification) for healthy gametes (sperm and ovum), and specific Aahara for male and female. Psychology and nutrition of couples before and after fertilization play a great role.Preconception stress in either parent can impact germ cells, thus influencing development in one or more generations, resulting in trans-generational effects [14][15] . This stand in support of the statements of ancient Ayurveda scholars and emphasize the need of stress free lifestyle for healthy conception and pregnancy outcome.
Regarding diet,Maharshi Sushruta advises to take food comprising Shali rice with milk to the male partner and the food mainly comprising oil (sesame oil) and Masha pulse(black gram) to the female before coitus [16].Maharshi Charaka, also mentioned that the man should use Ghrita and milk medicated with the drugs of Madhuravarga (sweet/anabolic drugs) and the woman should consume oil and Masha after the purifying measures and before coitus [17]. For women, Vagbhtahas recommended Phalaghrita and Mahakalyanakaghrita.. Ayurvda commentators have explained that the Madhura drugs increase Shukra and Pittakardrugs incresase Rakta [18][19].
The Ayurvedic diet described before conception for male and female is homologous to the properties of Shukra and Aartava, respectively, and is beneficial to improving sperm parameters, ovulation, and the factors responsible for conception. [20]. Recent studies show that the nutrition and fertility is linked to both the male and female. Malnutrition can adversely affect the division and replication of cells in the embryo at pre-implantation stage in which cells divide and replicate most rapidly. It may cause restricted fetal growth, LBW, missed abortion, congenital anomalies etc. [21]. WHO also recommends pre-conceptional care to reduce maternal and childhood mortality and morbidity [22].
After these 3 months of protocol, copulation is advised in Ritukala(ovulation period).

Garbhiniparicharya
Ayurveda has described a systematic plan for Garbhini under the title Garbhiniparichayra. It prescribes Ahara,Vihara&Vichara(thoughts) as these have a direct effect on the health of mother & child.There are two types of management for Garbhini (a)Generalmanagement(SamanyaAhara&Vihara) (b)specific management (MasanumasikaPathya)

Garbha-samvada ( Communication with Fetus )
Hearing is the first sense stimulated in the fetus that promotes the development of the neural pathways. Braindevelopment is linked to early auditory experiences. Noises from the placenta, maternal organs, and maternal voice all play a significant role as current in utero auditory stimuli, forming memories of his /her hearing experiences. [25][26]. It is also seen that fetuses respond to the father's voice but prefer the mother's voice after birth [27].Attachment and communication are already established before birth through auditory and multisensory experiences [28].

Garbhasangeeta (Music for the Fetus)
Sama-veda, the Veda of chants, offers knowledge of music in 1549 verses. Sama means "melody". Classical Indian music originated from this Veda. Our stalwarts prescribed to hear music during pregnancy in Paricharya. It is possible to give energy to the development of the body, mind, and soul of a child in the womb by listening to special types of music like the sounds of Veena, flute, Samveda mantras, and trimester wise ragas with specific frequency for healthy progeny [29].
A practical research has done by the Scottish government, NHS on hearing and listening in the womb' from 0 to 24 weeks and then till birth with practical research. It is stated that between 0 and 16 weeks, the unborn baby is surrounded by sound, vibrations, and motions that are 'felt' through the skin and skeletal systems [30]. Shahidullah and Hepper illustrate that reactive listening begins at around 16 weeks. This is significant as the ear is not completely anatomically developed until 24 weeks. At 16 weeks the unborn baby is particularly receptive to its mother's voice. It is fascinating that around 24 weeks, the babies develop preferences for music while in the womb [31] Recent research has shown that music can help pregnant women relax.. Music can also cause foetal effects such as increased foetal movements and decreased uterine contractions. [32][33] An increase in fetal movement may be associated with fetal well-being. It has direct influence on emotions; behavior, and neurotransmitter systems. Music exposure causes a variety of endocrine effects, including changes in adrenal and gonadal steroid levels. These changes in a pregnant woman can affect neuroblast proliferation, axonogenesis, synaptogenesis, and neuronal organisation, all of which have an impact on cognitive performance and behavioural gestalt. [34]. In a nutshell, music can be highly recommended for prenatal relaxation since it also leads to maternal relaxation.

Garbhamantra ( Sound of Mantra Chanting for Mother and Fetus )
"Mana na attrayate iti mantra" The mantra that saves mind 'Mana' means the mind;'tra' means deliverance, based on the vibratory aspect of energy and its modifications into the varied matter. As a result, a spiritual Mantra is a pure sound vibration that transports the mind from material to spiritual consciousness.. MantraShakti assists in the release of anxiety and stuck energy, both of which are causes of disease. Experience and experiments have shown that the correct frequency of Mantra sound, combined with the correct intent, helps the practitioner oxygenate the brain, reduce heart rate and blood pressure, aid in creating calm brainwave activity, and cure many ailments. [35]. Thus, in expectant mother Mantra chanting can prevent pregnancy-induced hypertension, intrauterine growth retardation.

Garbhaprarthana-Jyotirdhyana (Meditation)
Prayer for the fetus can be done alone or with family members in front of the lamp (Jyoti-flame).
Light symbolizes knowledge which keeps us free from the darkness of ignorance. Knowledge removes ignorance just as light removes darkness. As a result, the lamp is lit, and we bow before it, because knowledge is the greatest form of wealth. During special events, it is kept lit as a guide and witness to our thoughts and actions. The traditional instrument represents our Vasanas, or negative tendencies, while the wick represents our ego. As the lamp burns, it symbolises the annihilation of our bad habits and bodily ego. The flame burns upward, as knowledge also takes our views higher [36].

Yogasana, Pranayam, Dhyana (Yoga )
Yogic postures, Pranayam, meditation are some special efforts taken to stimulate baby's senses gently from outside to relieve maternal stress, improve maternal psychology resulting in maximum development of the physical and intellectual ability. The ancient, as well as modern medical research, speaks about the intimate relationship between our breathing patterns and our physical, emotional, mental, and spiritual health. It not only increases longevity but also supports overall well-being, selfdevelopment and helps in medical conditions. Now, Yoga is well accepted globally. Anulom-Vilom Pranayam has a significant effect on Systolic Blood Pressure and has a positive effect on digestion and mental freshness [37].
Researches show that Bhramari pranayama causes a significant reduction in cardiovascular hyper-reactivity. Pranayama is known in yoga to modulate autonomic output and restore the balance between two components of the autonomic nervous system -sympathetic and parasympathetic. The Bhramaripranayama, in particular, has been shown to stimulate the parasympathetic nervous system [38].
The nasal tone humming/buzzing mmmm sound slow nasal exhalation boosts the production of nitric oxide which is a vasodilator, improves blood circulation and oxygen to the heart, decreases plaque growth (which causes atherosclerosis) and blood clotting, lowers high blood pressure [39].  Recently guided yoga programs for pregnant women have become prevalent and are conducive to utero-fetal-placental circulationand improvements in labor and birth outcomes. These Asanas help to improve body posture, strengthens abdominal, pelvic, and thigh muscles, maintains the flexibility of pelvic joints which enables them to various positions during labor. The ligaments are more elastic which in turn can help to reduce labor pains, relieves backache which is common in pregnancy [40].

DISCUSSION
The relationship between a mother and her foetus is a one-of-a-kind symbiotic union.. During the prenatal and postnatal periods, the mother's diet, behavior, and psychology have a significant impact on the child's physical and mental development. It has been proven that every activity of the mother during pregnancy, such as Samvada (talk), Prarthana (prayer), Manashakti (positive thinking/emotions), and Sparsha(touch), is not only recognized by the unborn baby but also has a positive effect on physical and mental health.
According to the evidence, foetal growth is most vulnerable to maternal nutrient deficiencies during the pre-implantation period and the period of rapid placental development.. Nutrition is the most important intrauterine environmental factor that affects foetal genome expression and may have long-term consequences. Changes in foetal nutrition and endocrine status, for example, may result in developmental adaptations that permanently alter the structure, physiology, and metabolism of the offspring, predisposing individuals to metabolic, endocrine, and cardiovascular diseases.in adult life.Thus ,Garbhasanskara seems to be the path leading to modern epigenetic engineering.
Thus, the goal of Garbhasanskara is to raise a child who is healthy, happy, full of virtues, wellcultured, intelligent, and blissful. All the evidences, whether from modern studies or ancient Garbhasanskar practices, establishes that pregnant women must live in a positive environment, think positively, and remain happy and peaceful to have a healthy child.

CONCLUSION
Due to rapid industrialization and modernization, there have been massive changes in lifestyle all over the world. With this, women have emerged as equivalent contributors in work places and business industry. This definitely has brought changes in antenatal care, too. These circumstances emphasizes the need of GarbhaSanskara. In the present era, there is a need to adopt a lifestyle described by ancient science before and during pregnancy to avoid complications. According to Ayurveda, the act of 'Garbhsanskara', has strong and direct effects on the child's physical and mental functioning. Garbhsanskara includes special efforts taken to stimulate the baby's senses gently from outside for the maximum development of its physical and intellectual abilities. It has also been linked with reducing stress by working as a coping mechanism. Studies have indicated that positive thinking increases maternal interactions with the fetus and generally reduces stress. As stated earlier, due to changes in lifestyle along with cultural and geographical difference practical implementation of Garbhasanskara may be a little difficult as well. Therefore with appropriate modifications, Garbhasanskara, supported by policy decisions,can be a very effective tool for pregnancy to avoid stress, anxiety, depression and to achieve healthy progeny.

DISCLAIMER
The study highlights the efficacy of Garbhasanskara, which is an ancient tradition, used in some parts of India. This ancient concept should be carefully evaluated in the light of modern medical science and can be utilized partially if found suitable.

CONSENT
It is not applicable.

ETHICAL APPROVAL
It is not applicable.