The document discusses Ayurvedashram's preconception care program. It aims to improve health outcomes for mothers and babies through biomedical, behavioral and social interventions before conception. The program addresses prevalent risk factors like obesity, smoking, stress and nutrition which can negatively impact fertility and pregnancy. It seeks to fill a gap in evidence-based resources for managing lifestyle factors known to influence conception and child health.

1. Ayurvedic Preconception
Health Care program
@ Ayurvedashram
• Site Preceptor Pari Mudiginty, R.Ph, M.Pharm,
MBA, DAMS
• Sruthi Bhat, MPH candidate, Nova South Eastern
University

2. Preconception
care
• Preconception care is the provision of
biomedical, behavioral and social health
interventions to women and couples before
conception.
• Preconception care :
• Aims to improve the health status of the
mother and her child.
• Secure optimal health & nutritional condition
in both parents Reduces the occurrence of
fetal death & many congenital anomalies.
• Ensure that the women & her partner are in
an optimal state of physical & emotional
health at the onset of pregnancy.

3. What is
Preconception
timeframe?
• A woman’s or man’s health status and
their behaviors before planning a
pregnancy

4. Why preconception care ?
• Most women are not aware of their pregnancy until they
miss their first period.
• The most critical period for organ development occurs
during initial days, soon after the conception
• The first contact with antenatal care is often too late for
advice about health-promoting changes in lifestyle.
• There is a growing body of evidence that women’s and
men’s health and lifestyle before conception can affect
pregnancy outcome

5. Why do we
need
preconception
health care?
In the United States, prenatal care
has been practiced for preventing
poor pregnancy outcomes. But over
the past years, the limitations of this
strategy has been identified they are
Exposures to substances such as
tobacco, alcohol, prescription,
nonprescription and illicit drugs
before conception have negative
influences on pregnancy outcomes
Prenatal care starts too late to offer
primary prevention for many poor
outcomes.
Some poor pregnancy outcomes,
including spontaneous abortions
and congenital disabilities, have
already occurred before the first
prenatal visit.

6. What is the life course framework and its connection with
preconception health ?
• Lu and Halfon, states that protective and harmful
influences across the lifespan are critical
determinants of an individual’s health status.
• These influences are in the form of physical,
social, psychological and economic variables.
• Imbalances in these influences across different
population groups are critical in understanding and
addressing racial, ethnic and socioeconomic
disparities.

7. Life course
framework
and
Preconception
healthcare
Lu and Halfon compile two models
that explain the impact of the life
course framework on women’s health
and pregnancy outcomes. They are:
Early programming model
Cumulative pathways model

8. Life course framework and
Preconception healthcare
• Early programming model
Early programming model posits that exposures in early life could influence
future reproductive potential. In other words, early life exposures during
(including in utero) can encode the functions of organ systems which will
influence health status throughout an individual’s lifetime
• Cumulative pathways model
The cumulative pathways model conceptualizes that there can be a decline in the
reproductive health of an individual if the individual is continuously undergoing
stress, as stress can result in wear and tears on the body’s adaptive systems.

9. Background of the problem
• The United States has made improvements in
reducing infant and maternal mortality rates over the
past several decades.
• In spite of these gains, infant and maternal deaths
remain high, and disparities persist, particularly
among the Native Indian/Alaskan Native and non-
Hispanic Black populations.
• The U.S. infant mortality and maternal mortality rates
are higher than most other industrialized nations,
despite significant health care system investments.

10. Background of the problem
• Preconception health care can provide opportunities to
promote the health of women before they become
pregnant through improved access to health care.
• The Centers for Disease Control and Prevention (CDC)
defines preconception health as “the health of women
and men during their reproductive years, which are the
years they can have a child. It focuses on taking steps now
to protect the health of a baby they might have some time
in the future".

11. Prevalent risk factors among women when they get pregnant
According to CDC,
some risk factors are
prevalent among
Women when they get
pregnant, are
Pre-existing
medical condition
4.1%
Rubella
seronegative 7.1%
Smoking 11% Alcohol 10.1%
HIV/AIDS +ve
0.2%
Inadequate pre
natal care 15.9%
Cardiac Disease
3%
Hypertension 3% Asthma 6% Diabetes 9%
On teratogenic
drugs 2.6%
Overweight or
Obese 50%
Not taking folic
acid 69%
Dental caries/oral
disease (Women
20-39) >80%

12. Basic demographics
of New jersey
• *source county health
and ranking

13. Basic demographics of New jersey

14. Basic demographics
of New jersey
• *source county health
and ranking

15. Some
important
factors which
can affect the
pregnancy
outcomes
• According to a report by Singh et al., 4 out of 10
women in the United States report that their
pregnancies are unplanned.
• Maternal undernutrition and iron-deficiency anemia
increases the risk of maternal death.
• Rates of HIV transmission from mother to child is
between 15 and 45% in the absence of intervention
• Studies has reported that the stress, anxiety, sleep
issues, mental disturbances that women and men
experience while they are planning for pregnancy or
before conceiving can affect their health and the health
of their future children.
• These factors can lead to problems such as low birth
weight, preterm birth, miscarriage, developmental
issues in children, and postpartum depression.

16. How are we doing?
Low birth Weight in
New jersey county's
• Low Birthweight is the percentage of live
births where the infant weighed less than
2,500 grams (approximately 5 lbs., 8 oz.)
• Low Birthweight is an indicator of poor
birth outcomes, maternal exposures or
behaviors, and future morbidity risks for
the child.
• Percentage of live births with low
birthweight (< 2500 grams)
Gloucester 8%
Camden 9%
Salem 8%
Cumberland 10%
Atlantic 8%
Cape May 8%
Essex 10%
Hudson 7%
Passaic 9%
Mercer 9%
Middle sex 8%

17. How are we doing?
Infant Mortality measure in
New jersey county’
• Infant Mortality measures the number
of deaths among children less than one
year of age per 1,000 live births.
• Infant mortality represents the health
of the most vulnerable age group
(those under 365 days)
• Number of all infant deaths (within 1
year), per 1,000 live births
Gloucester 107
Camden 349
Bergen 191
Cumberland 111
Atlantic 175
Burlington 171
Essex 451
Hudson 246
Passaic 195
Mercer 207
Middle sex 259

18. How are we doing?
Sexually Transmitted infection in
New jersey county
• Sexually Transmitted Infections is the
number of newly diagnosed chlamydia cases
per 100,000 population of a county.
• Chlamydia is the most common bacterial STI
in North America and is one of the major
causes of tubal infertility, ectopic pregnancy,
pelvic inflammatory disease, and chronic
pelvic pain.
• STIs are associated with a significantly
increased risk of morbidity and mortality,
including increased risk of cervical cancer,
infertility, and premature death.
Gloucester 329.3
Camden 566.6
Salem 355.8
Cumberland 684.3
Atlantic 462.2
Cape May 324.1
Essex 698.1
Hudson 401.9
Passaic 480.3
Mercer 434.7
Middle sex 274.1

19. Some
important
factors which
can affect the
pregnancy
outcomes
• Studies report that eliminating smoking
before pregnancy could avoid 5–7% of
preterm-related deaths and 23–24% of cases
of sudden infant death syndrome.
• Preconception maternal mental disorders are
associated with adverse obstetric, neonatal,
and childhood physical and mental health
outcome.
• According to the American heart association,
higher blood pressure before conception may
increase the risk of miscarriage, even in
women who are not diagnosed with
hypertension

20. How are we doing?
Adult smoking in New jersey county
• Adult Smoking is the percentage of the adult
population that currently smokes every day
or most days and has smoked at least 100
cigarettes in their lifetime.
• Each year approximately 443,000 premature
deaths can be attributed to smoking.
• Cigarette smoking is correlated with various
cancers, cardiovascular disease, and
respiratory conditions, as well as low birth
weight and other adverse health outcomes.
Gloucester 16%
Camden 17%
Salem 17%
Cumberland 17%
Atlantic 19%
Cape May 15%
Essex 15%
Hudson 16%
Passaic 16%
Mercer 13%
Middle sex 12%

21. How are we doing?
Excessive drinking in New jersey county
• Excessive Drinking is the percentage of adults that
report either binge drinking, defined as consuming
more than 4 (women) or 5 (men) alcoholic
beverages on a single occasion in the past 30
days.
• Excessive drinking is a risk factor for many
adverse health outcomes, such as alcohol
poisoning, sexually transmitted infections,
unintended pregnancy, fetal alcohol syndrome,
sudden infant death syndrome, suicide,
interpersonal violence, and motor vehicle crashes.
Gloucester 20%
Camden 17%
Salem 17%
Cumberland 17%
Atlantic 17%
Cape May 19%
Essex 15%
Hudson 17%
Passaic 17%
Mercer 18%
Middle sex 17%

22. Some
important
factors which
can affect the
pregnancy
outcomes
• Pregnancy nutrition surveillance system data
show that one-third of all pregnant women in
America are obese.
• Half of the women of child-bearing age (20-
39) are either overweight or obese .
• Thirty percent of girls between 12-19 years
of age are overweight or obese

23. How are we doing?
Adult obesity in New jersey
county
• Adult Obesity is the percentage of the adult
population (age 20 and older) that reports a
body mass index (BMI) greater than or equal
to 30 kg/m
• Obesity increases the risk for health
conditions such as coronary heart disease,
type 2 diabetes, cancer, hypertension,
dyslipidemia, stroke, liver and gallbladder
disease, sleep apnea and respiratory problems,
osteoarthritis, and poor health status, negative
pregnancy outcomes.
Gloucester 31%
Camden 29%
Bergen 22%
Cumberland 35%
Atlantic 38%
Burlington 28%
Essex 29%
Hudson 23%
Union 22%
Mercer 25%
Middle sex 27%

24. How are we doing?
Physical inactivity in New jersey county
• PHYSICAL INACTIVITY
• Physical Inactivity is based on responses to
the Behavioral Risk Factor Surveillance
Survey and is the percentage of adults
ages 20 and over reporting no leisure-time
physical activity in the past month.
• Percentage of adults age 20 and over
reporting no leisure-time physical activity.
Gloucester 25%
Camden 26%
Bergen 22%
Cumberland 35%
Atlantic 26%
Burlington 22%
Essex 25%
Hudson 25%
Union 22%
Mercer 25%
Middle sex 27%

25. Some
important
factors which
can affect the
pregnancy
outcomes
• Dr. Lynch is the Director of Reproductive
Epidemiology at The Ohio State University
Medical Center. Her research, published in
Human Reproduction in January 2014,
determined that “Women who had the highest
levels of stress took 29% longer to get
pregnant compared to other women, and their
risk of infertility doubled.”
• Stress appears to have a more pronounced
effect in increasing the risk of delivering a low
birth weight (LBW) infant as well as preterm
birth PTB
• PTB and LBW offspring are more likely to
experience asthma and allergies in later life

26. Some
important
factors which
can affect the
pregnancy
outcomes
• Indiana University and the Karolinska
Institute conducted a study, about the infant
mortality risk following maternal stress within
a population-based sample of offspring born
in Sweden from 1973 to 2008 (N= 3,055,361)
• A total of 20,651 offspring were exposed to
preconception stress, 26,731 offspring were
exposed to prenatal stress, and 8,398 cases of
infant mortality were identified.
• The study concluded that preconception
stress increases the risk of infant mortality

27. Poor Mental Health Days
in New jersey county
• Poor Mental Health Days measure the
average number of mentally unhealthy
days reported in past 30 days.
• This measure is based on responses to
the Behavioral Risk Factor Surveillance
System (BRFSS) question: “Thinking
about your mental health, which
includes stress, depression, and
problems with emotions, for how many
days during the past 30 days was your
mental health not good?”
Gloucester 4.3
Camden 4.2
Salem 4.0
Cumberland 4.1
Atlantic 3.7
Cape May 3.8
Essex 3.6
Hudson 3.8
Passaic 3.6
Mercer 3.7
Middle sex 3.5

28. Poor or fair health in New
jersey county
• Poor or Fair Health measures the
percentage of adults in a county who
consider themselves to be in poor or
fair health.
• This measure is based on responses
to the Behavioral Risk Factor
Surveillance Survey (BRFSS)
question: “In general, would you say
that your health is excellent, very
good, good, fair, or poor?”
Gloucester 16%
Camden 18%
Salem 18%
Cumberland 23%
Atlantic 19%
Cape May 16%
Essex 21%
Hudson 21%
Passaic 21%
Mercer 15%
Middle sex 16%

29. Frequent mental distress
in New jersey county
• Frequent Mental Distress is the percentage
of adults who reported ≥14 days in
response to the question, "Now, thinking
about your mental health, which includes
stress, depression, and problems with
emotions, for how many days during the
past 30 days was your mental health not
good?"
• Percentage of adults reporting 14 or more
days of poor mental health per month.
Gloucester 12%
Camden 12%
Bergen 10%
Cumberland 13%
Atlantic 12%
Burlington 10%
Essex 12%
Hudson 11%
Passaic 12%
Mercer 11%
Middle sex 10%

30. Some
important
factors which
can affect the
pregnancy
outcomes
• Lauren Wise, a professor of epidemiology at
Boston University School of Public Health
did a research study among the couples to
know the relation between sleep and getting
pregnant.
• The study found that short sleep duration less
than 6 hours per night was associated with a
reduced probability of pregnancy.
• Poor sleep can also have an effect on labor
and delivery. Researchers from the University
of California at San Francisco recently found
that women who slept fewer than 6 hours per
night had longer labors and were 4.5 times
more likely to have cesarean deliveries

31. Insufficient Sleep in
New jersey county
• Is the percentage of adults who responded
to the following question by stating they
sleep less than 7 hours per night:
• “On average, how many hours of sleep do
you get in a 24-hour period? Think about
the time you actually spend sleeping or
napping, not just the amount of sleep you
think you should get."
• Percentage of adults who report fewer
than 7 hours of sleep on average.
Gloucester 37%
Camden 41%
Bergen 38%
Cumberland 40%
Atlantic 38%
Burlington 37%
Essex 44%
Hudson 41%
Union 39%
Mercer 37%
Middle sex 40%

32. Ayurvedashram
preconception
Care Program
• Several lifestyle factors have been identified which can
promote optimal fertility, including dietary behaviors,
stress management, sleep issues and maintenance of a
healthy weight.
• In addition, adequate nutrient status can influence not
only the ability to get pregnant, but the health of the
egg and sperm, and thus the health of the child.
• There are limited non-clinical evidence-based resources
for preventing and managing stress, improving physical
activity, sleep issues and mental wellbeing for adults
planning to conceive.
• Both mother and her baby benefits from a
preconception care program. It optimizes mothers
health and reduces the risk of congenital disabilities,
miscarriages, and other pregnancy-associated issues.

33. Ayurvedashram
preconception
care
• The preconception health program at Ayurvedashram is
focused not only on educating the people about
importance of preconception health but also in improving
both physical and mental health.
• The preconception health care program includes, dietary
guidelines, physical stress relief through Yoga,
Pranayama (breathing techniques), Ayurveda
detoxifications therapies (massage, herbal steam
baths),sleep management and mindfulness counseling
and practices to enhance emotional and spiritual well-
being.

34. Rationale
behind
Ayurvedashram
preconception
Care
• There are several evidence-based implementation
resources for adults for improving their health behaviors
such as smoking, alcohol consumption and STD
prevention.
• For example, Smokefree.go, It doesn't matter where you
start and ALA-FFS Online - American Lung Association
(ALA), Freedom from Smoking are the resources for
adults interested in smoking cessation.
• MENTOR - MENTOR. Expanding the world of quality
mentoring and CDC-Thornton 2002 - Thornton are the
resources for adult and youth for alcohol cessation.
• There are limited nonclinical evidence-based resources for
preventing and managing stress, improving physical activity,
sleep issues and mental wellbeing for adults who are
planning to conceive.
• To fill the gap in above-addressed area Ayurvedic
Preconception Care is introduced by Ayurvedashram.

35. Ayurvedic preconception care
@Ayurvedashram
• The four major components of Ayurvedashram Preconception care :
• Preconception Health assessment
• Preconception counseling
• Detoxifying therapy(depending on preconception health assessment)
• Ayurvedeic preconception care booklet.

36. Ayurvedic Preconception health care program
• Preconception health assessment by Ayurvedic health consultant through (Questionnaire,
physical exam based on Ayurvedic theory)
• The questionnaire will cover the topics about
• Nutrition assessment
• Exposure to environmental hazards
• Substance use, including tobacco and alcohol
• Medical conditions and medications
• Infectious diseases and vaccination
• Stress, anxiety and sleep

37. Preconception counseling
• Based on the questionnaire, the Ayurvedic health consultant will talk about
• Importance of nutritional diet and diet advice.
• Techniques to reduce weight through Ayurvedic techniques.
• Determining the time of conception by an accurate menstrual history.
• Importance of STI screening, measures for preventing HIV infection and
importance of vaccination for women who are at risk for or susceptible to Rubella,
Varicella, Hepatitis B and make them know about community resources in NJ
• Advice about how to maintain good control of any pre-existing medical conditions
such as diabetes

38. Evidence
• Participants in the central Pennsylvania women’s
health study’s program reported increases in their
intent to eat healthier and be physically active, as
well as increased physical activity, consumption of
folic acid, and self-efficacy following the
program’s six bi-weekly pre-conception education
sessions
• A study conducted by Whitworth and Doswell to
assess the effectiveness of regular pre-pregnancy
health promotion for improving pregnancy
outcomes when compared with no pre-pregnancy
care.
• The study found that intensive intervention
covering both alcohol consumption and
contraception appeared to reduce drinking among
risky drinkers and reduced smoking pre-pregnancy

39. Diet Recommendation
• Ayurvedic recommended food for males and females to
improve fertility.
• A diet rich in nutritious foods can help to ensure a healthy
immune system, healthy weight and vitality levels fit for
pregnancy.
• Certain foods contain specific nutrients which are essential to
reproductive health.
• Certain foods contain substances that may actually lower
fertility levels and consequently hinder the conception
process.

40. Ayurvedic Preconception nutrition
• According to ayurvedic literature, male should include milk & ghee in their
diet.
• For female, milk and black gram is advised for the period of one month.
• Acharya Kashyap(Ancient saint) explains about Lashunakshir (milk prepared
by garlic) & ghee for consumption if you are planning to conceive
• This diet will help in implantation & Stabilization of pregnancy.

41. Ayurvedic Preconception nutrition
• Asparagus racemose (A. racemose), is said to promote fertility and have a
range of health benefits.
• Consuming Asparagus racemose processed with milk can improve fertility.
Asparagus racemose possesses phytoestrogen content which is necessary for
spermatogenesis. Sesame seeds improve sperm count and motility. Some
studies have reported that garlic improves male sexual function and has a
beneficial effect in the recovery of testicular functions.

42. Ayurvedic Preconception nutrition
• When we see the contents of the milk, it has a good source of calcium & Adequate quantity
of water content.
• Milk delivers many nutrients like Protein, (contain nine essential amino acids), vitamins, etc.
• Milk is high needed biological value protein. These are essential for fetal development. It is
important for fetal linear growth.
• Consumption of milk also increases the blood concentration of insulin-like growth factor
(I GFI). It is a significant determinant of growth.
• Milk is rich in iodine because of which IQ will be boosted.
• Enhancing the maternal milk-intake during pregnancy results in a rise in fetal birth weight.

43. Reasoning behind ayurvedic diet?
• Ghee is rich in Vitamins A & E.
• It is rich in conjugated linoleic acid has an anti-Oxidant with Antiviral properties.
• It is rich in medium chain fatty acids which are absorbed directly into the liver &
burn it as energy.
• Butyric acid in ghee and it supports the production of killer T cells in the gut and
thus helps in developing the healthy immune system.
• Black gram is the rich source of folic acid, which is required to prevent the neural
tube defects, it also acts as potent anti-oxidant to reduce oxidative stress.

44. Ayurvedic recommended food males and
females to improve fertility.
• Fresh, organic fruits and vegetables, whole grains, protein from plant sources like beans, and
peas, sweet, juicy fruits such as mangoes, peaches, plums, and pears, asparagus, broccoli,
beans, spinach, pumpkin, tomatoes, and beets boost iron and promote fertility.
• Dried fruits and nuts such as dates, figs, raisins, almonds, and walnuts.
• Spices such as carom seed (ajwain) powder, cumin, turmeric powder, and black cumin boost
fertility.
• Substituting Sugar with Jaggery.
• Milk, ghee, nuts, sesame seeds, dates, pumpkin seeds, honey, saffron, and avocados.
• #This is for the purpose of information only, you have to consult an Ayurvedic consultant
if you are planning to follow the diet.

45. Stress and preconception health
• Dr. Lynch is the Director of Reproductive Epidemiology at The Ohio State
University Medical Center. Her research, published in Human Reproduction
in January 2014, determined that “Women who had the highest levels of
stress took 29% longer to get pregnant compared to other women, and their
risk of infertility doubled.”
• Stress appears to have a more pronounced effect in increasing the risk of
delivering a low birth weight (LBW) infant as well as preterm birth PTB
• PTB and LBW offspring are more likely to experience asthma and allergies in
later life

46. Preconception
care
importance of
managing
stress
• The stress and anxiety that women experience while they
are pregnant or even before conceiving can affect their
health and the health of their future children, leading to
problems including low birth weight, earlier delivery, and
postpartum depression.
• When stressed, the human body releases hormones to
handle higher stress, such as the so-called corticotropin-
releasing hormone (CRH), which increases stress
hormone cortisol.
• This mechanism also persists during pregnancy, and the
placenta, which supplies the fetus with nutrients, can also
emit stress hormone CRH.
• As a result, a small amount of this hormone enters the
amniotic fluid and affect the fetal metabolism

47. Preconception care importance of managing
sleep issue
• Sleep disorders are the most important public health problem not being
addressed in the United States.
• There are an estimated 40 million US citizens with chronic sleep disorders.
• Short sleep duration (7 hours of sleep per night) and poor sleep quality are
associated with cardiovascular morbidity and metabolic disorders such as
glucose intolerance, diabetes, heart disease, and hypertension.
• According to studies, people who sleep 7-9 hours per night are much less
likely to gain weight than those who sleep 6 hours or less.
• Lack of sleep also lowers one’s motivation to do physical exercise, and
insomnia which can lead to mood changes and depression.

48. Sleep and preconception health
• Lauren Wise, a professor of epidemiology at Boston University School of Public
Health did a research study among the couples to know the relation between sleep
and getting pregnant.
• The study found that short sleep duration less than 6 hours per night was associated
with a reduced probability of pregnancy.
• Poor sleep can also have an effect on labor and delivery. Researchers from the
University of California at San Francisco recently found that women who slept
fewer than 6 hours per night had longer labors and were 4.5 times more likely to
have cesarean deliveries

49. Preconception care
importance
• Current treatments and medications for sleep disorders are costly
and often harmful due to side effects.
• Many over-the-counter sleeping tablets, in addition to the commonly
doctor-prescribed benzodiazepines, non-benzodiazepines,
melatonin, anti-depressant, and antihistamine medications, may
lead to tolerance, dependence on the pills in order to fall asleep, or
abuse of the medication.
• Evidence suggests that using relaxation techniques can be helpful
components of a successful strategy to improve sleep habits.
• Mind and body practices which have been studied for their effects
on insomnia and other sleep disorders include Yoga, massage
therapy , Mindfulness Stress reduction.

50. Detoxifications
therapies
• Whole body oil massage is the manipulation of the soft tissue of
whole-body areas to bring about generalized improvements in health,
such as relaxation or improved sleep, or specific physical benefits,
such as relief of muscular aches and pains.
• Studies have shown that hormone levels associated with relaxation
and stress are significantly altered when massage therapy is
introduced to women’s prenatal care.
• Further, massage may positively impact neurotransmitter systems
implicated in mood regulation. Specifically, massage is associated
with decreased levels of cortisol and increased levels of serotonin
and dopamine.
• Serotonin improves negative mood states. Increased Dopamine is
associated with reduced levels of depression and stress.
• Massage therapy can be incorporated into routine prenatal care as an
emotional and physical health supplement shown to improve
pregnancy outcome and maternal health.

51. Evidence
• Massage therapy can help increasing pelvic blood supply, and reducing stress
and cortisol levels. The study shows that the pregnancy rate for women
treated with massage techniques before their next IVF transfer to be 63%
higher than the national average success rate for IVF.
• Women with raised cortisol levels (a measure of stress) are three times more
prone to miscarry during the first three weeks after conception. Massage
therapy can decrease the cortisol levels and therefore the likelihood of a
miscarriage.

52. Evidence
• Researchers Medina, Delgado, and Hernandez conducted a study to know
the effect of Yoga and massage therapy on maternal depression. Eighty-four
depressed women were randomly assigned to yoga, massage therapy or
standard prenatal care control groups. This study found that both yoga and
preconception herbal massage therapy would lower depression and anxiety
• Yoga and pranayama may help to improve fertility as it can enhance
relaxation, thus contributing to restoring a happy hormonal balance in the
body supporting fertility.

53. Enhancing mental Health
• Practicing yoga releases endorphins, substances that promote a
better response to pain and stress in the body as well as developing
better sleep quality.
• Studies have stated that pregnant women who practice yoga regularly
are said to report lower levels of stress, anxiety, and depression.
• Yoga masters believe that: Meditation and breathing techniques can
help moms to relax and cope with stress or anxiety

54. Enhancing mental Health
• Meditation is an integral part of yoga. It is also known as
"dhyana" in Sanskrit, it helps you achieve a harmonious
balance between your body and mind.
• Deep breath and breath awareness meditation involve
focusing on your regular breath to observe its nuances and
movement.
• Pranayama is also identified as 'controlled deep breathing.'
'Prana' means energy in Sanskrit and 'ayama' means a
distribution of energy. Yoga experts believe that when done
correctly, pranayama improves the circulation of blood
increases the oxygen level in your blood

55. Evidence
• A study was conducted to know the efficacy of yoga
on pregnancy outcomes at Gunasheela Surgical and
Maternity Hospital in Bangalore, India.
• Yoga practices, including physical postures, breathing,
and meditation were practiced by the yoga group one
hour daily, The control group walked 30 minutes twice
a day (standard obstetric advice) during the study
period.
• The number of babies with birth weight 2500 grams
was significantly higher (p < 0.01) in the yoga group.
• Preterm labor was significantly lower (p < 0.0006) in
the yoga group.
• Complications such as isolated intrauterine growth
retardation (IUGR) (p < 0.003) and pregnancy-induced
hypertension (PIH) with associated IUGR (p < 0.025)
were also significantly lower in the yoga group.

56. Evidence
• A study was conducted by Michalsen, Jeitler,
and Brunnhuber about effects of a yoga
program on perceived stress and
psychological outcomes in distressed women
before getting pregnant concluded that,
women who are suffering from mental
distress participating in a 3-month yoga class
showed significant improvements on
measures of stress and psychological
outcomes

57. Ayurveda
preconception
care program
Area addressed by Ayurvedic preconception care:
Advice on Nutrition
Preconception health counseling to make people aware about
their risky health behavior
Management of stress and sleep issues through Ayurvedic
practices
Measures to improve physical through Yoga
Measures Improving Mental health
Links to community resources

58. Ayurvedashram
Preconception Program
video link
? Want to ask to the organization

59. References
• Moos MK, Cefalo RC. Preconception health promotion: A focus for obstetric care. Am J Perinatol
1987;4:63–67
• Preconception Health Promotion: The Foundation for a Healthier Tomorrow, March of Dimes
• Lu, M. C., Kotelchuck, M., Hogan, V., Jones, L., Wright, K., & Halfon, N. (2010). Closing the Black-White
gap in birth outcomes: a life-course approach. Ethnicity & disease, 20(1 Suppl 2), S2-62-76.
• County Health Ranking.
• Efficacy of Yoga on Pregnancy OutcomeShamanthakamani Narendran, Raghuram Nagarathna, Vivek
Narendran, Sulochana Gunasheela, and Hongasandra Rama Rao NagendraThe Journal of Alternative and
Complementary Medicine 2005 11:2, 237-244
•

60. References
• O'Hair, C. M., Armstrong, K., & Rutherford, H. (2018). The Potential Utility for Massage Therapy During
Pregnancy to Decrease Stress and Tobacco Use. International journal of therapeutic massage & bodywork,
11(3), 15-19.
• Sushruta Samhita-KL Bhishagratna Translator (Chaukhamba Orientalia, Varanasi, India, 1991), Pages 3-23 (I), 45-49 (II)
• Preconceptional care in Ayurveda for a healthy mother and child A classical review
• Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2011). Yoga and massage therapy
reduce prenatal depression and prematurity. Journal of bodywork and movement therapies,16(2), 204-9.
• Dhuri, K. D., Bodhe, P. V., & Vaidya, A. B. (2013). Shirodhara: A psychophysiological profile in healthy volunteers. Journal
of Ayurveda and integrative medicine, 4(1), 40-4. Shirodhara can help in providing remediesfor the symptoms of anxiety,
stress, and fatigue

61. References
• Coussons-Read M. E. (2013). Effects of prenatal stress on pregnancy and human development: mechanisms
and pathways. Obstetric medicine, 6(2), 52-57.
• Amelia K Wesselink, Elizabeth E Hatch, Kenneth J Rothman, Jennifer L Weuve, Ann Aschengrau, Rebecca
J Song, Lauren A Wise. Perceived Stress and Fecundability: A Preconception Cohort Study of North
American Couples. American Journal of Epidemiology, 2018; DOI: 10.1093/aje/kwy186
• Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2011). Yoga and
massage therapy reduce prenatal depression and prematurity. Journal of bodywork and movement
therapies,16(2), 204-9.
• Michalsen, A., Jeitler, M., Brunnhuber, S., Lüdtke, R., Büssing, A., Musial, F., Dobos, G., … Kessler, C.
(2012). Iyengar yoga for distressed women: a 3-armed randomized controlled trial. Evidence-based
complementary and alternative medicine : eCAM, 2012, 408727