Sutikagara (सूतिकागारम्)

Sutikagara (सूतिकागारम्) refers to the the specially designed labour room for a woman who is about to deliver a baby in few months or has just delivered a baby. This room is a place for residence of a woman a few days before labour , during labour and few days after labour till she needs specific attention and care. Ayurveda scholars have paid detail attention to its structure, arrangements, facilities and all other relevant details.

परिचयः॥ Introduction

Today we see that the pregnant women get admitted to the hospital once the labour pains begin or a day before their planned day for caesarian section. Institutional deliveries have started in recent times in world after the rise of western medicine. However before that, the women used to deliver babies at home under the guidance and assistance of a skilled, experienced midwifes. Ayurveda scholars had thoroughly studied and understood the need of implementing special safety measures during labor so as to ensure safety and wellbeing of woman in labour and the newly born baby. For that, Ayurveda recommends construction of a place named as 'Sutikagara' which is specially designed room for delivery. Thus Sutikagara helps a medical person or a vaidya to make arrangements for labour procedure and management of complications that might arise during or post labour. The separate room of Sutikagara isolates mother and newly born baby from rest of the family and friends so as to ensure their safety and wellbeing during and post labor when their immune function is weak and they are susceptible for infections. Some relate Sutikagara with modern day accouchment ward.

व्युत्पत्तिः॥ Etymology

The term Sutikagara is made up of 2 terms namely 'Sutika' and 'Agara'.

Sutika (सूतिका)- This refers to a woman who has just delivered a baby or a parturient woman or a woman in lobour.

Agara (आगारम्)- Means house, apartment or a dwelling place

Thus, collectively it means a house or a dwelling place for a woman who is in labour or who has just delivered a baby.

सूतिका॥ Sutika

Ayurveda acharyas opine that the woman is called Sutika from her labour till one and half month post labour. There are differences of opinion regarding fixing the period up to which the woman is called as sutika. Some acharyas opine that the woman will be called as sutika up to 4 months from labour while others also opine that she should be referred as sutika until her menstruation begins.

The cause behind calling woman by this specific term lies in the certain physiological status of a woman in this period which is characterized by pains and aches of labour, sudden changes that occur after delivery of a child after carrying it for period of whole 9 months, changes in hormones, open wounds and cuts, psychological status of a new mother and the need of following a specific regime that will help her to pass through these changes smoothly. The food and lifestyle regime for sutika is different and it is designed by Ayurveda scholars to make the new mother capable of handling new changes, prevent the ill effects that might arise if the health is neglected at this time, nourishment of newborn and ensure safety of mother as well as the baby. This regime is called as 'Sutika paricharya' (सूतिका परिचर्या) in Ayurveda and is one of the many exclusive and elaborative routine plans proposed by Ayurveda for a specific phase in a woman's life. Other include Garbhini paricharya (गर्भिणी परिचर्या), Rajaswala paricharya (रजस्वला परिचर्या), Rtumati paricharya (ऋतुमती परिचर्या).

Also see Women's health and Ayurveda.

सूतिकागारस्य संरचना॥ Structure of sutikagara

Sutikagara is a temporarily made structure. It is not multipurpose nor it is used for more than one woman. Thus it has be built specifically for one woman and then dismantled once the purpose is served. The structure of sutikagara should be as described below,

• When to build ?- It is advised to build the sutikagara well in advance before delivery and ideally before the starting of the 9th month. The auspicious day is selected for starting the construction of the sutikagara.
• Location - The land for the sutikagara should be carefully selected. It should be free from stones, sand, gravel, earthen pot pieces (and any waste products dumped onto it). It should be thoroughly cleaned before construction. The place should also not have any smell or odours and unpleasant site.
• Measurements - Acharya Sushruta has suggested that, the land should be approximately 12 feet long and 6 feet wide. It should be covered on the top properly.
• Direction- It should be east or north facing.
• Materials used for construction - The structure is wooden. Thus the woods of specific plants have been suggested to build it. Woods of medicinal plants like Bilva (बिल्व Aegle marmelos), Tinduka (तिंदुकः Diospyrus malbarica), Inguda (इंगुदः Balanites aegyptica), Khadira (खदिरः Acacia catechu) or Bhallataka (भल्लातकः Semicarpus anacardium) are suggested for use. One can use other woods with the help of experts of Atharvaveda (अथर्ववेदः), when these woods are not available in the vicinity.
• Walls - The walls should be smeared well with the help of cow dung.
• Temperature - The construction should be comfortable for any season or the season in which the delivery will be conducted.
• Facilities- Separate places for cooking, water storage, medicine preparation (mortar & pestle), latrine and bathroom should be created at appropriate place as suggested by the Vastuvidyakushala (वास्तुविद्याकुशलः architect).
• Safety- As a part of traditionally practiced safety measures, it is advised that upon construction, appropriate rakshavidhi (offering prayers, sacrifices, auspicious chanting) should be conducted.
• Specifications according to Varnashrama Dharma (वर्णाश्रमधर्मः) - Acharya Sushruta has interestingly described a customized sutikagara construction based on Varnashramas (वर्णाश्रमाः). The selection of a type of land, wood for construction is different for each varnashrama as below,

Customized approach to build Sutikagara based on Varnashrama

Varnashrama	Colour of the soil or Land selected for Sutikagara construction	Wood used in construction
Brahmana	White	Bilva (Aegle marmelos)
Kshatriya	Red	Nyagrodha (Ficus bengalhensis)
Vaishya	Yellow	Tinduka (Diospyros malabarica)
Shudra	Black	Bhallataka (Semicarpus anacardium)

It is needed to explore the properties of each of the different types of land and woods to understand their specific health benefits for a woman having peculiarities associated with certain Varnashrama to which she belongs.

सूतिकागारे द्रव्यसंभारः॥ Arrangements in sutikagara

Along with the facilities to fulfill daily needs of a woman Sutikagara should be well equipped with all the necessary herbs, medicines and other tools to facilitate smooth delivery and post partum period after that. Following things should be made available in Sutikagara according to Ayurveda scholars.

Medicines and Herbs	Food items	Beverages and fermented drinks	Other tools
Various herbs like- Vidanga, Shunthi, Pippali, Marich, Pippalimoola, Langali, vacha, ela, atasi, Chavya, chitraka etc.	Ghruta (घृतम् Ghee)	Sura (सुरा A specific type of liquor or wine)	2 pieces of stones
	Tailam (तैलम् Oil)	Asava (आसवम् Fermented herbal liquid medicinal formulations)	Instruments made up of iron
	Madhu (मधुः Honey)	Maireya (मैरेयम् A type of an intoxicating drink useful as medicine in certain situaitons)	Gold or silver made needles
	Different types of Lavana (लवणानि medicinal salts )		Mortar and Pestle
	Lashuna ( लशुनः Garlic)		2 wooden Beds
	Sarshapa (सर्षपः Mustard)		Firewoods
	Yawagu (यवागुः Rice gruel)		Other instruments or tools advised by experienced old ladies or midwives etc.

Along with the above mentioned items who can be present or who should be available easily near Sutikagara has also been mentioned in Ayurveda samhitas. It is mentioned that, aged and experienced women who are themselves multipara, very kind hearted, caring, having appropriate behavior, affectionate & tolerant nature, free from grief, having knowledge of doing right things at right time should be present in Sutikagara. Also brahmanas who are expert in Atharvaveda should also be available whenever required in Sutikagara. Some rituals practiced just before the delivery like Punyaha wachana (पुण्याह वाचनम्) etc and to perform Jatakarma samskara (जातकर्म संस्कारः) after the delivery of the baby Athrvaveda expert brahmanas are required. Therefore all these factors should be considered while designing and developing sutikagara.

सूतिकागारप्रवेशविधिः॥ Process of entering the sutikagara

Once the Sutikagara is ready, the pregnant woman is advised to enter into it right after the start of 9th month of pregnancy.

The detailed process of entering into Sutikagara is described in brief below.

• Time to enter- After the beginning of the 9th month of pregnancy, an auspicious day and on auspicious constellation should be selected to enter the Sutikagara. One should select the time when the moon is situated in the highest place and is in association with other beneficial planets.
• Pre-procedures- On Maitra muhurtam (मैत्र मुहूर्तम्), shantihomas (शान्तिहोमाः fire oblations) should be performed before entering Sutikagara. Gau (गौ cows), brahamans (ब्राह्मणाः purohits), agni (अग्निः fire), udaka (उदकम् water) should enter first inside Sutikagara. The cows should be offered grass and water, The brahmanas should be offered and pleased by giving them Rice flakes, fruits, flowers etc. A pregnant woman should then take a sip of water and take the blessings from gau (cows) and brahamanas for the welfare.
• Then a lady should enter the Sutikagara by keeping her right foot into the room first. She shall then stay there and wait till the onset of labour.
• During her Sutikagara stay, a lady should be constantly involved in auspicious deeds, and stay in association with women having good and noble qualities and behavior.