Sutikagara (सूतिकागारम्)

Sutikagara 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.

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.

Etymology

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

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

Agara- 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.

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 upto which the woman is called as sutika. Some acharyas opine that the owman will be called as sutika upto 4 months from labour while others also opine that she should be referred as sutika untill 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' 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, Rajaswala paricharya, Rtumati paricharya.

Also see Women's health and Ayurveda.

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 (Aegle marmelos), Tinduka (Diospyrus malbarica), Inguda (Balanites aegyptica), Khadira ( Acacia catechu) or Bhallataka (Semicarpus anacardium) are suggested for use. One can use other woods with the help of experts of Atharvaveda, 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 (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 - Acharya Sushruta has interestingly described a customized sutikagara construction based on Varnashramas. 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.

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 (Ghee)	Sura (A specific type of liquor or wine)	2 pieces of stones
	Tailam (Oil)	Asava (Fermented herbal liquid medicinal formulations)	Instruments made up of iron
	Madhu (Honey)	Maireya (A type of an intoxicating drink useful as medicine in certain situaitons)	Gold or silver made needles
	Different types of Lavana (medicinal salts )		Mortar and Pestle
	Lashuna (Garlic)		2 wooden Beds
	Sarshapa (Mustard)		Firewoods
	YAwagu (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. According t o

स्त्रियश्च बह्व्यो बहुशः प्रजाताः सौहार्दयुक्ताः सततमनुरक्ताः प्रदक्षिणाचाराः प्रतिपत्तिकुशलाः प्रकृतिवत्सलास्त्यक्तविषादाः क्लेशसहिन्योऽभिमताः, ब्राह्मणाश्चाथर्ववेदविदः; यच्चान्यदपि तत्र समर्थं मन्येत, यच्चान्यच्च ब्राह्मणा ब्रूयुः स्त्रियश्च वृद्धास्तत् कार्यम्

Process of entering the sutikagara

नवमे मासि सूतिकागारमेनां प्रवेशयेत् प्रशस्ते तिथ्यादौ |

तत्रारिष्टं ^[१] ब्राह्मणक्षत्रियवैश्यशूद्राणां श्वेतरक्तपीतकृष्णेषु भूमिप्रदेशेषु बिल्वन्यग्रोधतिन्दुकभल्लातकनिर्मितसर्वागारं ^[२] यथासङ्ख्यं तन्मयपर्यङ्कं समुपलिप्तभित्तिं सुविभक्तपरिच्छदं प्राग्द्वारं दक्षिणद्वारं वाऽष्टहस्तायतं चतुर्हस्तविस्तृतं रक्षामङ्गलसम्पन्नं विधेयम् ||५|| (Sush. Samh. Sha. 10.5)

प्राक् चैवास्या नवमान्मासादप्रहृतास्थिशर्कराकपाले

प्रशस्ते देशे वास्तुविद्याप्रशस्तं सर्वर्त्तुसुखमुखहृतसर्वो-

पकरणं सन्निहितज्वलनं प्राग्द्वारमुदङ्द्वारं वा सूतिकागारं

कारयेत्||१४|| तत्रानुकूलेषु नक्षत्रादिषु पुण्याहशब्देन गोब्राह्मणवृद्धा- न्न्त्वाऽऽवर्तमाना प्रदक्षिणं प्रविश्य बहुशः प्रसूताभिर- नुरक्ताभिरविषादाभिः क्लेशक्षमाभिः परिवृता स्व- स्त्ययनपरानुलोमनैराहारविहारैरनुलोमितवातमूत्रपुरीषा प्रसवकालमुदीक्षेत| स्वल्पेऽपि च विण्मूत्रपुरीषा प्रसव- कालमुदीक्षेत| स्वल्पेऽपि च विण्मूत्रविबन्धे फलवर्तीः प्रणिदद्यात्||१५||(Asht. Samg. Sha. 3.14-15)