Definition of sutika: According to Kashayapa, after delivery of child, till the placenta is not expelled, a woman cannot be called as sutika or in other words “sutika” term can only be used after expulsion of placenta.
Duration of Peurperium (Sutika Kaal): All the classics have mentioned different duration of normal peurperium i.e. ten days, one month, four months, and six months with respect to the re-appearance of menstruation.
Physical Changes in Peurperium: The woman becomes weak or emaciated due to the development of fetus and due to the unsteadiness of all the dhatus, labor pains and excretion of kleda and blood.
- Dhatukshaya: Decrease in all dhatus.
- Dhatu Shaithilya: Loss of steadiness in dhatus.
- Vaat Prakopa: Increases accumulation of vaat dosh due to involution of uterus.
- Agnimaandya: Reduced digestion.
- Shunya Sharir-artava: Body becomes empty.
Among all the above changes, if involution of uterus doesn’t take place at proper time, it leads to many sutika rogas.
Involution of Uterus: Involution is a process by which the bulky uterus following delivery progressively returns to normal pre-gravid state. Its size comes at the level of umbilicus immediately after the child birth. During the first 24 hrs, the level remains constant. Thereafter there is a steady decrease in height. By 11th day, uterus sinks behind the symphysis pubis. By the end of second week, the uterus becomes a pelvic organ. Sometimes, the involution may be prolonged in woman who is suffering from hydraminos, twin pregnancy, multipara, post partum hemorrhage, infections, membranes or clots remaining inside the uterine cavity and anemia.
Principles of Sutika-parichariya:
- To give complete attention to restore the normal health status of the mother-baal vridhhi.
- To increase the digestive power i.e. Agnisandhikshan.
- Garbhaashya shodhan.
- To take care of the breasts, including promotion of lactation i.e. stanya pravartan and stanya pushti.
- Yoni Sanrakshan is necessary to prevent vaginal infections.
- Kumarbharan i.e. to feed the baby properly.
In all the classics, for garbhashaya shodhan, Panchkol is to be taken orally as an abhyantar chikitsa and yoni dhoopan should be done for local or sthaanic chikitsa which are mentioned. While describing the treatment of sutika rogas, Aacharayas have explained that if garbhaashya involution is not occurring at proper time, pippali mool powder with butter milk can be used so that the uterus comes to normal state. Pippalimool churna contains katu rasa and is ushna virya, kapha-vaat shaamak, so it does a good job in garbhashya shodhan by digesting avshishta dosha, kapha, kleda, rakta and mala, resulting in good involution of uterus. The per vaginal discharge is lessened, so it prevents further sutika rogas.