This article is totally the Ayurvedic concept of false presentations and difficult labour and also miscarriage. This was the concept of Acharya Shrusuta, who is also known as father of surgery.So lets start with the cause of Mudha garvha.
The different causes of Mudha Garbha are Sexual intercourse during pregnancy, riding on horseback, etc., or in any sort of conveyance, a long walk, a false step, a fall, pressure on the womb, running, a blow, sitting or lying down on an uneven ground, or in an uneven posture, repression of any natural urging of the body, fasting, voluntary, partaking of extremely bitter, pungent, parchifying articles, eating in inordinate quantities of Sakas and alkaline substances, dysentery (Atisara), use of emetics or purgatives, swinging in a swing or hammock, indigestion, and use of medicines which induce the labour pain or bring about abortions, and such like causes tend to expel the foetus from its fixture. These causes tend to sever the child from the uterine wall with its placental attachment owing to a kind of Abhighata(uterine contraction) just as a blow tends to sever a fruit from its pedicel.
The foetus, thus severed and dislodged from its seat, excites peristalsis not only in the uterus, but induces a sort of constant, spasmodic contraction of the intestinal cavities (Koshthas), producing pain in the liver, spleen, etc. The Apana Vayu, thus obstructed through the spasmodic contraction of her abdomen, produces any of the following symptoms, viz. a sort of spasmodic pain in the sides, or in the neck of the bladder, or in the pelvic cavity, or in the abdomen, or in the vagina, or Anaha (tympanites with obstruction, etc.) or retention of urine, and destroys the fetus, if immature, attended with bleeding. In case the fetus continues to develop and is brought in an inverted posture at the entrance to the vaginal canal, and is impacted at that place, or if the Apana Vata gets disordered and consequently cannot help the expulsion of the same, such an obstructed fetus is called Mudha garbha.
Classification and Symptoms: – Cases of Mudha-garbha may be roughly divided into four different classes such as, the Kilah, the Pratikhurah, the Vijakah and the Parighah. The sort of false presentation in which the child comes with its hands, legs and head turned upward and with its back firmly obstructed at the entrance to the vagina, like a stake or a kila, is called Kilah. The sort of presentation, in which the hands, feet and head of the child come out, with its body impacted at the entrance to the vagina, is called Prathikhurah. The type in which only a single hand and the head of the child come out (with the rest of its body obstructed at the same place), is called the Vijakah. The type in which the child remains obstructing the head of the passage in a horizontal position, like a bolt, is called the Parighah. Certain authorities aver that, these are the only four kinds of Mudhagarbha. But we cannot subscribe to the opinion. (which recognizes only four kinds of false presentations), inasmuch as the deranged Vata (Apana) can present the fetus in various different postures at the head of the vaginal canal. Sometimes, the two thighs of the child are first presented, and sometimes it comes with a single leg flexed up. Sometimes the child comes with its body, bent double, and thighs drawn up, so that only breech is obliquely presented. Sometimes the child is presented, impacted at the head of the passage with its chest, or sides, or back. Sometimes the child is presented with its arm around its head, resting on the side, and the hand coming out first. Sometimes only the two hands are first presented, the head leans on one side; sometimes the two hands, legs and the head of the child, the rest of the body being impacted at the exit in a doubled up posture. Sometimes one leg is presented, the other thigh being impacted at the passage (Paayu). I have briefly described these eight sorts of presentation of which the last two are irremediable. The rest should be given up as hopeless if these are attended with the following complications viz., deranged sense-perception of the mother, convulsions, displacement or contraction of the reproductive organ (yoni) a peculiar pain like the after-pain of child birth, cough, difficult respiration, or vertigo.
As a fruit, fully matured, is naturally severed from its pedicel and falls to the ground and not otherwise, so the cord, which binds the foetus to its maternal part, is severed in course of time, and the child comes out of the uterus ( into this world of action ). On the other hand, as a fruit, worm-eaten or shaken by the wind or a blow, untimely falls to the ground, so will a foetus be expelled out of its mother’s womb, before its time. For four months after the date of fecundation, the foetus remains in a liquid state, and hence its destruction or coming out of the womb goes by the name of abortion. In the course of the fifth and sixth months the limbs of the foetus gain in firmness and density, and hence, it’s coming out at such a time is called miscarriage.