GARBHA UPAGHATKAR BHAVAS AND PREGNANCY LOSS: A CRITICAL APPRAISAL OF AYURVEDIC AETIOPATHOGENESIS IN THE CONTEXT OF CONTEMPORARY EVIDENCE ON SPONTANEOUS ABORTION AND MISCARRIAGE

Abstract

Background: Spontaneous abortion and miscarriage continue to represent a substantial obstetric and public health challenge globally, with an estimated 15–20% of clinically recognised pregnancies ending in loss. While contemporary biomedical research has characterised a spectrum of genetic, anatomical, endocrinological, immunological, and environmental aetiologies, classical Ayurvedic texts codify a parallel and remarkably comprehensive set of risk factors under the rubric of Garbha Upaghatkar Bhavas — literally, 'factors capable of inflicting harm upon the developing foetus.' The Charaka Samhita (Sharirasthana 8/21) and allied texts enumerate physical, behavioural, dietary, and psychosomatic determinants of embryo–foetal damage with a specificity that invites systematic biomedical correlation.

Objectives: This study critically appraises the Garbha Upaghatkar Bhavas as documented in canonical Ayurvedic literature, maps each factor to its contemporary biomedical equivalent, identifies substantive convergences and divergences, evaluates the antenatal care (ANC) implications of ancient observational findings on maternal lifestyle and foetal outcome, and proposes a conceptual integrative framework for further clinical investigation.

Methods: A textual-analytical and narrative review design was employed. Classical Sanskrit primary sources — Charaka Samhita, Sushruta Samhita, and Ashtanga Sangraha — were systematically reviewed and translated. A structured search of PubMed, Scopus, and Google Scholar (2014–2024) retrieved contemporary peer-reviewed literature on spontaneous abortion aetiology, maternal nutrition, psychosocial stress in pregnancy, and epigenetics. Thematic coding and comparative analysis were performed.

Results: Eight principal Garbha Upaghatkar Bhavas were identified, each demonstrating robust biomedical analogues: improper posture (mechanical cervical incompetence), suppression of natural urges (autonomic dysregulation, pelvic floor dysfunction), improper exercise (uterine hyper-contractility), thermal-pungent dietary excesses (prostaglandin-mediated uterotonic effects), dietary monotony (micronutrient deficiency), traumatic abdominal injury (placental abruption), vehicular vibration (mechanical embryo dislodgement), and psychoacoustic stress (hypothalamic–pituitary–adrenal axis activation, cortisol-mediated uterine contractility). Ayurvedic classifications of hereditary tendency for recurrent abortion (Garbha Prastravati) parallel contemporary X-linked or epigenetic frameworks of recurrent pregnancy loss.

Conclusion: The Ayurvedic Garbha Upaghatkar Bhavas constitute a clinically relevant, multimodal aetiopathological framework that predates modern understanding of pregnancy loss by over two millennia. Systematic prospective validation studies are warranted to transform these observational insights into evidence-based ANC guidelines within integrative obstetric practice.