|Year : 2014 | Volume
| Issue : 2 | Page : 27-32
Effect of time (Kālam) of delivery on the outcome of pregnancy
Aruna Muralidhar1, Sindhu Shanker2, Leena M Kumari2, Latha Venkatram2, HR Nagendra2, R Nagarathna2
1 Department of Obstetrics and Gynaecology, Rangadore Memorial Hospital, Bengaluru, Karnataka, India
2 Division of Yoga and Life Sciences, Arogyadhama, S-VYASA Yoga University, Bengaluru, Karnataka, India
|Date of Web Publication||22-Jun-2015|
Rangadore Memorial Hospital, 1st Cross, Shankarapuram, Basavangudi, Bengaluru - 560 004, Karnataka
Source of Support: None, Conflict of Interest: None
Background: Lunar phases have proven conclusive effects on outcomes of pregnancy. Studies have shown conception on a "full moon" day results in a male infant and that on a "no moon" day results in a female infant. It is common belief that the delivery during inauspicious time of the day (Rāhukālam [RK]) could have deleterious effects on pregnancy outcome although there are no scriptural references to this. The present study was designed to look at the effects of specific time periods or Kālams on pregnancy outcomes. Materials and Methods: This retrospective controlled study reviewed the maternal and birth outcome from 1885 parturition records (2010-2012) of the obstetric unit of Rangadore Hospital, Basavanagudi, Bengaluru. Pregnancy outcome of deliveries during day in 4 time periods (90 min each) as designated in calendar prepared by Ontikoppal Panchangam for Bengaluru were compared. The three study periods were RK (inauspicious), Yamaganda Kβlam (YK) (inauspicious), and Gulika Kālam (GK) (auspicious). The control period was that which did not fall under any of the specified Kālams. All night time deliveries (8 pm to 6.00 am) were excluded. Chi-square test was used to compare the number of events of different maternal and fetal outcomes in the four different periods. Outcome Measures - Maternal: Cardio topographic abnormalities during first or second stages of labor, postpartum hemorrhage, perineal tear, Analgesic medication requirement, and Epidural analgesia requirement. Fetal: Presence of meconium stained amniotic fluid, APGAR scores, physical injuries to baby at birth, need for phototherapy, need for neonatal intensive care unit, and other complications. Results: There was no significant difference between four Kālams in any of maternal and fetal outcomes. Conclusions: The present study suggests that there is no influence of the birth time falling within the three Kālams (RK, YK, and GK) on complications of maternal outcomes and fetal outcomes.
Keywords: Astrology, complications, pregnancy outcome, kβlam
|How to cite this article:|
Muralidhar A, Shanker S, Kumari LM, Venkatram L, Nagendra H R, Nagarathna R. Effect of time (Kālam) of delivery on the outcome of pregnancy. Int J Yoga - Philosop Psychol Parapsychol 2014;2:27-32
|How to cite this URL:|
Muralidhar A, Shanker S, Kumari LM, Venkatram L, Nagendra H R, Nagarathna R. Effect of time (Kālam) of delivery on the outcome of pregnancy. Int J Yoga - Philosop Psychol Parapsychol [serial online] 2014 [cited 2020 Feb 29];2:27-32. Available from: http://www.ijoyppp.org/text.asp?2014/2/2/27/159117
| Introduction|| |
Childbirth is a very precious and important event in a woman's life leading to blissful motherhood. However, it is unfortunate that every minute at least one woman dies from complications related to pregnancy or childbirth (World Health Organization).  It literally translates to 529,000 maternal deaths per year. In addition, for every maternal death around 20 more suffer from injury, infection or disease, amounting to approximately 10 million per year.  Pregnancy and subsequent childbirth are affected by a host of factors which can lead to complications both at maternal and fetal levels. Preeclampsia, intrauterine growth retardation, preterm delivery, cardiotocographic abnormalities (CTG) abnormalities during second stage of labor, postpartum hemorrhage (PPH), perineal tears, abnormal APGAR scores, low birth weight are some of the known complications for which special monitoring is ensured. Apart from these, there seems to be some unknown factors that lead to many unexpected complications. Indian science of astrology (Jyotisha) says that "time" is an important factor that influences each and every event of life.
Over thousands of years of observational research astrology evolved mathematical ways of understanding the individual's characteristics and also to forecast the major events of life. Astrology became an integral part of Indian lifestyle to plan and organize their day-to-day chores from cradle to cremation. Indian astrology is the study of the response of man to more mystical planetary stimuli. The planets actually send forth radiations in the cosmos. However, they have a cause-effect sense of balance that influences the living organisms. This influence makes each human being adopt particular behavioral patterns, in thoughts, words, and deeds. Modern science has just started to corroborate the scientific basis for many of their findings. Considering the time and place of birth of the individual, an astrologer is trained to fix (birth chart, kundali) the individual's relation to the position of the sun, moon, and eight other planets. This is used to calculate the influence of the subtle cosmic energies of the moving planet positions on life events of the individual. Following some rules for navigating these energy-significant periods of time, it is believed that one can maximize the positive end results in daily activities while avoiding the negative ones. From birth to death, every major event of life (bad or good) was considered a refining process to reach the highest goal of life. Hence to perform any activity, the right "time" had to be chosen. Herein came the concept of categorizing time into Kālam, Vāram, Nakshratam, Tithi, and Karanam, which characterized a given 24 h period from one sunrise to the next. These were determined with reference to Sun, Moon, planets, and stars. Apart from vedic tradition, even other leading faiths believe that the primordial energy is imminent and all-pervading, as it had transcended time and space. Predictions based on the time factor (Muhoortha or Kālam), is a branch of astrology that can be called an applied science. Each day (24 h) is segmented into specific sections of time called Kālam. Each Kālam has its own positive or negative planetary interactions thereby influencing the life of man. Depending on the type of Kālam, it can either have a beneficial effect or a harmful effect. 
Several scientific studies have shown the influence of lunar phases on outcomes of pregnancy. Sarkar and Biswas  tested the validity of a traditional belief that the effect of conception on a "full moon" day results in a male infant and that on a "no moon" day results in a female infant. Valandro et al.  observed by higher frequencies of abortions in the months when the perigees were closest as compared to farther perigees. A very large retrospective study on 5,927,978 French births showed that the synodic lunar cycle (length of time during which the moon makes one orbit of the sun relative to the earth) has a statistically significant relationship with the number of births. 
Traditional wisdom says that activity done at certain times of the day give good or bad results due to overriding universal influences. There is a common belief that births during inauspicious periods have more problems of pregnancy than those that happen during auspicious muhurtas. Based on this, our mothers, while planning elective caesarean sections for medical indications, request the obstetricians to avoid inauspicious periods (Rāhukālam [RK] or Yamaganda Kālam [YK]). Looking at the scriptural references, it is stated that these time periods (RK, Gulika Kālam [GK], and YK) influence the results of undertaking a voyage,  and there is no reference to their effect on outcome of pregnancy. Hence, the present study was aimed at assessing the effects of GK (GK-auspicious time), YK (YK-most inauspicious), and RK (RK-inauspicious) on the outcomes of pregnancy with the hypothesis that these Kālams does influence the outcome of pregnancy.
| Materials and methods|| |
This retrospective single-blind controlled study was carried out by reviewing the birth records of 1885 births between 2010 and 2012 at the obstetrics department of Rangadore Hospital, Bengaluru. The study protocol was accepted by the ethical committee of the SVYASA University.
The records included the files of all the deliveries conducted by all the obstetric units (eight) of the hospital. The obstetricians in the research team prepared the two excel sheets in the computer for documentation of maternal and fetal outcomes from these records.
The following maternal outcomes were documented: Cardiotopographic abnormalities during first or second stages of labor, preterm delivery, perineal tear, PPH, preterm delivery, requirement for epidural analgesia, analgesic medication requirement, and other complications.
The fetal outcomes included need for neonatal intensive care unit (NICU), APGAR scores, meconium stained amniotic fluid, physical injuries on the infant during birth, need for phototherapy, and other complications (uncommon complications which could not be grouped under any of the above categories).
Two researchers sat in the medical records department (MRD) of the hospital regularly from 9 am to 5 pm during the weekdays (6 day/week). The clerical staff of MRD issued about 50 files per day to the researchers who went through each file carefully to write down all the necessary data in their personal laptops (one for maternal and one for fetal outcomes). The files that had all required data (maternal and/or fetal) were included. It took about 12 weeks to complete the data entry. The first author, an obstetrician, was involved in supervising and clarifying the doubts while going through the records.
All data entry was checked by the statistician. Analysis was carried out using SPSS version 10 (IBM Corporation, NY, US) to plot. As all these specific study periods lasted for 90 min during the day between 6.00 am till 8.30 pm it was decided that we exclude all files of night time (8.30 pm to 6.00 am) deliveries for analysis. A control period of 90 min which did not fall in any of these 3 major study periods was selected for each day of the week. Descriptive statistics was used to calculate the number of subjects who delivered in different time periods, GK, YK, RK, and control periods, as determined by referring to the Standard Indian Calendar prepared for Benguluru by Ontikappal Panchangam group [Table 1].
The frequency of different complications that occurred in these 4 periods was tabulated. Nonparametric Chi-square tests were used to compare the frequencies of different complication in the 4 time intervals.
| Results|| |
[Figure 1] shows the study profile. A total of 2016 files were checked. Of these, 1078 had complete maternal and 1885 had a complete fetal outcome. Of these files, 263 were of night time (8.30 pm till 6.00 am) deliveries. Among the cases (1078) which had complete maternal outcome data, there were 94 births (8.71%) in RK, 89 in YK (8.25%), 87 in GK (8.07%), and 87 (8.07%) in control period; these frequencies were used for final analysis of maternal complications [Table 2].
|Table 2: Comparison of maternal complications in four time periods (Chi-square test)|
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Of the 2016 files checked, 1885 had complete data of fetal complications. Of this, 379 cases of night time (8.30 pm till 6 am) deliveries were excluded. Among the cases (1885) which had complete fetal outcome data, there were 154 births (8.16%) in RK, 131 in YK (6.94%), 167 in GK (8.85%), and 146 (7.74%) in the control period; these frequencies were used for final analysis of fetal complications [Table 3].
|Table 3: Comparison of fetal complications in four time periods (Chi-square test)|
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Maternal CTG abnormalities in the fetus during second stage of labor ranged from 23 to 30% in different Kālams with nonsignificant difference between the four Kālams (P = 0.56).
Postpartum hemorrhage ranged from 1% to 7%. Although the differences between groups were nonsignificant (P = 0.11), the numbers in RK appeared to be highest (n = 7, 7.4%) and the number in the control period was the least (n = 1, 1.4%).
Frequency of perineal tear was the least in the auspicious period, the GK (n = 29, 33%) and highest in the inauspicious period of YK (n = 36, 40.44%), but there was no significant (P - 0.81) difference between the four periods.
Analgesic medication requirement was the least in the auspicious period, the GK (n = 38, 43.67%) and highest in the inauspicious period of RK (n = 50, 53.19%) with nonsignificant (P - 0.76) difference between the four periods in Chi-squared test.
Epidural analgesia requirement showed a similar pattern of changes. It was the least in the auspicious period, the GK (n = 31, 35.63%) and highest in the inauspicious period of RK (n = 38, 40.42%) with nonsignificant (P - 0.67) difference between the four periods in Chi-squared test.
[Table 3] shows the differences in fetal outcomes between the four time periods.
Need for admission to NICU ranged from 25% to 30% in different Kālams with nonsignificant difference between the four Kālams (P = 0.44).
APGAR scores in the infant at the time of birth ranged from 7% to 11%. Although the differences between groups were nonsignificant (P = 0.71), the numbers (15 each) in the inauspicious periods (RK, YK) appeared to be highest and the number in the control period was the least (10).
There were no cases of physical injury in YK at all. There was nonsignificant difference (P = 0.67) between the four periods.
Need for phototherapy ranged from 4% to 8% with least number in control period (4.1%) and highest in YK (7.63%); there was nonsignificant (P - 0.46) difference between groups.
Meconium stained amniotic fluid
There was nonsignificant difference (P - 0.39) in Chi-squared test although the numbers appeared to be high in deliveries that occurred during the inauspicious time of YK (16.03%).
Again, there was no significant (P - 0.48) difference between the four periods in the category of "other complications" that included many other minor uncommon complications.
| Discussion|| |
This is a retrospective controlled pilot study carried out on 1885 birth records that looked at the time of delivery and its relation to the incidence of pregnancy outcome. The Indian calendar refers to three different time periods (1.5 h each) in a day that may be considered "inauspicious" (RK and YK) or "auspicious" (GK) as these may influence some of the major life events of an individual. The results showed that there was no significant difference in any of the time periods as compared to a control period on the outcome of pregnancy (maternal or fetal).
There are many studies that have looked at the influence of the moon's position on pregnancy outcomes. Fourier's spectral analysis of 5,927,978 births in 6 years (1968-1974) by Guillon et al., showed a weekly rhythms with lowest birth rate on a Sunday and highest on Tuesday and an annual rhythm with maximum births in May and minimum in September-October. A study by Valandro et al., showed a significant effect of extreme perigeal lunar positions on the number of hospitalized spontaneous abortions. Although a few of these studies with large sample sizes support the influence of time factor on pregnancy outcomes, the number of studies which negate the influence of time factor outnumber them. A retrospective study by Arliss et al.  on 564,039 births across 62 lunar cycles (1997-2001) found no significant difference in the frequency of births, route of delivery, births in multigravid women or birth complications, across the 8 phases of the moon or between documented high and low volume intervals of the lunar cycle. Similar observations of nonsignificant correlations of the birth rate with the lunar cycle have been documented. ,
The present study is the first study that has looked at the influence of the time (auspicious and inauspicious) of birth on the frequency of pregnancy complications.
- A rampant cultural belief that deliveries in RK cause more birth complications was considered while designing the study without considering other variables as portrayed in the scriptures
- A sample size of 1885 birth records with only 87-167 cases in each Kālam was too small to study the influence of subtle forces on the outcomes
- Several known factors may have influenced the prevalence of complications:
- We used the hospital records of all cases that were treated by 8 different obstetricians. The differences in the protocol used in managing the complications by different obstetricians may have influenced the frequency of occurrence of complications at the time of delivery
- We did not document many other details such as maternal age, BMI, parity, gestational age at delivery, mode of delivery, birth weight of the baby, etc., that may have influenced the outcome.
- Only the time of delivery was taken into consideration. The science of Jyotisha delves into many other factors such as Nakshatras, Grahas, and Rashis that influence the events of life. Accordingly, the influence of time and place of birth of the mother appears to be a more important determinant than the time of delivery (RK, GK or YK)
- Statements in the texts of Jyotisha say that RK, GK or YK may not influence the outcome of pregnancy. They mention that these have to be taken into consideration while starting a journey for war or pilgrimage. It says "if one starts Yuddha Yatra (journey for war) in RK, it may result in loss of money, extinction of family or death or defeat" (Dashānga Rāhu Cakram). 
Strengths of the study
This is the first study that has involved the obstetricians and statisticians to unearth the traditional knowledge. The conclusions of the study, although has supported the null hypothesis, has opened up the doors for future research.
| Conclusion|| |
This study suggests that there is no influence on the time of delivery (three Kāālams, RK, GK, or YK) on the maternal and fetal complications. This study paves the way for further studies on the influence of time and space on man.
Suggestions for future research
Study of the mother's and infant's horoscope (kundali) in prospective studies may throw light on the influence of time on pregnancy outcomes. Software programs are now available that do consider the interplay of many of these factors as described in astrology which may be used for future work.
We plan to carry out a double blind prospective study in which the exact time and place of birth of the mother is noted at the time of registration. The astrologer in the research team would predict all the possible complications (including the time of delivery) in second trimester itself, which will be verified after the delivery on a larger sample. Studies of this type may help the obstetricians for better management and reduce maternal and infant mortality.
| Acknowledgments|| |
We thank the administration of Rangadore Hospital for encouraging this research. We are grateful to Dr. Nagesh Bhat, Dr. Ramachandra Bhat, Dr. Alex Hankey and Dr. Satya Priya for their inputs. We thank Dr. Balaram Pradhan and Dr. Amritanshu Ram for their statistical support.
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[Table 1], [Table 2], [Table 3]